The growth of Medicaid managed care programs enrolling persons living with HIV/AIDS (PLWH) necessitates that States, HIV providers and consumers with specialized HIV expertise to become involved in the design and implementation of Medicaid managed care plans. To assist States and communities with these planning activities, the Health Resources and Services Administration, HIV/AIDS Bureau (HAB), operates the Managed Care Training and Technical Assistance Program. Program goals are to enhance the capabilities of (HIV/AIDS) Ryan White CARE Act providers to participate in managed care and to strengthen relationships between between key public and private stakeholders.
Over the past two years, 15 States have received technical assistance and training through this program. Developing and enhancing collaboration among State Medicaid and Ryan White agencies, providers, and consumers has proven critical to successful planning for enhanced integration of Medicaid, HIV, and managed care systems. This presentation will discuss the process by State and community partnerships were developed and common goals and future activities were agreed upon. Positive results of these collaborations include: a) new mechanisms for information exchange between CARE Act and Medicaid programs; b) joint Medicaid and Health Department planning and policy initiatives; c) and the introduction or expansion of managed care networks to involve CARE Act providers. This presentation will detail the experiences of four states: two with disease management initiatives and two with new HIV service integration models. Key challenges, successes, and lessons learned from all 15 States in HAB's national managed care TA program will be summarized.
Learning Objectives: At the conclusion of the workshop, participants will: 1. understand the specialized issues that must be addressed when designing HIV/AIDS managed care programs 2. describe methods used in four states to increase collaboration between state health departments, Medicaid programs and Ryan White providers impacted by managed care 3. describe how these collaborations improved the integration of HIV providers into managed care, and two State disease management programs 4. be able to obtain and utilize training tools and TA materials developed to educate providers and key policymakers about managed care systems for PLWH
Keywords: Managed Care, HIV/AIDS
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.