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Integration of Oregon Health Plan and Ryan White CARE Act Services for People Living with HIV/AIDS

Jeffrey D. Capizzi, ABD1, Julie E. Maher, PhD, MS2, Sia Lindstrom, MA, MPH2, Judy Mohr-Peterson, PhD3, Mark O. Loveless, MD4, Richard Conviser, PhD5, and Lois Eldred, DrPH6. (1) Program Design Evaluation Services, Multnomah County Health Department, 800NE Oregon ST., Suite 550, Portland, OR 97232, 503-731-4291, jeff.capizzi@state.or.us, (2) Program Design and Evaluation Services, Multnomah County Health Department and Oregon Department of Human Services, 800 NE Oregon Street, Suite 550, Portland, OR 97232, (3) Office of Medical Assistance Programs, 500 Summer St. NE, E-35, Salem, OR 97301-1077, (4) Public Health and Preventive Medicine, Oregon Health and Sciences University, 3181 SW Sam Jackson Park Rd, Portland, OR 97201, (5) Chief, Service Evaluation and Research Branch - HRSA, Office of Science and Epidemiology, HIV/AIDS Bureau, 5600 Fishers Lane, Rm 7C-07, Rockville, MD 20857, (6) Chief, Demonstration Project Development and Evaluation Branch, HIV/AIDS Bureau, HRSA, USDHHS, 5600 Fishers Lane, Room 7C-07, Rockville, MD 20857

Background: Oregon Health Plan (OHP), a Medicaid waiver program, allows low-income people living with HIV/AIDS (PLWH) to access medical services. The CARE Act supports CareAssist (Oregon’s AIDS Drug Assistance Program), which pays for medications, insurance premiums, and other services for eligible PLWH. We assessed whether integration of OHP and CareAssist was associated with continuity of care and AIDS-related acute events among PLWH. Methods: We linked OHP and CareAssist year 2000 databases and limited analyses to PLWH in OHP. Those receiving CareAssist services were compared with those not in CareAssist with respect to demographics, OHP enrollment, and OHP claims for opportunistic infections (OIs), side effects, and AIDS-related inpatient and emergency room visits (ER), using a significance level of 0.05. We examined non-OHP insurance information from CareAssist. Results: 19% (141/752) of PLWH in OHP were also in CareAssist. Those in CareAssist were significantly more likely than those not in CareAssist to be male (82% vs. 74%) and under age 45 (89% vs. 78%). The mean OHP enrollment time was significantly lower among those in CareAssist (7.9 vs. 9.8 months), but 33% of those in CareAssist had other insurance (mean coverage=3.5 months). After adjusting for OHP enrollment time, PLWH in CareAssist were significantly less likely to have an OHP claim for an OI or AIDS-related inpatient or ER visit. Conclusions: Together, OHP and CareAssist played an important role in maintaining insurance coverage for PLWH. In addition, PLWH in OHP receiving CareAssist services appeared to have fewer acute events than those not in CareAssist.

Learning Objectives:

Presenting author's disclosure statement:
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.

HIV/AIDS Policy Poster Session

The 132nd Annual Meeting (November 6-10, 2004) of APHA