In a 3-part series, the National Academy for State Health Policy explored how states can use policy levers to more effectively utilize limited resources and provide better care, improve care coordination services, and ensure consistent access to care for people living with HIV.
Through their Medicaid and Ryan White HIV/AIDS Programs, states play an integral role in ensuring access to care for people living with HIV. In a 3-part series, the National Academy for State Health Policy explored how states can use policy levers to more effectively utilize limited resources and provide better care, improve care coordination services, and ensure consistent access to care for people living with HIV.
Collaboration between the 2 programs is crucial and can help states minimize duplication and fragmentation of services and ensure that resources are used more effectively, the authors of the series argue.
Improving collaboration between Medicaid and AIDS Drug Assistance Programs
Similar to Medicaid, the Ryan White HIV/AIDS Program serves low-income people, providing medical care, prescription drugs, and supportive services for people living with HIV.
A major component of the Ryan White HIV/AIDS Program is the AIDS Drug Assistance Programs, which provides a safety net for those not eligible for Medicaid by offering prescription drugs, as well as assistance with health insurance premiums and drug cost-sharing.
The report outlines 4 opportunities for Medicaid and Ryan White HIV/AIDS rograms to identify and address barriers at the intersection of the 2 programs:
Improving care coordination services
“Care coordination can be an important tool for states to increase rates of virologic suppression by helping people living with HIV access and maintain treatment, stay engaged in care, and address other needs such as housing, nutrition, transportation, and behavioral health services,” wrote the authors of the report.
Benefits of collaboration between the 2 programs will transfer over into care coordination, they explained. As both programs offer care coordination services, states must avoid the duplication of services to patients who may qualify for both programs or switch between the 2 based on eligibility. By doing this, the authors contended, state policy makers will be able to maximize limited resources.
In order to ensure access to physical and behavioral health, they recommended:
Coordinating eligibility between Medicaid and Ryan White programs
States have a number of factors to consider when structuring eligibility in order to support consistent access to care, such as whether the state has expanded its Medicaid program and how to leverage waiver authorities and managed care to support consistent enrollment.
States also have to decide how Medicaid and Ryan White HIV/AIDS Program grantees can work together to reduce “churning” between programs and minimize coverage disruptions for people living with HIV.
As the 2 programs share a mutual interest in ensuring coordinated and efficient eligibility processes are in place, the authors recommend 4 strategies: