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More on the study Public Financing and Delivery of HIV Care
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As the HIV/AIDS epidemic has grown, there has been a substantial growth in expenditures by public programs that provide care for people living with HIV/AIDS (PLWH). Of those PLWH who are insured, most are covered by public sector programs (primarily Medicaid or Medicare). Sources of coverage and care for the uninsured or underinsured include safety net programs such as the Ryan White CARE Act, as well as community health centers, public hospitals and private free clinics. (Kaiser Family Foundation. 2000. Financing HIV/AIDS Care: A Quilt with Many Holes. Capitol Hill Briefing Series on HIV/AIDS.) These multiple sources of care are not well coordinated and programs may vary substantially by state, resulting in uneven access to care. The separate public funding streams for HIV care also raise concerns regarding administrative costs and inefficiencies.
As part of the 2000 CARE Act reauthorization legislation, Congress directed the Institute of Medicine to conduct a study that will address issues related to the public financing and delivery of HIV services. The study will explore and address the effectiveness and efficiency of service delivery within the context of a changing health care and therapeutic environment, as well as the changing demography of the epidemic. It will also explore the actual costs, potential savings, and overall financial impact of modifying the program under title XIX of the Social Security Act to establish eligibility for medical assistance on the basis of HIV infection rather than providing such assistance only if the patient has progressed to AIDS. In addition, the committee will consider the current funding streams for HIV Care to identify unmet need and service gaps. The final goal of the study is to develop recommendations for a policy framework to improve the continuity, equity and efficiency of HIV care.
The IOM committee will consist of approximately 15 members with expertise in the following fields: health care finance, local and state public health, federal public policy, medicine, infectious diseases, health systems, health services research, health economics, operations research, law and ethics, case management (e.g., nursing or social work), substance abuse, and mental health. The committee will meet five times over an 18-month period ending March 2003 to deliberate and prepare its report.
In an effort to minimize bias and conflicts of interest, committee members cannot currently:
be employees of the Department of Health and Human Services;
have input into the priority setting or allocation of CARE Act funds; or
receive significant HIV/AIDS funding from HRSA, CMS.
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Last Updated: 1/28/2003, 11:48 AM
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