Using a Happiness Index to Measure the Benefits for a Cost Benefit Analysis of Antiretrovirals for Older Adults with HIV in New York City
In: (2014) Clin Res HIV/AIDS 1(2): 1009.
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In: (2014) Clin Res HIV/AIDS 1(2): 1009.
SSRN
In: Current Opinion in HIV and AIDS: May 2010 - Volume 5 - Issue 3 - p 255–260
SSRN
In: Journal of HIV/AIDS & social services: research, practice, and policy adopted by the National Social Work AIDS Network (NSWAN), Band 6, Heft 3, S. 55-73
ISSN: 1538-151X
In: Behavioral medicine, Band 40, Heft 3, S. 108-115
ISSN: 1940-4026
In: Journal of HIV/AIDS & social services: research, practice, and policy adopted by the National Social Work AIDS Network (NSWAN), Band 11, Heft 4, S. 363-374
ISSN: 1538-151X
In: Ageing international, Band 38, Heft 3, S. 179-194
ISSN: 1936-606X
In: Journal of HIV/AIDS & social services: research, practice, and policy adopted by the National Social Work AIDS Network (NSWAN), Band 16, Heft 4, S. 335-350
ISSN: 1538-151X
In: https://doi.org/10.7916/D8H41RB1
In 1990, New York State instituted Comprehensive Medicaid Case Management, also known as Target Case Management (TCM), for people dealing with multiple comorbid conditions, including HIV. The goal of TCM is to assist clients in navigating the health care system to increase care engagement and treatment adherence for individuals with complex needs. HIV-positive individuals engaged in care are more likely to be virally suppressed, improving clinical outcomes and decreasing chances of HIV transmission. The purpose of this study was to understand the impact of TCM management on outcomes for people with HIV. Data were obtained from Amida Care, which operates not-for-profit managed care Medicaid and Medicare Special Needs Plans (SNPs) for HIV clients. Changes in clinical, cost, as well as medical and pharmacy utilization data among TCM clients were examined between January 2011 through September 2012 from the start of case management enrollment through the end of the study period (i.e., up to 6 months after disenrollment). Additionally, CD4 counts were compared between Amida Care TCM clients and non-TCM clients. Notable findings include increased CD4 counts for TCM clients over the one-year study period, achieving parity with non-TCM clients (i.e., Mean CD4 count > 500). When looking exclusively at TCM clients, there were increases in medication costs over time, which were concomitant with increased care engagement. Current findings demonstrate that TCM is able to achieve its goals of improving care engagement and treatment adherence. Subsequent policy changes resulting from the Affordable Care Act and the New York State Medicaid Redesign have made the Health Home the administrator of TCM services. Government entities charged with securing and managing TCM and care coordination for people with HIV should provide thoughtful and reasonable guidance and oversight in order to maintain optimal clinical outcomes for TCM clients and reduce the transmission of HIV.
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