Emerging Practices and Policy in Medicaid Managed Care for People with HIV/AIDS: Case Studies of Six Programs
As treatment strategies for HIV/AIDS undergo rapid change, states struggle with the dual challenges of providing quality health care and containing costs. By June 1996, in an effort to meet those challenges, 35 states (including the District of Columbia) reported enrolling at least some people living with HIV/AIDS (PLWHIV) in their risk-based Medicaid managed care programs.
The six Medicaid managed care programs studied for this report – Massachusettes, New Jersey, Tennessee, Texas, San Francisco (California) and Orange County (California) — cope with overseeing changes in HIV/AIDS treatment in different ways. These programs treat PLWHIV the same as other populations in certian areas, including: marketing/enrollment, consumer involvement, and capitated benefits.