Documenting challenges for people living with hiv

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Documenting challenges for people living with hiv

  1. 1. Documenting Challenges for People Living with HIV/AIDS TransitioningBetween Publicly-Supported Healthcare Payer Sources in CaliforniaInvestigators: Wayne Steward, Emily A. Arnold, Patrick Hazelton, Shane Collins and StuartGaffneyBetween October 2012 and February 2013, 37 interviews with respondents in 10 urban,suburban, and rural California counties. Interviews were conducted with 30 public healthpolicymakers and clinic-level providers, as well as with 7 patients who experienced one or bothof the LIHP (Low Income Health Program) and Medi-Cal managed care transitions. Interviewtopics included: continuity of patient care, integration of wrap-around support services, capacityto handle payer source transitions, administrative burden, and preparations for health care reformimplementation in 2014. Preliminary data analysis reveals barriers to continuity of care includeincreased administrative burden for patients and providers and reduced access to HIV specialtyclinics and pharmacies in certain counties. Conversely, facilitators to continuity of care includecontracting Ryan White clinics and HIV specialty pharmacies into the LIHP and maintaininglinkage to Ryan White comprehensive care services. California’s LIHP and Medi-Cal managedcare programs represent ambitious attempts to expand health coverage for low-incomeindividuals. Lessons learned in responding to the challenges of maintaining quality HIVspecialty care during Medicaid expansion may be useful to other states in anticipation of fullimplementation of the Affordable Care Act in 2014.

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