Health-based payment for HIV/AIDS in Medicaid managed care programs.
Date of Pub
Gamliel, Sandy; Honberg, Lynda
In recent years, State Medicaid programs have begun adopting health-based payment systems to help ensure quality care for
people living with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), and to ensure equity
for the managed care organizations (MCOs) in which these people are enrolled. In this article, the authors discuss reasons
why such payment systems are needed and describe AIDS-specific capitation rates that have been adopted in several State Medicaid
waiver programs. The authors also examine comprehensive risk-adjustment systems both within Medicaid and outside the program.
Several research questions needing further work are discussed.
Capitation Fee : Health Status Indicators : HIV Infections/economics/therapy : Human : Insurance, Disability : Managed Care
Programs/economics/organization & administration : Medicaid/economics/statistics & numerical data : Models, Organizational
: Patient Advocacy : Program Evaluation : Quality of Health Care : Rate Setting and Review : State Health Plans/economics/organization
& administration : United States : United States Health Care Financing Administration