1 Division of State HIV/AIDS Programs, HIV/AIDS Bureau, Health Reasources and Services Administration, Rockville, MD.
2 Division of Policy and Data, HIV/AIDS Bureau, Health Resources and Services Administration, Rockville, MD.
3 Division of Community HIV/AIDS Programs, HIV/AIDS Bureau, Health Reasources and Services Administration, Rockville, MD.
4 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
5 Division of Quality and Health Outcomes, Children and Adults Health Programs Group, Center for Medicaid & CHIP Services, Centers for Medicare and Medicaid Services, Rockville, MD.
6 Program and Performance Improvement Office, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
7 Office of the Associate Administrator, HIV/AIDS Bureau, Health Resources and Services Administration, Rockville, MD.
Medicaid is the single largest source of health care coverage for people living with HIV (PLWH) in the United States. Therefore, high-quality HIV care and associated viral suppression among Medicaid beneficiaries have the potential to greatly impact the HIV epidemic. The HIV Health Improvement Affinity Group (HHIAG) supported state efforts to improve health outcomes for PLWH enrolled in Medicaid through new or enhanced collaborations between state public health departments and state Medicaid agencies.
Supported by multiple federal health agencies for 1 year, state health department and Medicaid staff from 19 states participated in state-to-state learning and sharing of promising approaches. This evaluation assessed the HHIAG's processes, short-term outcomes, and lessons learned through review of state materials, a web survey, and telephone interviews.
Of the 19 states, 13 (68%) ultimately established new, or refined existing, data-sharing agreements between Medicaid and public health departments. Nearly all states with data-sharing agreements successfully matched the data or streamlined the data-matching process (n = 12/13). Two-thirds of states (67%, n = 8/12) with matched data generated an HIV care continuum for state Medicaid/Children's Health Insurance Program beneficiaries; 75% (n = 6/8) of these states also initiated quality improvement activities.
The HHIAG created an unique opportunity for multiple federal agencies and states to collaborate and implement data-driven, state-specific solutions to improve care delivery and, ultimately, clinical outcomes for PLWH. The HHIAG model has the potential to be replicated to address other public health issues that cross agency and institutional boundaries, such as hepatitis C.