Improvements in access to care for HIV and AIDS in a statewide medicaid managed care system

James Bailey, David L. Van Brunt, Stephen P. Raffanti, Wendy J. Long, Patrick H. Jenkins

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Some experimental Medicaid managed care systems have expanded eligibility criteria for chronically ill persons, but these systems' impact on access to care remains unknown. Objective: To determine whether initiating a statewide Medicaid managed care system (TennCare) guaranteeing universal access for persons living with HIV or AIDS (PLWHs) increased their enrollment in public sector insurance. Design, setting, and participants: A retrospective longitudinal descriptive analysis of trends in population characteristics during the study period was performed. The study population included all PLWHs in Tennessee (1992-1997) identified by the State Health Department. These data linked with Medicaid/TennCare enrollment files identified percentages of Tennessee's HIV/AIDS population enrolled in Medicaid (1993) or TennCare (1994-1997) and eligi-bility/demographics changes during program initiation. Main outcome measure: Annual percentage of PLWHs enrolled in Medicaid/TennCare. Results: Absolute numbers of PLWHs served by Medicaid/TennCare increased 475% from 1992 (n = 593) to 1997 (n = 2818). Similar increases in Tennessee's overall HIV-positive population occurred. Percentages of PLWHs enrolled in Medicaid/TennCare increased (1993 to 1997): HIV (28% to 34%) and AIDS (32% to 44%). The largest percentage of PLWHs added to the program were uninsured/uninsurable. Conclusions: Absolute numbers of PLWHs covered by Medicaid/TennCare substantially increased. Percentages of PLWHs covered increased more modestly, partly owing to large increases in overall numbers of HIV-positive Tennesseans during the study period. Increases in coverage were greatest for the AIDS population. Tennessee's broad expansion of eligibility for PLWHs resulted in improved access, but did not result in enrollment of most PLWHs. States contemplating similar Medicaid expansions should not expect all PLWHs to crowd into public sector insurance programs.

Original languageEnglish (US)
Pages (from-to)595-602
Number of pages8
JournalAmerican Journal of Managed Care
Volume9
Issue number9
StatePublished - Sep 1 2003

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Medicaid
Managed Care Programs
Acquired Immunodeficiency Syndrome
HIV
Public Sector
Insurance
Population
Population Characteristics

All Science Journal Classification (ASJC) codes

  • Health Policy

Cite this

Bailey, J., Van Brunt, D. L., Raffanti, S. P., Long, W. J., & Jenkins, P. H. (2003). Improvements in access to care for HIV and AIDS in a statewide medicaid managed care system. American Journal of Managed Care, 9(9), 595-602.

Improvements in access to care for HIV and AIDS in a statewide medicaid managed care system. / Bailey, James; Van Brunt, David L.; Raffanti, Stephen P.; Long, Wendy J.; Jenkins, Patrick H.

In: American Journal of Managed Care, Vol. 9, No. 9, 01.09.2003, p. 595-602.

Research output: Contribution to journalArticle

Bailey, J, Van Brunt, DL, Raffanti, SP, Long, WJ & Jenkins, PH 2003, 'Improvements in access to care for HIV and AIDS in a statewide medicaid managed care system', American Journal of Managed Care, vol. 9, no. 9, pp. 595-602.
Bailey, James ; Van Brunt, David L. ; Raffanti, Stephen P. ; Long, Wendy J. ; Jenkins, Patrick H. / Improvements in access to care for HIV and AIDS in a statewide medicaid managed care system. In: American Journal of Managed Care. 2003 ; Vol. 9, No. 9. pp. 595-602.
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