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Managed
(Capitated) Care Model
Five of the Managed Care projects share, as a central theme, the study of the health care provided to individuals with HIV disease under models where the health care is capitated, or paid on a "flat fee" basis per patient per month.
The programs at AIDS Healthcare Foundation, East Boston Neighborhood Health Center, and Johns Hopkins University were actual medical programs running under managed care funding (AHF, Hopkins) or simulated managed care conditions (EBNHC) designed to permit managed care rates to be established. Each of the programs provided state-of-the-art medical treatment for HIV/AIDS at its clinic.
The VNAF program provided palliative care add-on services to supplement home healthcare services for end-stage AIDS patients.
The New York State AIDS Institute developed a managed care system for implementation in the State of New York through a series of Special Needs Plans (SNPs).
The models developed by this group of grantees, with the exception of that of the VNAF, are not explicitly designed to be integrated psychosocial and medical care models in contrast to those developed by the Comprehensive (or Integrated) Healthcare Model Grantees.
AIDS
Healthcare Foundation
East
Boston Neighborhood Health Center
Johns
Hopkins University School of Medicine
New
York State Department of Health, AIDS Institute
Visiting
Nurse Association Foundation (VNAF)
AHF
operated four healthcare centers to provide direct medical services
to individuals living with HIV/AIDS under a capitated system of
care.
EBNHC
provided coordinated, non-fragmented, comprehensive care to
individuals with HIV/AIDS while developing a capitated system of
care.
The
Johns Hopkins University reduced financial barriers to adequate care
for HIV/AIDS patients without comprising the quality of care by
providing care under capitated financing.
The
New York State AIDS Institute studied information related to cost,
utilization and access to care as persons with HIV/AIDS transitioned
from fee-for-service to a managed care environment.
VNAF’s
Transprofessional Model used an interdisciplinary, care management
approach – a blend of curative and palliative services – to
improve services for end-stage AIDS patients.
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