Fund end of AIDS epidemic

As New York battles over limited health funding as the budget is finalized this week, there is an opportunity to save money and lives by providing the $70 million needed to fund the blueprint to End the AIDS Epidemic in the state by 2020. Yet only $25 million in new health care funding is on the table. At this urgent time, a groundbreaking new study demonstrates how focused investments in fostering health outcomes drive Medicaid cost savings and reduce new HIV infections.

Conducted jointly by Amida Care, New York’s largest Medicaid HIV special needs health plan, and the HIV/AIDS research organization ACRIA, “The Impact of Comprehensive Case Management on HIV Client Outcomes,” recently published in the journal PLOS ONE, provides unprecedented evidence of the success of targeted case management. For people with complex medical conditions, the difficulty of navigating the health care system combined with social disparities prevent them from accessing the care they need, staying in care, and adhering to treatment. TCM provides care coordination and supportive services that help people learn to navigate the system, stay engaged in care, and focus on their health.

During a 21-month period, more than 2,000 HIV-positive Amida Care Medicaid members who received TCM showed significant improvements in their immune system health. The group’s average CD4 counts, a measure of immune strength, nearly doubled, rising to be on par with Amida Care’s HIV-positive non-TCM clients, who did not require the level of care that TCM provides and already had substantially higher CD4 levels.

The success of care coordination has important implications for the blueprint. Spearheaded by Gov. Andrew Cuomo, the blueprint seeks to decrease new HIV infections from 3,000 a year to less than 750 by 2020, with a particular focus on populations disproportionately impacted by HIV, including people of color, young men having sex with men and transgender individuals. Comprehensive, coordinated care and services help people with HIV increase their chances of becoming virally suppressed, which enables them to live healthier lives and greatly reduces the likelihood that they will transmit the virus to others.

In past findings from 2008 to 2014, Amida Care saw improved immune system health results in impressive cost savings: a dramatic 74 percent reduction in hospitalizations and a 64 percent decline in emergency room visits accounting for more than $88 million in in-patient cost-savings to the state. Preventing one person from becoming infected with HIV can save an estimated $500,000 in lifetime medical costs, with 85 percent of people with HIV securing care from Medicaid and/or Medicare over their lifetime.

Good health is about more than pills, doctors’ visits, and the absence of disease; as the study demonstrates, it is about addressing all of the person’s needs. To provide comprehensive, quality care for New Yorkers living with HIV, the state must provide sufficient funding to advance the work outlined in the blueprint. The $70 million in investments that must be made this year include new funding for the state Department of Health AIDS Institute, HIV/AIDS Services Administration expansion for people living with HIV in New York City, and investments to the state Office of Temporary Disability Assistance to expand rental assistance.

More than ever, we have the tools to combat HIV. We can take steps toward an AIDS-free New York and serve as a model for the rest of the nation. As state legislators finalize the 2016 budget, we urge them to make our public health and related housing assistance a top priority by fully funding the state’s visionary Blueprint to End the AIDS Epidemic.