The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act gives funding to cities, states, and other public and private entities to provide care and support services to individuals with HIV and AIDS who have low-incomes and little or no insurance. The CARE Act is a discretionary program that relies on annual appropriations from Congress to provide care for low-income, uninsured, or underinsured individuals who have no other resources to pay for care. Despite its successes, funding has been insufficient to address all of the inequalities and gaps in coverage for people with HIV. In response to a congressional mandate, an Institute of Medicine committee was formed to reevaluate whether CARE allocation strategies are an equitable and efficient way of distributing resources to jurisdictions with the greatest needs and to assess whether quality of care can be refined and expanded. Measuring What Matters: Allocation, Planning, and Quality Assessment for the Ryan White CARE Act proposes several types of analyses that could be used to guide the evaluation and improvement of allocation formulas, as well as a framework for assessing quality of care provided to HIV-infected persons.
Each year it is estimated that approximately 40,000 people in the U.S. are newly infected with HIV. In the late 1990s, the number of deaths from AIDS dropped 43% as a result of highly active antiretroviral therapy. Unfortunately, the complex system currently in place for financing and delivering publicly financed HIV care undermines the significant advances that have been made in the development of new technologies to treat it. Many HIV patients experience delays in access to other services that would support adhering to treatment. As a result, each year opportunities are missed that could reduce the mortality, morbidity, and disability suffered by individuals with HIV infections. Public Financing and Delivery of HIV/AIDS Care examines the current standard of care for HIV patients and assesses the extent the system currently used for financing and delivering care allows individuals with HIV to actually receive it. The book recommends an expanded federal program for the treatment of individuals with HIV, administered at the state level. This program would provide timely access and consistent benefits with a strong focus on comprehensive and continuous care and access to antiretroviral therapy. It could help improve the quality of life of HIV/AIDS patients, as well as reduce the number of deaths among those infected.
The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act gives funding to cities, states, and other public and private entities to provide care and support services to individuals with HIV and AIDS who have low-incomes and little or no insurance. The CARE Act is a discretionary program that relies on annual appropriations from Congress to provide care for low-income, uninsured, or underinsured individuals who have no other resources to pay for care. Despite its successes, funding has been insufficient to address all of the inequalities and gaps in coverage for people with HIV. In response to a congressional mandate, an Institute of Medicine committee was formed to reevaluate whether CARE allocation strategies are an equitable and efficient way of distributing resources to jurisdictions with the greatest needs and to assess whether quality of care can be refined and expanded. Measuring What Matters: Allocation, Planning, and Quality Assessment for the Ryan White CARE Act proposes several types of analyses that could be used to guide the evaluation and improvement of allocation formulas, as well as a framework for assessing quality of care provided to HIV-infected persons.
The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act gives funding to cities, states, and other public and private entities to provide care and support services to individuals with HIV and AIDS who have low-incomes and little or no insurance. The CARE Act is a discretionary program that relies on annual appropriations from Congress to provide care for low-income, uninsured, or underinsured individuals who have no other resources to pay for care. Despite its successes, funding has been insufficient to address all of the inequalities and gaps in coverage for people with HIV. In response to a congressional mandate, an Institute of Medicine committee was formed to reevaluate whether CARE allocation strategies are an equitable and efficient way of distributing resources to jurisdictions with the greatest needs and to assess whether quality of care can be refined and expanded. Measuring What Matters: Allocation, Planning, and Quality Assessment for the Ryan White CARE Act proposes several types of analyses that could be used to guide the evaluation and improvement of allocation formulas, as well as a framework for assessing quality of care provided to HIV-infected persons.
The number of people living with HIV/AIDS (PLWHA) in the United States is growing each year largely due both to advances in treatment that allow HIV-infected individuals to live longer and healthier lives and due to a steady number of new HIV infections each year. The U.S. Centers for Disease Control and Prevention (CDC) estimates that there were 1.2 million people living with HIV infection in the United States at the end of 2008, the most recent year for which national prevalence data are available. Each year, approximately 16,000 individuals die from AIDS despite overall improvements in survival, and 50,000 individuals become newly infected with HIV. In 2011, the CDC estimated that about three in four people living with diagnosed HIV infection are linked to care within 3 to 4 months of diagnosis and that only half are retained in ongoing care. In the context of the continuing challenges posed by HIV, the White House Office of National AIDS Policy (ONAP) released a National HIV/AIDS Strategy (NHAS) for the United States in July 2010. The primary goals of the NHAS are to: reduce HIV incidence; increase access to care and optimize health outcomes; and reduce HIV-related health disparities. Monitoring HIV Care in the United States addresses existing gaps in the collection, analysis, and integration of data on the care and treatment experiences of PLWHA. This report identifies critical data and indicators related to continuous HIV care and access to supportive services, assesses the impact of the NHAS and the ACA on improvements in HIV care, and identifies public and private data systems that capture the data needed to estimate these indicators. In addition, this report addresses a series of specific questions related to the collection, analysis, and dissemination of such data. Monitoring HIV Care in the United States is the first of two reports to be prepared by this study. In a forthcoming report, also requested by ONAP, the committee will address the broad question of how to obtain national estimates that characterize the health care of people living with HIV in the United States. The second report will include discussion of challenges and best practices from previous large scale and nationally representative studies of PLWHA as well as other populations.
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