HIV/AIDS Prevention

In September 1995, Kathy Rauch, a Public Health Analyst, became the Divisions of HIV/AIDS Prevention's coordinator for issues related to HIV/ AIDS prevention in the context of managed care and the divisions' principal liaison to the Health Care Financing Administration (HCFA) and the Health Resources Services Administration (HRSA).

The Divisions' managed care activities have focused on developing model language and collecting performance measures for use in managed care contracts. Ms. Rauch is assisting a contractor, the George Washington University Medical Center, in developing model contract provisions for HIV/AIDS prevention services for inclusion in Medicaid managed care contracts and in contracts that public health agencies establish with managed care organizations. Using models from states where they are in effect, Ms. Rauch will draft a sample Memorandum of Agreement (MOA) delineating a proposed division of responsibilities between public health agencies and managed care organizations in carrying out community-oriented prevention activities.

Performance Measures

Various organizations are developing performance measures for HIV prevention services. New York State's AIDS Institute has a measure of the extent of teen education about HIV. Other measures under development include offering HIV counseling to pregnant women, offering HIV testing to pregnant women, and providing prophylaxis for Pneumocystis carinii pneumonia. After the measures have been successfully tested in the field, DHAP plans to distribute them to state AIDS programs and state Medicaid agencies for possible incorporation into Medicaid managed care contracts, particularly in areas with high HIV prevalence.

HIV Prevention Checklist

A checklist of major issues related to HIV/AIDS prevention in the context of managed care also will be developed. The planned checklist is intended to facilitate discussions about HIV/AIDS prevention between state public health and Medicaid officials and between local public health and managed care plan officials. It will address such issues as enrollment, surveillance, coverage and benefits, service delivery, coordination between plans and public health agencies, and quality. This project is part of a CDC-wide activity.

Intervention Funding

In fiscal year 1996, CDC funded an intervention with the HMO Group Health Cooperative of Puget Sound in Seattle, Washington, to improve HIV risk assessment and counseling effectiveness of primary health care providers in managed care settings. Using a pre- and post-test research design, health care staff are being given special training that targets attitudes, beliefs, knowledge, and skills associated with the effectiveness of their HIV risk assessment and counseling interactions with their patients. If successful, results from this project may be used for improving the training of other HIV providers in similar managed care settings. James W. Carey, Ph.D., M.P.H., Behavioral Intervention Research Branch, is the CDC Project Officer. If you have questions, contact Dr. Carey by telephone at 404-639-8300 or E-mail at jfc9@cdc.gov.

Departmental Representation

The Divisions of HIV/AIDS Prevention are represented on the Department of Health and Human Service's (DHHS) Managed Care Forum AIDS Work Group. This work group was established to enhance collaborative efforts between DHHS agencies on issues related to HIV/ AIDS prevention and care in managed care settings.

Inquiries about the Divisions' managed care projects should be addressed to Kathy Rauch; Office of the Director, Division of HIV/AIDS Prevention -- Surveillance and Epidemiology; Centers for Disease Control and Prevention, Mail Stop D-21; Atlanta GA 30333; telephone 404-639-0902; fax 404-639-0910; or E-mail, kjr1@cdc.gov.

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