Developing a managed care delivery system for people with HIV/AIDS

Capitated managed care is now a significant part of the healthcare landscape in the United States. Consequently, states across the country are looking to it as a means of lowering their costs for Medicaid recipients. Implementing Medicaid managed care plans, however, requires considerable planning and research to ensure that providers are fairly reimbursed and that patients continue to receive quality care. Efforts to ensure adequate reimbursement and quality care are particularly important for persons with HIV/AIDS and those with other chronic conditions, populations that require considerable healthcare resources and often are covered by Medicaid. The transition to Medicaid managed care can be smoothed through stakeholder input and consideration of the overall healthcare marketplace and political climate, the structure of managed care organizations, the means of informing consumers of their managed care choices, the potential size of the Medicaid patient base, and the need to integrate clinical and social services for patients with HIV/AIDS.