HMO For HIV/AIDS Patients Expands Into Broward

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Earvin Magic Johnson (Twitter)

From our media partners at Sun Sentinel:

Medicaid-eligible HIV/AIDS patients in Broward Countyhave new access to a managed health care plan designed to meet their specialized needs.

Clear Health Alliance, an HIV/AIDS HMO offered by Simply Healthcare Plans and endorsed by basketball superstar Earvin "Magic" Johnson, recently received state approval to expand from Miami-Dade County into Broward, said Elizabeth Murray, the company's vice president of provider relations.

The insurer has applied for Agency for Health Care Administration clearance to offer its specialty plan in all 67 counties, and expects to get the OK to expand into Palm Beach County soon.

"Our goal is the delivery of high-touch quality care with the right doctors, in the patient's medical home with the right medicines," Murray said. "This is important for Broward because more people will have access to a plan that is resourced to meet their needs and improve community health."

Broward County ranks second in the nation for newAIDS cases per capita, right behind Miami-Dade. Palm Beach County ranks sixth.

Clear Health Alliance joins only two other providers offering HMO coverage for patients living with HIV and/or AIDS, Positive Healthcare Partners and the Provider Service Network. The plan is available to anyone eligible for Medicaid and living with HIV/AIDS.

"They're offering another choice, and we feel that choice keeps them competitive and gives our clients more options, so we think it's great," said Joey Wynn, chairman of the South Florida AIDS Network, an advisory board to the Broward Health Department on HIV matters.

Murray said that soon after the Coral Gables-based Simply Healthcare Plans opened shop in Florida in 2010, the company's chief operating officer, Peter Jiminez, recognized that HIV/AIDS patients needed a specialized, low-cost health care plan to help them navigate the complexities of their care.

So early last year, the company decided to create Clear Health Alliance. State approval to serve Miami-Dade County came first, and in April, Johnson, through his Magic Johnson Enterprises, signed on as both an investor and spokesman.

In January, Johnson appeared at Holy Cross Hospital to answer HIV patients' questions on what Clear Health Alliance's expansion into Broward would mean. It was one of many ways the insurance company's representatives have reached out to engage the community, Wynn said.

"They have been very proactive, very cooperative and open and participatory with us," he said, praising the Clear Health Alliance staff for its experience. "They're finding out how we do things instead of just telling us what they have."

In order to get state approval, the company had to demonstrate that it has a comprehensive list of qualified doctors, hospitals, pharmacies and other providers contracted through its plan and that they have adequate expertise in HIV/AIDS.

"The Clear Health Alliance team is experienced with HIV disease, and we know this is very important when coordinating access to care and treatment for our members living with this disease," Murray said. "Most people will be able to stay with their doctor when they enroll in our plan, and the medicines recommended by the Department of Health and Human Services and recognized as proven to control the virus are also available to all of our members at no additional cost."

Benefits vary from county to county but typically include unlimited eye exams and glasses, transportation, meals and access to nutritional services, she said.

So far, Clear Health Alliance has about 800 patients signed on to its plan, nearly 200 of them in Broward County.