Special Needs Program for HIV Positive
AHF MCO of Florida, a subsidiary of AIDS Healthcare Foundation, the nation’s largest HIV health care, prevention and education provider, launched a new Medicaid Reform health plan for residents of Broward County, Florida who have HIV in May 2010. The plan, named Positive Healthcare Florida, is the state’s first special needs Medicaid Reform health plan specifically for Medicaid recipients who are HIV-positive and their families.
Positive Healthcare Florida, approved by Florida’s Agency for Health Care Administration, is a comprehensive health plan that includes routine and emergency care and prescription drug coverage. The plan’s staff of Registered Nurses work with members and their doctors to coordinate timely and appropriate levels of care so members can avoid costly emergency room visits and preventable illnesses. These nurses also educate the plan’s members how to improve and sustain their health through proper medication adherence and preventive health behaviors.
“Positive Healthcare Florida is a unique health plan. It is built around the medical and psychosocial needs of HIV- positive Medicaid recipients. The plan’s primary goal is to keep its members healthy and leading productive lives. We achieve the goal through careful member health monitoring and delivery of the right health care at the right time. Our Registered Nurse Care Managers are an integral part of member care. They are our members’ personal health coaches, that our members can contact whenever they need medical advice or have a health issue,” explained Donna Stidham, RN, AIDS Healthcare Foundation’s Chief of Managed Care.
With HIV infection rates on the raise in Florida, especially in Broward County, and the costs to care for Medicaid recipients with HIV escalating, Positive Healthcare Florida presents a cost-effective solution that promises improved member health outcomes.
“Under the fee-for-service structure, Medicaid beneficiaries, especially those with a chronic illness, have a difficult time getting timely preventive, specialty and follow-up care. The patient in fee-for-service has to do the majority of the care co- ordination for him- or herself. Positive Healthcare Florida takes the burden of coordinating care between multiple providers off the patient and places the responsibility with the plan’s nurses. The result of shifting care coordination to a clinician is much improved health outcomes, lower costs and greatly improved patient satisfaction,” according to Stidham.
AHF MCO of Florida hopes that its approach to caring for Broward County’s HIV-positive Medicaid population will garner sup- port from the Florida Legislature as it ponders further rollout of Medicaid Reform across the state. Positive Healthcare Florida is ready to take on the care of the rest of the state’s HIV- positive Medicaid recipients.
AHF MCO of Florida also operates a Medicare Advantage Part D health plan for HIV-posi- tive Medicare beneficiaries who live in Broward and Miami-Dade Counties. This plan, called Positive Healthcare Partners (HMO), has been in operation since 2008
FOR MORE INFORMATION ON THE PLAN CONTACT:
Donna Stidham Chief, Managed Care
AIDS Healthcare Foundation Office CA: 323-436-5025 Office FL: 954-522-3132
Cell: 805-660-0703 OR
Michael Kahane Bureau Chief-Southern Region
AIDS Healthcare Foundation 110 SE 6th Street,
Suite 1960 Ft. Lauderdale, FL 33301