Better quality of life and improved health care for individuals living with HIV

By Don Berwick, M.D., Administrator of the Centers for Medicare & Medicaid Services

Today, we celebrate the vast improvements in treatments and the quality of life for individuals living with HIV.  This day serves as a reminder of the many accomplishments in fighting AIDS during the past three decades, but also highlights how much more work we have left in fighting this disease.

Thanks to major advances in science and medicine, people living with HIV face a much different reality today.  In 1981, when AIDS first emerged in the US, the disease was equivalent to a death sentence. Now, thirty years later, people with HIV who receive medication and proper care live longer, healthier lives — just as they could with any other chronic illness.

Despite the powerful arsenal at our disposal, some of our best defenses remain out of reach for a significant proportion of the more than 1.2 million Americans living with HIV. An estimated 30 percent of this group does not have health coverage of any kind. As a result, they have no way to cover the cost of medications and treatment that we know are life-preserving.

We took an important step to remove this barrier this past summer. The Centers for Medicare & Medicaid Services (CMS), in collaboration with, the Health Resources and Services Administration (HRSA), and the Centers for Disease Control (CDC), released new guidance that encourages States to take advantage of important Medicaid options that will help improve care for individuals living with HIV.

These options can make it easier for States to prevent or delay the institutionalization of people living with HIV and can help people living in nursing homes or other institutions transition back home when they are able. States can expand Medicaid access to low-income people living with HIV, enabling them to become eligible for services without having to be considered permanently disabled due to an AIDS diagnosis. States can provide more effective, earlier treatment of HIV by making available a limited or comprehensive package of services, which may include anti-retroviral therapies or case management to ensure adherence to treatment.  Better coordinated care opportunities were also made available to support physical and behavioral health and linkages to long-term supports for individuals with multiple chronic conditions through the state option to establish health homes.

This epidemic has claimed the lives of 600,000 Americans.  We can and are doing more to slow transmission of the disease and to ensure people living with HIV have access to the health care that will help them lead longer and healthier lives. I am confident of the positive quality of life effects that these options will make for Medicaid beneficiaries living with and fighting through HIV/AIDS every day.

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