HIV and managed care: implications for academic medicine

Article Abstract:

Academic health centers must integrate their services and promote the importance of their mission in the managed care era. Academic health centers are dedicated to three missions: research, education, and patient care. Academic providers led HIV research efforts in the 1980s and can train primary care providers to cost-effectively treat HIV patients in the 1990s. Despite these functions, managed care companies may not provide adequate funding for research and medical education. Academic centers must examine and reshape their medical care delivery system. The AIDS epidemic underscores the importance of integrating medical and community-based services into a cost-effective, patient-friendly continuum of care. These organizational changes may prove difficult to implement because of the arrangement of academic centers and the funding mechanisms of different managed care plans.

Care and treatment, Economic aspects, Managed care plans (Medical care), Hospitals, Teaching, Hospitals, University, Teaching hospitals, University hospitals

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HIV risk adjustment: issues and proposed approaches

Article Abstract:

Risk adjustment may remove the financial incentives that encourage health plans to provide suboptimal care to people with HIV disease. Risk adjustment spreads the medical costs accrued by patients with expensive chronic illnesses among the total population. This removes the financial penalty that befalls providers or insurers who enroll patients with costly illnesses. This system ensures that health plans within local areas are fairly compensated for the services they provide. Risk adjustment must account for geographic changes in HIV infection rates, increased patient survival over time, changes in the manifestation and patterns of disease, and the development of new technologies and experimental therapies. HIV risk adjustment must compensate for geographic variability between major cities and geographic variablitity between neighborhoods within cities.

Finance, Health insurance, Risk (Insurance)

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Similar abstracts:

• Abstracts: HIV care: a changing health care system. HIV disease and managed care: an overview. Risk behavior for HIV infection in participants in preventive HIV vaccine trials: a cautionary note

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