What is the HIV Health Improvement Affinity Group?
The HIV Health Improvement Affinity Group (HHIAG) offers federal support for state-level efforts to improve rates of sustained virologic suppression among Medicaid and Children’s Health Insurance Program (CHIP) enrollees who are living with HIV. Those efforts are guided by teams made up of state public health and Medicaid/CHIP agencies, who will collaborate to develop and implement performance improvement projects that address gaps along the HIV care continuum for Medicaid/CHIP enrollees.
The HHIAG is a joint initiative between the Centers for Medicare and Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC), and the Health Resources and Services Administration (HRSA), in collaboration with the HHS Office of HIV/AIDS and Infectious Disease Policy, and in partnership with the National Academy for State Health Policy.
Group members began their work via webinar in October 2016, and at an in-person meeting in Washington, DC, on December 6-7, 2016. For a 12-month period, they will participate in monthly state team calls with CMS, CDC, and HRSA, and in monthly HHIAG virtual meetings with other states and quality-improvement experts. CDC, CMS, and HRSA staff, as well as other state and local partners, will also provide technical assistance to the state teams.
By participating, states will benefit from:
- Direct technical assistance as they develop and implement a viral suppression improvement plan for their state Opportunities for state-to-state learning and sharing of best and promising approaches to improve viral load suppression (VLS) among enrollees who are living with HIV
- Stronger collaborative relationships among state Medicaid/CHIP programs, state public health departments, and federal and other partners
In addition to these direct benefits to the states, HHS expects to learn valuable lessons that will be useful to other states that want to improve VLS rates and may identify additional opportunities to improve HIV and other health outcomes.
A total of 19 states elected to participate: Alaska, California, Connecticut, Georgia, Illinois, Iowa, Louisiana, Maryland, Massachusetts, Michigan, Mississippi, Nevada, New Hampshire, New York, North Carolina, Rhode Island, Virginia, Washington, and Wisconsin.
These states represent diverse regions from around the country and account for more than half of all people in the United States who were living with diagnosed HIV in 2013.
State-level teams will work together in three different learning communities that will give participants an opportunity to learn from one another and to receive technical assistance as they develop and implement a viral suppression improvement plan for their state. Those communities are:
Data Linkage and Outcome Learning Community
The improvement plans for the six states in this learning community (California, Georgia, Iowa, Maryland, North Carolina, and Wisconsin) will focus on instituting or expanding currently limited data-sharing activities, as well as analyzing these data to identify targets for performance improvement. Group members also intend to use their newly improved capacity to evaluate system effectiveness at multiple levels and along multiple dimensions for continuous quality improvement and public health actions.
Data Analysis and Utilization for Delivery System Improvement Learning Community
The six states participating in this learning community (Illinois, Louisiana, Massachusetts, New York, Rhode Island, and Washington) will focus on using data to identify quality-improvement opportunities. Some states hope to use aggregate or state-level data analyses to identify areas where they can make delivery-system improvements by: using existing Medicaid authorities to make new evidence-based services available to people living with HIV/AIDS; promoting integration of services funded by Medicaid and the Ryan White HIV/AIDS Program; encouraging systems that focus on interdisciplinary care teams; and accelerating value-based purchasing through accountable care organizations.
Provider Engagement and Quality Improvement Learning Community
Members of this learning community (Alaska, Connecticut, Michigan, Mississippi, Nevada, New Hampshire, and Virginia) plan to improve clinical outcomes and achieve greater VLS rates through increased efforts to engage providers and improve quality of care. Improvement plans in this group focus on developing mechanisms to better share data between their state’s public health and Medicaid organizations. These improved information-sharing mechanisms will help states to identify people who may have been unable to access care or who have fallen out of care and get them into treatment.