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Case Studies: Medicaid Managed Care and HCV Care

Thursday, November 7, 2019


Hepatitis C (HCV) is more far prevalent among people who get their care under Medicaid, compared to those who are commercially insured. This presents a challenge and opportunity for state Medicaid programs to innovate in order to improve HCV care to improve outcomes and cut costs. Examples of best practices in HCV care by three Medicaid managed care organizations--the predominant service channel for Medicaid--are featured in Case Studies: Medicaid Managed Care Plan Best Practices in Hepatitis C Linkage to Care, Treatment, and Retention.

This 12-page paper is an easy and worthy read of case studies in New York State, San Francisco, and Virginia that present a comprehensive service approach similar to HRSA's Ryan White HIV/AIDS Program (RWHAP), which has achieved remarkable HIV outcomes among Ryan White patients. The report concludes with a summary of collaborative opportunities available to health departments and Medicaid MCOs, like data sharing and collaboration/planning to develop common strategies (e.g., common authorization criteria).

The report was prepared by NASTAD with support from CDC support, in partnership with the Association for Community Affiliated Plans. Questions? Contact Dori Molozanov at NASTAD.


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