Johns Hopkins To Announce AIDS Capitated Care Program

January 14, 1997

Johns Hopkins has established the region's first AIDS care capitation program for patients covered by Medicaid, the state-supported health insurance plan. Also one of the first in the nation, the program will use Hopkins specialists and its network of sub-specialists to provide all health care to subscribers.

The program is a prototype for HIV care that could be adopted nationally in the next few years, according to John G. Bartlett, director of the division of infectious diseases.

Hopkins will announce details of the program, called "Moore Options," at a press briefing Thursday, Jan. 16 at 10 a.m. in the Johns Hopkins Outpatient Center, Room 2140.

Under capitation, Hopkins will receive a preset fee per month from its managed care partners to cover all medical care for patients in Moore Options. Hopkins will assume the financial risk for care that exceeds the amount per person paid by the state Medicaid program.

Moore Options is named for the Moore Clinic at Johns Hopkins, an outpatient infectious disease treatment facility, which was named in honor of Joseph Earle Moore, M.D. Moore, an authority on syphilis, ran an outpatient treatment and research clnic at Hopkins from 1929 to 1954.

The AIDS care program initially will be available through Priority Partners, which is Hopkins' Medicaid Managed Care Organization, and Chesapeake Family First, United Healthcare of the Mid-Atlantic's medical assistance program.

"Moore Options is a dramatically new concept in capitation, but it makes sense in the case of AIDS," says Bartlett. "It represents a logical evolution for the Johns Hopkins AIDS Care Program, which was established in 1983. Unlike other capitation programs, we use AIDS specialists as primary care providers and coordinators for all sub-specialty care required by the patients."

It is especially important for AIDS patients because such patients usually have complex problems that are most effectively managed by experienced physician specialists, Bartlett adds. "Because of our expertise in AIDS care, we are confident we can provide care that is both excellent and cost-effective."

Published studies show that AIDS patients treated by experienced care providers have shorter hospital stays, better outcomes and lower cost.

"The AIDS capitation program focuses on what has been a flagship effort at Hopkins for high quality, cost-effective care for AIDS patients," says John D. Stobo, M.D., chairman and CEO of Johns Hopkins HealthCare. "It epitomizes Hopkins' commitment to benefit the health of the Maryland community."

Bartlett attributes much of the success of the AIDS service to the immense AIDS care data base the service has amassed during the last eight years. "This data base, which was started in 1989, has helped us study the impact of an integrated network of care using highly specialized services on a specific group of patients with a medically complex disease."

The goal of Moore Options is to provide care for 600 of the approximately 3,000 Maryland AIDS patients on Medicaid, says Bartlett. Planning for the program began in 1987, he says.

The capitation program was designed by The Johns Hopkins AIDS Service in cooperation with Johns Hopkins HealthCare LLC, the Maryland Department of Health and Mental Hygiene, and health maintenance organizations in Maryland. Moore Options will provide all primary and specialty care required by the patients, such as diagnostic services, inpatient and emergency care, home care with skilled nursing, prescription drugs, hospice care, mental health, and routine dental and eye care and case management.

"Providing members with the best care in the most appropriate setting is our overriding goal," says Bernard Mansheim, M.D., chief medical officer for United Healthcare of the Mid-Atlantic. "Moore Options achieves that goal for our AIDS patients."
-end-


Johns Hopkins Medicine

Related Health Care Articles from Brightsurf:

Study evaluates new World Health Organization Labor Care Guide for maternity care providers
The World Health Organization developed the new Labor Care Guide to support clinicians in providing good quality, women-centered care during labor and childbirth.

Six ways primary care "medical homes" are lowering health care spending
New analysis of 394 U.S. primary care practices identifies the aspects of care delivery that are associated with lower health care spending and lower utilization of emergency care and hospital admissions.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

Spending on primary care vs. other US health care expenditures
National health care survey data were used to assess the amount of money spent on primary care relative to other areas of health care spending in the US from 2002 to 2016.

MU Health Care neurologist publishes guidance related to COVID-19 and stroke care
A University of Missouri Health Care neurologist has published more than 40 new recommendations for evaluating and treating stroke patients based on international research examining the link between stroke and novel coronavirus (COVID-19).

Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.

International medical graduates care for Medicare patients with greater health care needs
A study by a Massachusetts General Hospital research team indicates that internal medicine physicians who are graduates of medical schools outside the US care for Medicare patients with more complex medical needs than those cared for by graduates of American medical schools.

The Lancet Global Health: Improved access to care not sufficient to improve health, as epidemic of poor quality care revealed
Of the 8.6 million deaths from conditions treatable by health care, poor-quality care is responsible for an estimated 5 million deaths per year -- more than deaths due to insufficient access to care (3.6 million) .

Under Affordable Care Act, Americans have had more preventive care for heart health
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health.

High-deductible health care plans curb both cost and usage, including preventive care
A team of researchers based at IUPUI has conducted the first systematic review of studies examining the relationship between high-deductible health care plans and the use of health care services.

Read More: Health Care News and Health Care Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.