Antiretroviral Improvement Among Medicaid Enrollees

Antiretroviral Improvement Among Medicaid Enrollees (AIMS): An Insurance-based Data to Care Initiative for Medicaid Enrollees in Virginia

This study will evaluate whether a new program will affect how often human immunodeficiency virus (HIV) antiretroviral therapy (ART) prescriptions are filled and whether the program improves the health of people living with HIV.

Virginia Commonwealth University and study collaborators are working together to learn about challenges that Virginia Medicaid members have in taking their prescribed medication. To do this, the researchers are implementing and evaluating a program called Antiretroviral Improvement among Medicaid enrolleeS (AIMS). This program is designed to support members to fill ART prescriptions.

The program involves supporting Medicaid members with HIV directly by talking to them about challenges with filling their ART prescriptions and linking them to resources that can help with those challenges. Some members will be offered access to warm health technology support.

The researchers think this support may increase how often ART prescriptions are filled and hope that the AIMS program can improve individuals' health and increase HIV viral suppression.

Inclusion criteria:

• Current enrollment in Virginia Medicaid;
• Continuous Virginia Medicaid enrollment for the preceding 9 or more months;
• Current age 19-64 years;
• Identified as living with HIV according to an HIV case identification algorithm;
• Non-dual eligible for Medicare;
• History of ART prescription claim(s) within the past 12 months;
• Prior ART prescription claim, with claims for the most recent ART prescription refill(s) >30 days late.

Exclusion criteria:

• Record of non-Medicaid health insurance or other health care service payer in past 3 months;
• New prescription claim(s) within 30 days for within-class ART drug(s) not previously prescribed;
• Service claim(s) for resistance testing and other ART prescription claim(s) within 30 days of most recent late ART prescription(s) for ART drug(s) not previously prescribed;
• Enrollee's linked HIV provider practices at a healthcare facility offering PositiveLinks;
• No record in the Virginia HIV surveillance data;
• Non-English speaking.