January 13, 1997
Media Contact: Marc Kusinitz
Phone: (410) 955-8665
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."