NHCN Meeting: Hepatitis C Medicaid Affinity Group
Approximately 2.5 million people in the United States are living with hepatitis C (HCV) infection. One recent analysis estimated that in one year, HCV infection led to:
- More than 2.3 million outpatient medical visits;
- More than 73,000 emergency room visits; and
- A cost of inpatient visits for one year of more than $15 billion.
A disproportionate number of people infected with HCV are in correctional settings. Earlier this year I spoke to the National Hepatitis in Corrections Network on the impact of hepatitis C on incarcerated populations.
Why Corrections Is Important for Hepatitis C
- Hepatitis C prevalence is overrepresented in the incarcerated population. In 1997, 15% of all inmates had chronic HCV. Prevalence has not reduced significantly in that time despite the advent of new curative direct acting antivirals (DAA) treatments.
- Most inmates with HCV do not receive treatment. A 2016 study using corrections data from 41 states found that only 0.45% of all state prison inmates who had HCV on January 1, 2015 were receiving treatment.
The Hepatitis C Medicaid Affinity Group
One way we may be able to address these issues is through the Hepatitis C Medicaid Affinity Group, which was launched in December 2017 with the aim of:
- Fostering state collaboration and the sharing of promising practices;
- Supporting states in developing and implementing innovative HCV-related policies and programs; and
- Increasing the number and percentage of Medicaid beneficiaries diagnosed and successfully treated for HCV.
The high prevalence and costs of treating HCV in the corrections system provides a unique opportunity for new collaborations between state Medicaid programs and corrections.
Increasing access to screening, diagnosis and early HCV treatment through Medicaid can make a significant contribution toward saving lives, reducing new infections, controlling health care costs, and ultimately eliminating viral hepatitis, all goals described in the National Viral Hepatitis Action Plan.
Possible Collaborations Between Medicaid and Corrections
Preliminary areas of collaboration to explore include:
- Leveraging joint subscription payment models. An alternative strategy for state-level financing for HCV treatment that involves a set payment to a drug manufacturer(s) for unlimited access to DAAs.
- Reducing Medicaid coverage disruptions. Because Medicaid does not generally provide funding for inmate medical care, there may be coverage disruptions if the state terminates Medicaid enrollment upon incarceration. An alternative to termination is suspension of benefits. Suspension can make re-enrollment easier and faster, avoiding coverage gaps, re-enrollment challenges, and delays upon release.
- Improving linkages to care post-release. Reentry linkage to care includes pre-release planning and post release coordination, generally via a care coordinator. Many people being released are eligible for Medicaid benefits so supporting newly released individuals to access their health service benefits when they return to the community can be a way to get people treated and cured of HCV.
To learn more about the Hepatitis C Medicaid Affinity Group or provide ideas for collaboration, visit this page.
To express interest in participating in the group, email Corinna Dan.
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