Performance Improvement 2010. Promote Health Care, Primary Care and Service Availability

01/01/2010

An Agency for Healthcare Research and Quality (AHRQ) independent panel of experts in primary care and prevention concluded that recommendations for improving clinical preventive services were effectively integrated into health plans through printed publications, electronic use of health information technology tools, and incorporation into plan patient health education materials.  To improve dissemination, the panel recommended developing new prevention tools designed for nurses delivering counseling recommendations, disseminating more information about methodology to members of the health plan staff, and having agency staff attend provider professional meetings and make presentations on panel recommendations.  (9035)

Prior to the passage of the Patient Protection and Affordable Care Act in 2009, states sought to cover the uninsured, constrain rising medical costs, and re-shape Medicaid as a more market-based program.  A study by the Lewin Group funded by the Health Resources and Services Administration (HRSA) looked at 17 states to determine the effect of these efforts.  Researchers found that health reforms in some states were broad in scope, others focused exclusively on the Medicaid program, and Medicaid generally played a central role in health reform proposals and activities.  The state health reforms included coverage expansions, changes to service delivery and financing, and investments in improving the health care infrastructure. (8917)

A HRSA five-year randomized trial study of interventions in clinical settings intended to reduce the risk that HIV-positive patients transmitting HIV to others found that provider-delivered interventions reduced HIV risk.  Compared to patients receiving no intervention, patients receiving a provider-delivered intervention demonstrated reduced risk that was sustained over time.  Risk was measured by reduced unprotected vaginal and/or anal intercourse with persons of HIV-negative or unknown status.  Compared to the standard of care, patients assigned to receive interventions from medical care providers reported a significant decrease in risk after 12 months of participation.  Patients receiving prevention services from health educators, social workers or paraprofessional HIV-infected peers reported significant reduction in risk at 6 months, though not at 12 months.  It appears that, among options for implementation of programs designed to reduce risk of HIV transmission, medical provider-delivered methods are comparatively robust. (8387

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