Journey to Self-Reliance: HIV and AIDS Care
Abt is helping Vietnam transition its HIV program from donor to domestic financing in a way that ensures financial protection of people living with HIV and AIDS and builds a sustainable system for delivering lifesaving drugs. Centralized procurement of antiretroviral drugs has lowered costs. HIV services have been integrated into Vietnam’s Social Health Insurance (SHI) scheme, and 99.7 percent of the country’s out-patient treatment facilities have been integrated into the public health system. Abt also helped provinces develop local subsidy plans for insurance copayments and premiums. Of people living with HIV, 90 percent are now enrolled in the SHI program, up from 35 percent in 2015. Domestic funding for HIV/AIDS has grown from covering less than a third of the program to covering more than half in 2019.
In Mozambique, many people living with HIV remain hard to reach and maintain on treatment. With Abt’s help, healthcare facilities are improving their ability to reach these people with efficient, data-informed care. Abt has created dashboards, provided surge support, tailored technical assistance, and engaged communities to improve HIV detection and increase treatment. The 148 participating facilities and communities they serve are now better equipped to assume more responsibility to improve performance. Among other promising achievements, the number of patients on treatment increased from 207,753 to 221,164 in just one quarter.
Client
U.S. Agency for International Development (USAID)
Project
USAID Sustainable Financing for HIV
Efficiencies for Clinical HIV/AIDS Outcomes (ECHO)
Advancing U.N. Sustainable Development Goals
Evaluating Innovative Medicare and Medicaid Models
Under the Affordable Care Act, the U.S. Centers for Medicare and Medicaid Services (CMS) is reforming payment systems to lower costs and improve the quality of care. Abt has examined two innovative approaches aimed at achieving these goals.
The first focused on a program that sought to expand access to community housing for Medicaid enrollees with disabilities. The Medicaid Innovation Accelerator Program (IAP) supported partnerships between state Medicaid and housing agencies. Our evaluation provided CMS with real-time information to refine the program. Results suggest the IAP successfully strengthened crucial partnerships to support community housing options. This is important because many people with disabilities prefer community living.
The second assessed CMS’s attempt to overcome a sizable barrier to Medicare reform. Financing impedes many rural health providers from participating in Accountable Care Organizations (ACOs), groups of providers that coordinate care to improve population health. A new ACO Investment Model (AIM) provided up-front financing to these providers. Abt detailed how the model increased rural-provider participation in ACOs and reduced Medicare spending without lowering quality of care.
Client
U.S. Centers for Medicare and Medicaid Services (CMS)
Project
Evaluation of the Medicaid Innovation Accelerator Program
Evaluation of the ACO Investment Model for the Center for Medicare & Medicaid Innovation
Advancing U.N. Sustainable Development Goals
Opioids: From Prescribing Guidelines to Clinical Practice
Recognizing the need for clear prescribing guidelines for providers, the U.S. Centers for Disease Control and Prevention (CDC) issued the Guideline for Prescribing Opioids for Chronic Pain. The Guideline and its recommendations are being adopted by clinicians and have contributed to change in opioid prescribing practices. Abt reviewed the literature to determine evidence-based recommendations for CDC's consideration.
Client
U.S. Centers for Disease Control and Prevention (CDC)
Project
Support Development of Opioid Prescribing Guidelines
Advancing U.N. Sustainable Development Goals
Prescribing guidelines are insufficient to change practice without implementation. Thus, Abt and partners developed clinical quality improvement (QI) measures for healthcare systems to understand and track their prescribing practices and guided the implementation of opioid QI efforts. Using these tools, we have supported two collaboratives with more than 120 diverse primary care practices in 11 states in their efforts to improve prescribing and to monitor use of QI measures. Additionally, Abt contributed to a guide for the Six Building Blocks of Opioid Management. We have engaged primary care practices to use it and are evaluating its effectiveness.
Abt is recognized for its multidisciplinary approach to opioid prevention and treatment. We have studied how effective housing models and community supports promote recovery, and how linking recovery and employment services can help address the epidemic.
Client
U.S. Agency for Healthcare Research and Quality (AHRQ)
Project
Implement and Evaluate CDC Opioid-Related Quality Improvement Measures in Clinical Settings
Evaluating and Implementing the Six Building Blocks Team Approach to Improve Opioid Management in Primary Care
Advancing U.N. Sustainable Development Goals
