Insurance Purchase and Continuation Programs/ CARE-HIPP

Arleen Leibowitz, UC-Los Angeles
HIV/AIDS Policy & Health Care Financing

Background: CARE-HIPP (Health Insurance Purchase Program) is a California State program that purchases private, continuation health insurance for persons living with HIV (PLH) in lieu of directly providing them antiretroviral medication through the AIDS Drug Assistance Program (ADAP).

Methods: This project examines both the cost-effectiveness of the current program and the potential to expand it. This research involves a number of steps: (1.) estimating the numbers and characteristics of current CARE-HIPP recipients; (2.) calculating the full cost of providing coverage for antiretroviral medication to CARE-HIPP enrollees through the premium purchase program and through ADAP; (3.) determining what the cost of providing antiretroviral medication to this population through ADAP coverage uniquely would be in the absence of private insurance purchase; (4.) calculating the cost-effectiveness ratio by comparing incremental costs and benefits; and (5.) making comparable calculations for populations of PLH who may reasonably be expected to have the option of continuing their private health insurance policies, namely those PLH with private insurance other than CARE-HIPP who currently also receive some ADAP assistance.

Results: The current CARE-HIPP program is highly cost-effective. It not only is less costly to provide antiretroviral medication through CARE-HIPP than directly through ADAP, but CARE-HIPP also provides coverage for physician and hospital services. The program would also be cost-effective for likely expansion populations.
Conclusions: The CARE-HIPP program should be continued and expanded.