Theme: Models of Care Year: 2018
Background:
Hepatitis C virus (HCV) infection continues to be a pressing public health issue.
Identification of chronic infection is important in primary care settings and community
health centers to link and retain patients in appropriate care. However, restrictive
Medicaid policies around fibrosis level, substance sobriety, and prescriber
restrictions limit patient’s access to new HCV treatment. This innovative treatment
program was developed in the primary care setting in order to deliver quality care
through comprehensive behavioral health consultation to meet the demand of those
engaging in treatment.
Description of model of care/intervention:
This program integrated onsite HCV treatment to create a “test and treat” approach
within a federally qualified health center (FQHC) network utilizing mid-level providers
to address this issue. An interdisciplinary care team was established to optimize
patient experience around HCV care and treatment by minimizing social
determinants of health that lead to negative health outcomes associated with HCV
infection by providing comprehensive behavioral health consultation (BHC) to HCV
positive patients seeking treatment.
Effectiveness:
From January 2015 to May 2017, the PHMC Care Clinic medical providers referred
189 patients for HCV treatment. Of these, 112 patients have successfully obtained
sustained virologic response (SVR) lab results, a 59.3% success rate from referral to
cure. Additionally, BHC was significant at increasing our insurance approval rates
(85% vs 68%, P=0.0095) and significant in moving patients from approval to starting
treatment (OR= 14.24, P=0.003).
Conclusion and next steps:
This treatment program successfully integrated HCV treatment in a patient
population heavily effected by substance abuse and mental illness in a primary care
community health center. Support and adoption of this program in urban primary
care community health centers can help meet the need of the increasing number of
patients who are eligible for treatment.
Disclosure of Interest Statement: See example below:
There is no disclosure of interest at this time