New program helps with hepatitis C treatment Doctors Smiling in Hallway

"By reimbursing care through a bundled payment that is partly contingent on achieving a cure for the patient, this program allows providers to innovate their practice patterns."

Hepatitis C is a dangerous, often silent disease that may not become apparent to those affected with symptoms until serious damage is done.

The disease is highly prevalent here in Arizona. About 90,000 residents are living with hepatitis C, making it one of the state’s most commonly reported infectious diseases.

The rate of new infections appears to be increasing, with approximately a 30 percent increase in new cases between 2013 and 2015.

That is why it’s so important to bring attention to the condition in May, during Hepatitis Awareness Month.

The good news is there are medications that can cure the disease. The challenge is making sure patients have access to these drugs and stick with their course of treatment.

As healthcare and benefit providers serving the Medicaid population in Arizona, we are familiar with the obstacles that many patients with hepatitis C face.

To properly care for these patients, we need to treat hepatitis C and support adherence to treatment by coordinating all care, including physical and behavioral health services and social supports.

Care1st Health Plan Arizona and Maricopa Integrated Health System (MIHS) have launched a program that takes a new approach to treating hepatitis C patients.

In addition to ensuring they receive hepatitis C anti-viral drug therapy, we enable our providers to address the patient’s adherence to the medicine by addressing their whole-person care and social needs.

By reimbursing care through a bundled payment that is partly contingent on achieving a cure for the patient, this program allows providers to innovate their practice patterns.  

MIHS specialists can provide case managers and navigators to better coordinate care and connect their patients to local services to help meet their basic needs such as, food, housing, childcare and transportation assistance.

This is the first time a Medicaid plan in the U.S. has used a value-based bundled payment system for hepatitis C treatment to reimburse care providers based on patient outcomes, rather than the typical fee-for-service approach, making it possible to treat the patient holistically by providing social service supports and tailor medical care to address all of the patient’s needs.

Using this model allows us to step outside network restrictions so patients can receive all their medical care under one roof, easing the burden of having to make multiple trips to different facilities. It also enables physicians to improve monitoring of the patient’s status and progress.

Successfully treating hepatitis C is critical to reducing the threat of this disease in Arizona. New approaches such as ours can help empower healthcare practitioners to think outside the box and innovate care protocols to break down the barriers that prevent hepatitis C patients from receiving – and complying with – the treatment they need for better health.

-Dr. Satya Sarma is chief medical officer and Scott Cummings is state president of Care1st Health Plan Arizona.