Dr Stella Safo on How Changing Financial Models Might Create Management Challenges for HIV

As we move away from a system of external development grants that help us maintain our HIV models to a system where our returns on investment support the work that we do, there’s a concern that there will be some slimming down of services that get patients in to our practice, explained Stella A. Safo, MD, assistant professor of Medicine at the Icahn School of Medicine at Mount Sinai.

Transcript

What are the biggest management challenges that we’re still facing when trying to treat patients with HIV?

HIV has made a tremendous amount of progress from being a disease that was a death sentence and hugely stigmatized to now being something that people manage like a chronic illness like diabetes. But I think one of the biggest management problems that we face is that the HIV care models that we use are based on a lot of funding. We’ve had a lot of philanthropic funding that supports the care models For example, in my practice, I have a massage therapist that takes care of my patients because we got a grant that allows that.

As we move away from a system of external development grants kind of helping us maintain our HIV models to a system where our [ROIs] returns on investment support the work that we do, there’s a concern that there will be some slimming down of those services and those services are actually some of the things that help bring patients into our practices. We know with population health and value-based care delivery that it’s all about getting your patients to come in. In HIV, because of the stigma and all of the other issues, we work really hard on getting our patients to come in, and one of the ways we do that is through nontraditional services like massage therapy, reiki, etc. So, our big management question is going to be what happens to our ability to continue that work when the financial models behind that change going down the line.