Measuring What Matters

The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act gives funding to cities, states, and other public and private entities to provide care and support services to individuals with HIV and AIDS who have low-incomes and little or no insurance. The CARE Act is a discretionary program that relies on annual appropriations from Congress to provide care for low-income, uninsured, or underinsured individuals who have no other resources to pay for care. Despite its successes, funding has been insufficient to address all of the inequalities and gaps in coverage for people with HIV. In response to a congressional mandate, an Institute of Medicine committee was formed to reevaluate whether CARE allocation strategies are an equitable and efficient way of distributing resources to jurisdictions with the greatest needs and to assess whether quality of care can be refined and expanded. Measuring What Matters: Allocation, Planning, and Quality Assessment for the Ryan White CARE Act proposes several types of analyses that could be used to guide the evaluation and improvement of allocation formulas, as well as a framework for assessing quality of care provided to HIV-infected persons. Table of Contents Front Matter Executive Summary 1 Introduction 2 Overview of the HIV/AIDS Epidemic and the Ryan White CARE Act 3 Public Health and HIV/AIDS Surveillance 4 HIV Reporting Data and Title I and II Formulas 5 Estimating Resource Needs 6 Measuring Quality of Care 7 Findings and Recommendations Appendix A: Acronyms Appendix B: Financial Resources of States for HIV/AIDS Reporting Appendix C: Analyses of the Sensitivity of the Formula Allocations to Underlying Changes in Input Data Appendix D: Methodological Details of HCSUS Analyses Appendix E: Tables of HIV/AIDS Quality Measures from Selected Sources Appendix F: Biographies