Ryan White Policy Project

The O’Neill Institute has established a Ryan White Policy Project to consider issues related to sustaining and adapting the Ryan White HIV/AIDS Program (Ryan White) within a changing health care environment.  This project is supported by funding from Gilead Sciences.

Funded by the federal government at nearly $2.3 billion per year, the Ryan White program is the third largest source of financing for HIV care after Medicaid and Medicare and is the cornerstone of the Nation’s response to the domestic HIV epidemic.  The purpose of this Ryan White Policy Project is to consider issues that arise as the context in which the program operates is altered both by technological advances and fundamental shifts in health care financing and service delivery with the implementation of the Affordable Care Act (ACA).

Eliminating Hepatitis C among People Living with HIV in the United State: Leveraging the Ryan White HIV/AIDS Programs to Move Us Forward

One in four people living with HIV will become infected with Hepatitis C (HCV) during their lifetime. Released in June 2019, this policy brief shows how the Ryan White HIV/AIDS Program has a major role to play in helping eliminate HCV among people living with HIV. This brief identifies target populations and various barriers as well as providing strategies to address those issues. These strategic actions include comprehensive efforts to overcome barriers to treatment, better metrics for taking progress toward elimination, increased emphasis on re-screening, and stronger planning and commitment to HCV elimination in states, communities, and clinics.

Quick Take on the Ryan White HIV/AIDS Program in the United States

Released in January 2019, this Quick Take document discusses how the Ryan White HIV/AIDS Program is leading the way in getting people with HIV virally suppressed by ensuring stable access to HIV primary care and medication along with critical support services. The documents describes the parts of the Ryan White Program and the importance of the program for meeting the health care needs of people with HIV and addressing new challenges.

Quick Take on HIV Prevention in the United States

Also released in January 2019, this Quick Take document provides an overview of the HIV epidemic in the United States and describes the range of tools and approaches used to prevent HIV infection, including HIV testing and linkage to care, treatment as prevention, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), and syringe and harm reduction services. The document also discusses the need for continued support for and new investment in HIV prevention.

PROTECTING AND ADVANCING HIV PUBLIC HEALTH GAINS DURING HEALTH SYSTEM REFORM Health Care Reform and HIV: Policy Experts Examine How to Protect and AdvanceHIV Public Health Gains

The Ryan White program has led the way in the development of integrated models of care that other parts of the United States health system are seeking to replicate. It has also enabled states, territories, and local jurisdictions to mount flexible responses to their unique epidemics, while also raising the standard of care and expectations for population-level outcomes for everyone. This issue brief examines the changing role of the Ryan White program and how it supports Medicaid, Medicare, and private insurance to prevent HIV transmission and reduce health care spending.

ALIGNING THE RYAN WHITE HIV/AIDS PROGRAM WITH INSURANCE COVERAGEAligning the Ryan White HIV/AIDS Program with Insurance Coverage

Originally built as a standalone system, the Ryan White program has evolved to a complement to the insurance system. Nonetheless, as the health system seeks to better integrate services and design more effective and efficient care delivery models, this report offers strategies for better aligning the Ryan White program with insurance to ensure that people with HIV do not get left behind.

REFINING RYAN WHITE HIV/AIDS PROGRAM ADMINISTRATIVE ACTIVITIES TO INCREASE POPULATION-LEVEL IMPACTRefining Ryan White HIV/AIDS Program Administrative Activities to Increase Population-Level Impact

The Ryan White program has always looked and acted differently than other parts of the health system.  This report provides recommendations for ways to streamline existing planning and monitoring activities to retain critical aspects of community engagement. It also forcefully calls for increased Ryan White program investments to build health department data management systems and capacity to better partner with Medicaid, Medicare, health plans, and HIV prevention programs to monitor engagement in care and intervene when care is interrupted.

LEVERAGING THE RYAN WHITE HIV/AIDS PROGRAM TO BOLSTER THE HIV CLINICAL AND NON-CLINICAL WORKFORCEBolstering the HIV Clinical and Non-Clinical Workforce

Generations of dedicated HIV care providers and community partners have built today’s HIV care system. While more must be done to better reach underserved populations and communities, the need is great to bolster and sustain the existing HIV care workforce. This report offers recommendations for building upon recent changes to the AIDS Education and Training Center (AETC) program and other efforts to support clinical and non-clinical providers. 

These reports were informed by consultations with people living with HIV, HIV medical and non-medical providers, Ryan White grantees, and federal HIV policy and program staff. The Ryan White Policy Project is supported by funding from Gilead Sciences, Inc. The report was prepared by Crowley and Garner. Crowley reports no recent personal financial interests related to the report.  Garner is policy director for Foley Hoag representing Gilead Sciences.

Other project publications include:

Crowley, Jeffrey, and Jen Kates. Updating the Ryan White HIV/AIDS Program for a New Era: Key Issues and Questions for the Future.”. 2013.