Improving Marketplace Health Insurance Enrollment for Eligible HIV and AIDs Positive Clients in Need of Specialty Medical Care Services

Abstract

Nearly 5,500 individuals living in Wake County, North Carolina, are diagnosed with HIV and AIDs (North Carolina Department of Health and Human Services, 2018). Individuals living with HIV and AIDs have complex health conditions that are left unmet and untreated due to gaps in community awareness and self-efficacy in obtaining insurance through the marketplace. These individuals may be eligible for marketplace insurance with premium coverage through benefits under the Ryan White HIV/AIDs program. Nevertheless, many remain uninsured and lack access to specialty care services. The purpose of this DNP project was to improve the health and outcomes of individuals living with HIV and AIDs. The project aimed to increase the number of eligible patients who apply for insurance through the healthcare marketplace by developing a process to reduce barriers to enrollment and increase patient self-efficacy towards obtaining insurance. As a result of a process improvement and workflow change, 38 individuals were successfully enrolled in a marketplace insurance plan with their insurance premium covered.