impact care quality. Thus, it will be important to monitor both trends in care quality for individuals with HIV and enrollment among the various sources of care coverage as the ACA is implemented. In its first report, the committee identified core indicators to monitor the impact of the NHAS and the ACA on HIV care as well as care quality. These or similar indicators could be used to measure care quality within the context of the ACA.

Recommendation 6. The Office of National AIDS Policy, working with the Department of Health and Human Services, should ensure the collection and linkage of data on core indicators4 to monitor quality of care for people with HIV during and following the implementation of the Patient Protection and Affordable Care Act.

Data tracking health care coverage sources, enrollment, service utilization, and core outcomes among people with HIV are important for monitoring the impact of the ACA and the NHAS on access to and quality of HIV care in the United States over time. The data may be used to identify any difficulties encountered as individuals with HIV transition among sources of care coverage and to inform future planning related to the health care workforce and possible redistribution of resources to improve the quality and efficiency of care and reduce HIV-related health disparities. Reporting the data at least once every 2 years will permit stakeholders, including policy makers, health care coverage programs and plans, organizations of health care professionals, and others, to anticipate future needs and make appropriate midcourse corrections to advance the goals of the NHAS and maximize access to quality HIV care under the ACA.

Recommendation 7. The Department of Health and Human Services should produce and disseminate a report at least once every 2 years on the care of people with HIV. This report should characterize trends and identify gaps in coverage and care during and following the implementation of the Patient Protection and Affordable Care Act.

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4Fourteen core indicators for monitoring access to clinical HIV care and mental health, substance abuse, and supportive services were recommended by the committee in its first report, which includes discussion of the collection and linkage of data needed to estimate the indicators. HHS currently is in the process of implementing the use of seven common core indicators for HIV diagnosis, treatment, and care services across HHS-funded programs (http://blog.aids.gov/2012/08/secretary-sebelius-approves-indicators-for-monitoring-hhs-funded-hivservices.html). This recommendation is not intended to duplicate federal efforts to monitor HIV care and supportive services but to ensure that such monitoring occurs in conjunction with the tracking of changes in enrollment patterns and benefit packages among different sources of coverage for HIV care.



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