'Dream Team' sets up HIV/AIDS health plan in Miami [The Miami Herald] - Insurance News | InsuranceNewsNet

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June 19, 2012 Newswires
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‘Dream Team’ sets up HIV/AIDS health plan in Miami [The Miami Herald]

Anna Edgerton and John Dorschner, The Miami Herald
By Anna Edgerton and John Dorschner, The Miami Herald
McClatchy-Tribune Information Services

June 19--Billing themselves as a new "Dream Team," leaders of the University of Miami medical school, a Coral Gables health insurance executive and basketball legend Earvin "Magic" Johnson announced Monday a new alliance to service patients with HIV/AIDS.

The parties are joining to provide care through a new type of Medicaid health maintenance organization, Clear Health Alliance, an HIV/AIDS plan offered by Simply Healthcare. The health insurer, Simply Healthcare, was created by veteran entrepreneur Miguel B. "Mike" Fernandez.

Fernandez said the plan was started last month with 350 Miami-Dade patients because "we have the distinction of having the largest number of new HIV/AIDS cases in the country." Clear Health will soon expand into Broward County and eventually throughout the state.

Johnson, a celebrated member of the Dream Team that won gold in the 1992 Olympics who has long been HIV-positive, said Monday, "For myself, everything's been good, but in 20 years there have been millions of people who have died, so I know that I've been blessed. Yes, I've taken my meds. Yes, I've had a positive attitude, and, yes, I've done everything I've supposed to do."

But there was a large need among many HIV/AIDS patients for proper education and treatment of their complex disease, said Johnson, who is in town as a television commentator for the NBA Finals.

Two months ago, his company, Magic Johnson Enterprises, announced it was becoming an investor in Simply Healthcare Plans and getting a seat on the board.

On Monday, Pascal Goldschmidt, dean of the medical school, called the new partnership "a game changer for thousands of patients with HIV/AIDS and it will make a huge difference ... to bring healthcare to underserved patients in our community."

Michael Kolber, director of UM's Comprehensive AIDS Program, said UM doctors will provide primary and specialty care to patients in the Clear Health Alliance and will also offer advice on how to best allocate resources within the program. One example: Recommending transportation assistance so that a healthcare professional can make sure that patients with memory loss take their medications.

Kolber said the UM AIDS specialists will see Clear Health patients in a variety of settings in addition to the UM-Jackson Memorial campus, including clinics run by Borinquen and Care Resource, which provides HIV/AIDS care in Miami-Dade and Broward.

"Not everybody can make it to Jackson," Kolber said. UM's AIDS team is dedicated to making sure that patients have a "medical home," a central place to coordinate care. "We think this is critically important."

Fernandez said that Clear Health is also planning clinics of its own in Wynwood, Overtown and Liberty City.

On a state level, Clear Health moved earlier this month to enhance its reputation by hiring Thomas Liberti as a "strategic advisor." For the past 15 years, Liberti has been chief of the HIV/AIDS Bureau at the Florida Department of Health.

The HIV/AIDS Medicaid HMO was made possible by a law enacted by the Legislature last year allowing the creation of such plans. This year, trying to control soaring Medicaid costs, the Legislature decided HIV patients statewide will be required to join specialized HMOs as part of an overall Medicaid reform.

Michael Rajner, a Broward AIDS activist, said he's concerned with the state's "taking away a patient's right to choose."

UM's Kolber said a coordinated system of care is needed to provide efficient, cost-effective treatment.

Meanwhile, Simply Healthcare is waging a battle to get a toehold in Central Florida, where Orlando Health, a nonprofit system that operates six medical facilities, hasn't agreed to a contract with Simply.

Simply has fought back with an ad in newspapers, plus "mobile billboards and protesters carrying signs," Simply spokeswoman Pam Gadinsky said.

___

(c)2012 The Miami Herald

Visit The Miami Herald at www.miamiherald.com

Distributed by MCT Information Services

Wordcount:  629

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