Ryan White HIV/AIDS Program (RWHAP) Outcomes within the Context of the Affordable Care Act (ACA)

Geographic Scope: Nationwide

Client(s): HRSA - HAB

Service: Applied Research & Evaluation

Technical Expertise: Health Care Reform, HIV & Infectious Diseases


The Affordable Care Act (ACA) is changing how health services are delivered and paid for—and HIV services delivered through the Ryan White Care Act are no exception. Initiated in September 2015, the goals of this HRSA-funded mixed-method evaluation project are to evaluate the impact of coverage obtained through the ACA and RWHAP service use post-ACA on client health outcomes.

The goals of this project are to evaluate the:

  • Impact of coverage obtained through the ACA and other health-insurance related factors, including medication coverage, on RWHAP client health outcomes, including viral suppression and retention in care;
  • Extent to which RWHAP services (core and support) are available and being used by clients post-ACA and their impact on RWHAP client outcomes;
  • Barriers to care are RWHAP clients experiencing post-ACA and what is the impact of these barriers on health outcomes due to changes in health coverage.
The project team, including JSI, will be conducting a mixed methods evaluation to answer the research questions, drawing upon HRSA RWHAP Services Report (RSR) data and data collected from a chart review with 24 sites across the United States. Qualitative data will be collected from site visits, interviews with providers and focus groups with clients.

JSI will contribute to the research strategy, analysis plan and interpretation of findings, and will lead the chart review component of the project and conduct focus groups. A final evaluation report will be drafted and submitted to HRSA/HAB at the end of the two year project.