At a glance
The National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention's Epidemiologic and Economic Modeling Agreement (NEEMA) supports projects that address priority diseases and populations. NEEMA funds projects that focus on cross-cutting outcomes and populations.
NEEMA 2.0 (2019-2024)
Evaluating potential preventive healthcare policy changes on health outcomes
Laws and policies that address the social determinants of health, including accessible and quality health care, are anticipated to broadly affect health outcomes. Healthy People 2030 indicates that "preventive care reduces the risk for diseases, disabilities, and death" and that, "law and policy changes can also help more people access these critical services." While analyses of laws and policies facilitating preventive care exist, they have the potential to be more beneficial to decision-makers if they also include generalized health outcomes, such as years of life saved, quality-adjusted life-years (QALY) saved or lost, and economic analyses.
This project will estimate the potential impacts of Braidwood Management Inc. v Becerra, an ongoing federal court case which challenges provisions of the ACA that require specific preventive services be covered free of cost, on the cost of and access to preventive services. Findings will include: (1) analysis of changes in service use pre and post ACA for select USPSTF grade A and B recommended services across payor types, and (2) examination of potential effects that increased cost-sharing for preventive services may have on health outcomes including QALYs through changes in service use.
Closing gaps in the health disparity indicators for priority racial/ethnic minority populations
Despite advances in prevention and treatment, significant disparities exist in rates of HIV, sexually transmitted infections (STIs), tuberculosis (TB) and viral hepatitis in the United States. The root causes of these disparities are SDOH (e.g., pervasive stigma, lack of access to quality health care, housing insecurity, racism, and other forms of discrimination). The purpose of this project is to take the first step towards quantifying the potential benefits of addressing social determinants of health and reducing disparities. This project has two tracks: The track on HIV and gonorrhea builds on existing HIV model for assessing achievement the Ending the HIV Epidemic in the U.S. (EHE) initiative targets by estimating the potential benefits of infections averted, which can be achieved by closing the gaps in HIV and STI disparities among priority racial/ethnic minority populations as defined in the national strategic plans. The track on STIs, TB, and viral hepatitis will evaluate potential health and economic impacts of reducing health disparities in STIs, TB, and viral hepatitis as defined in the national strategic plans.
Optimizing routine screening for HIV, viral hepatitis, STIs, and TB in clinical settings
HIV, viral hepatitis, sexually transmitted infections (STIs), and tuberculosis (TB) remain critical threats to the public’s health in the United States with millions of people estimated to be living with these infections – many of whom may be unaware of their infection. Successful implementation of routine screening and linkage to care for HIV, viral hepatitis, STIs, and TB are critical to reach the greatest number of persons with undiagnosed infection and link them to care and treatment as effectively and efficiently as possible. This project aims to use mathematical modeling to explore the implementation of integrated screening to identify the most impactful and cost-effective routine screening interventions in clinical settings for HIV, viral hepatitis, STIs, and TB under a prescribed set of scenarios.