Integrating HIV Care into a Patient Centered Medical Home: Practice Transformation in a Federally Qualified Health Center Network

Access Community Health Network (ACCESS) provides HIV care and treatment services in Cook and DuPage Counties of Illinois, serving nearly 900 persons living with HIV each year. Their providers must divide their time between five sites geographically distributed across more than 1,000 square miles. As the number of HIV patients has increased over time and those diagnosed with HIV are living longer, ACCESS’ ability to provide continuous care has been stretched to capacity. ACCESS Practice Transformative Model will fully integrate its HIV care into their primary care system using the Patient Centered Medical Home model. HIV patients will be treated by a care team, including primary care providers and infectious disease specialists, with their care coordinated by Registered Nurse-trained Care Coordinators. In this way, they will expand the capacity of their system to take care of HIV patients who are living longer and facing a full range of health issues.