Montefiore Medical Center received a $3.5 million grant as part of the $10 million Health Care Innovation Award from the Center for Medicare & Medicaid Services to identify, diagnose and treat people with hepatitis C (HCV). This grant also was awarded to the NYC Department of Health and Mental Hygiene, the Fund for Public Health in New York, the Icahn School of Medicine at Mt. Sinai, Weill Cornell Medical College, VNSNY Choice and HealthFirst.
The award has been named Project INSPIRE NYC (Innovate & Network to Stop HCV & Prevent complications via Integrating care, Responding to needs and Engaging patients & providers) and aims to achieve:
1.Better care, by increasing the number of patients starting hepatitis C therapy, strengthening management of behavioral health problems, reducing hospitalizations and emergency department visits and maintaining a high level of satisfaction among enrollees;
2.Better health, with increased hepatitis C cure rates, fewer hepatitis C-related complications and increased screening for depression and alcohol abuse;
3.Lower costs, by reducing expenses from preventable hospitalizations, emergency department visits and complications of hepatitis C infection.
"This innovative model of care builds on our strengths and commitment to our community and will avert deadly consequences of chronic hepatitis C for many people living in the Bronx," said Alain Litwin, M.D., professor of Medicine at Montefiore Medical Center and Albert Einstein College of Medicine of Yeshiva University.
Over three-years, the project will reach out to Medicare and Medicaid patients who are at risk for Hepatitis C in eight different locations throughout the Bronx using an integrated model of care. Montefiore's project builds on successful tactics that were already utilized in its methadone clinics where 50 percent of patients have chronic hepatitis C, FQHC with on-site HCV treatment, and in its CICERO program for people with HIV. Primary care champions will work closely with care coordinators and specialists to increase access to effective hepatitis C care for patients. HCV care coordinators will provide care coordination, navigation, health promotion, and medication adherence to offer each enrollee a patient-centered medical home. Also available to patients will be a peer educator, a person who was cured of hepatitis C, who can share his or her experiences and help patients navigate through the process.
The project will be supported by a telemedicine system linking a hepatologist, infectious diseases specialist, and mental health provider with the primary care provider. Its goal is to further educate the physician and increase the capacity of patients served.
"Project INSPIRE NYC brings together an outstanding partnership for an innovative model for increased access to much-needed care for people with hepatitis C in New York City. It responds to advances in medical care that now make chronic hepatitis C a curable disease. And it can be sustained and replicated on a larger scale," said NYC Health Commissioner Mary Bassett, M.D. "Far too many New Yorkers are infected, but haven't been tested and treated. This grant is one part of the Department's response to this deadly epidemic."
An estimated 146,500 New Yorkers have chronic hepatitis C, though about half do not know that they are infected. Hepatitis C is a liver disease that results from infection with the hepatitis C virus. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong condition. Hepatitis C is usually spread when blood from a person infected with hepatitis C enters the blood stream of someone who is not infected. Today, people most often become infected with hepatitis C by sharing needles or other equipment to inject drugs. Before 1992, when widespread screening of the blood supply began in the United States, hepatitis C was also commonly spread through blood transfusions.
Most people living with hepatitis C have few symptoms of illness until 10 to 30 years after initial infection, when life-threatening complications can develop. People with hepatitis C are at risk for developing cirrhosis, liver cancer and other types of liver damage.
Given unprecedented advances in hepatitis C treatment, a cure has become achievable for most. Treatment is now shorter, less toxic and more effective than in the past. Most people with hepatitis C can be cured by taking antiviral medication for several months.
"We will be able to make a significant impact in combating hepatitis C by innovating the way we deliver health care, on par with other innovations," said Dr. Litwin. "That's the whole point of Project INSPIRE NYC."
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