Demographic, Insurance, and Health Characteristics of Newly Enrolled HIV-Positive Patients After Implementation of the Affordable Care Act in California.

Objectives. To examine changes in HIV-positive patient enrollment in a large health care delivery system before and after key Affordable Care Act (ACA) provisions went into effect in 2014. Methods. Analyses compared HIV-positive patients newly enrolled in Kaiser Permanente Northern California betwee...

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Published in:American Journal of Public Health Vol. 106; no. 7; pp. 1211 - 1214
Main Authors: Satre, Derek D., Parthasarathy, Sujaya, Altschuler, Andrea, Silverberg, Michael J., Storholm, Erik, Campbell, Cynthia I.
Format: Article
Published: American Public Health Association Jul2016
Subjects:
Online Access:View this record in EBSCOhost
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      dt: Jul2016
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      pub: American Public Health Association
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        10.2105/AJPH.2016.303126
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        atl: Demographic, Insurance, and Health Characteristics of Newly Enrolled HIV-Positive Patients After Implementation of the Affordable Care Act in California.
      aug:
        au:
          Satre, Derek D.
          Parthasarathy, Sujaya
          Altschuler, Andrea
          Silverberg, Michael J.
          Storholm, Erik
          Campbell, Cynthia I.
        affil:
          Division of Research, Kaiser Permanente Northern California Region, Oakland
          Department of Psychiatry, University of California, San Francisco
      su:
        United States
        California
        Medical care
        Health services accessibility
        Health insurance
        Sex distribution
        Health & social status
        Psychology of HIV-positive persons
        Medical care use
        Probability theory
        Patient Protection & Affordable Care Act
        Health insurance exchanges
      sug:
        subj:
          Medical care
          Health services accessibility
          Health insurance
          Sex distribution
          Health & social status
          United States
          California
          Direct individual life, health and medical insurance carriers
          Direct group life, health and medical insurance carriers
          Psychology of HIV-positive persons
          Medical care use
          Probability theory
          Patient Protection & Affordable Care Act
          Health insurance exchanges
      ab: Objectives. To examine changes in HIV-positive patient enrollment in a large health care delivery system before and after key Affordable Care Act (ACA) provisions went into effect in 2014. Methods. Analyses compared HIV-positive patients newly enrolled in Kaiser Permanente Northern California between January and June 2012 (n = 339) to those newly enrolled between January and June 2014 through the California insurance exchange or via other mechanisms (n = 549). Results. After the ACA, the HIV-positive patient enrollment increased. These new enrollees were more likely to be male (93.6% vs 89.1%; P = .01), to be enrolled in high-deductible benefit plans (≥ $1000; 18.8% vs 5.5%; P = .01), and to have better HIV viral control (HIV RNA levels below limits of quantification 79.5% vs 73.6%; P = .05) compared with pre-ACA new enrollees. Among post-ACA new enrollees, there were more patients in the lowest and highest age groups. Post-ACA exchange enrollees (22%) were more likely to be male and to have high-deductible plans than those enrolled through other mechanisms. Conclusions. More men, higher deductibles, and better HIV viral control characterize newly enrolled HIV-positive patients after the ACA in California.Public health implications. Evolving characteristics of HIV-positive enrollees may affect HIV policy, patient care needs, and service utilization.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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