Demographic, insurance, and health characteristics of newly enrolled HIV-positive patients after implementation of the affordable care act in California

D.D. Satre, S. Parthasarathy, A. Altschuler, M.J. Silverberg, E. Storholm and C.I. Campbell

American Journal of Public Health, 2016, vol. 106, issue 7, 1211-1213

Abstract: Objectives. To examine changes in HIV-positive patient enrollment in a large healthv 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.

Keywords: California; human; Human immunodeficiency virus infected patient; insurance; limit of quantitation; major clinical study; male; normal human; patient care; public health; transcription regulation; adult; age distribution; blood; California; cost; female; health care policy; health insurance; HIV Infections; middle aged; sex ratio; socioeconomics; statistics and numerical data; United States, virus RNA, Adult; Age Distribution; California; Cost Sharing; Female; HIV Infections; Humans; Insurance, Health; Male; Middle Aged; Patient Protection and Affordable Care Act; RNA, Viral; Sex Distribution; Socioeconomic Factors; United States (search for similar items in EconPapers)
Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2016.303126_8

DOI: 10.2105/AJPH.2016.303126

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