Demographic, Insurance, and Health Characteristics of Newly Enrolled HIV-positive Patients After Implementation of the Affordable Care Act in California
Published in: American Journal of Public Health, v. 106, no. 7, July 2016, p. 1211-1213
Posted on RAND.org on September 13, 2016
Read More
Access further information on this document at American Journal of Public HealthThis article was published outside of RAND. The full text of the article can be found at the link above.
Research Question
- What were the characteristics of HIV-positive patients newly enrolled in a large California health plan after key provisions of the ACA took effect in 2014?
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.
Key Findings
- HIV-positive patient enrollment increased after the ACA.
- New enrollees were more likely to be male, to be enrolled in high-deductible benefit plans, and to have better HIV viral control.
Recommendation
HIV policy, patient care needs, and service utilization may need adjustment to account for evolving characteristics of HIV-positive enrollees.
This article was published outside of RAND. The full text of the article can be found at the link above.
This report is part of the RAND Corporation external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.
The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.