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1.
Lancet ; 397(10279): 1127-1138, 2021 03 20.
Article in English | MEDLINE | ID: covidwho-1525996

ABSTRACT

In 2010, the US health insurance system underwent one of its most substantial transformations with the passage of the Affordable Care Act, which increased coverage for millions of people in the USA, including those with and at risk of HIV. Even so, the system of HIV care and prevention services in the USA is a complex patchwork of payers, providers, and financing mechanisms. People with HIV are primarily covered by Medicaid, Medicare, private insurance, or a combination of these; many get care through other programmes, particularly the Ryan White HIV/AIDS Program, which serves as the nation's safety net for people with HIV who remain uninsured or underinsured but offers modest to no support for prevention services. While uninsurance has drastically declined over the past decade, the USA trails other high-income countries in key HIV-specific metrics, including rates of viral suppression. In this paper in the Series, we provide an overview of the coverage and financing landscape for HIV treatment and prevention in the USA, discuss how the Affordable Care Act has changed the domestic health-care system, examine the major programmes that provide coverage and services, and identify remaining challenges.


Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , COVID-19/economics , HIV Infections/drug therapy , HIV Infections/prevention & control , Insurance Coverage/legislation & jurisprudence , Insurance, Health/legislation & jurisprudence , Acquired Immunodeficiency Syndrome/drug therapy , Adult , Aged , Anti-Retroviral Agents/therapeutic use , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Female , Gender Identity , HIV Infections/economics , HIV Infections/epidemiology , Humans , Incidence , Male , Medicaid/statistics & numerical data , Medically Uninsured/statistics & numerical data , Medicare/statistics & numerical data , Middle Aged , Patient Protection and Affordable Care Act , Risk Assessment , SARS-CoV-2/genetics , United States/epidemiology
5.
Am J Manag Care ; 27(4): e101-e104, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1194879

ABSTRACT

In public health insurance programs, federal and state regulators use network adequacy standards to ensure that health plans provide enrollees with adequate access to care. These standards are based on provider availability, anticipated enrollment, and patterns of care delivery. We anticipate that the coronavirus disease 2019 pandemic will have 3 main effects on provider networks and their regulation: enrollment changes, changes to the provider landscape, and changes to care delivery. Regulators will need to ensure that plans adjust their network size should there be increased enrollment or increased utilization caused by forgone care. Regulators will also require updated monitoring data and plan network data that reflect postpandemic provider availability. Telehealth will have a larger role in care delivery than in the prepandemic period, and regulators will need to adapt network standards to accommodate in-person and virtual care delivery.


Subject(s)
COVID-19 , Health Planning , Health Services Accessibility/standards , Insurance Coverage/standards , Insurance, Health/standards , Public Sector , Health Insurance Exchanges , Humans , Insurance Coverage/legislation & jurisprudence , Insurance Coverage/organization & administration , Insurance, Health/legislation & jurisprudence , Insurance, Health/organization & administration , Medicaid/legislation & jurisprudence , Medicare/legislation & jurisprudence , United States
6.
Psychiatr Serv ; 72(1): 100-103, 2021 01 01.
Article in English | MEDLINE | ID: covidwho-1059742

ABSTRACT

Because of the COVID-19 pandemic, many mental health care services have been shifted from face-to-face to virtual interactions. Several health policy changes have influenced telehealth uptake during this time, including changes in technology, Internet connectivity, prescriptions, and reimbursement for services. These changes have been implemented for the duration of the pandemic, and it is unclear if all, some, or none of these new or amended policies will be retained after the pandemic has ended. Accordingly, in the wake of changing policies, mental health care providers will need to make decisions about the future of their telehealth programs. This article briefly reviews telehealth policy changes due to the COVID-19 pandemic and highlights what providers should consider for future delivery and implementation of their telehealth programs.


Subject(s)
COVID-19 , Drug Prescriptions , Insurance, Health , Mental Health Services , Telemedicine , Continuity of Patient Care , Drug Prescriptions/standards , Humans , Insurance, Health/legislation & jurisprudence , Insurance, Health/organization & administration , Insurance, Health/standards , Insurance, Health, Reimbursement/legislation & jurisprudence , Insurance, Health, Reimbursement/standards , Mental Health Services/legislation & jurisprudence , Mental Health Services/organization & administration , Mental Health Services/standards , Telemedicine/legislation & jurisprudence , Telemedicine/organization & administration , Telemedicine/standards , United States
7.
J Health Polit Policy Law ; 46(4): 599-609, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1050485

ABSTRACT

In January 2021, the incoming Biden administration inherited urgent priorities for curbing health care spending and expanding health care coverage to millions of Americans while also addressing the COVID-19 pandemic and resulting economic downturn. Among these competing priorities is the issue of access to and affordability of prescription drugs. Here, the authors outline Biden's plan for directly lowering prescription drug spending for payers and patients and for expanding access to prescription medications through improved health insurance coverage. These policies could provide important financial protections for Americans against high prescription drug prices. Despite widespread public support for addressing prescription drug prices, many of Biden's plans rely on congressional action, which will be complicated by the narrow majority held by Democrats in the House and an evenly divided Senate. However, there may be other opportunities for reducing prescription drug spending and improving health insurance enrollment among the uninsured. While directly lowering drug prices would provide the most widespread savings for payers and patients alike, any successful effort for increasing the number of Americans enrolled in health insurance or rendering it more affordable will still likely effectively lower patients' out-of-pocket costs and improve access to prescription drugs.


Subject(s)
Health Expenditures , Health Services Accessibility , Insurance Coverage/economics , Insurance, Health/economics , Prescription Drugs/economics , Humans , Insurance Coverage/legislation & jurisprudence , Insurance, Health/legislation & jurisprudence , Politics , United States
11.
J Gen Intern Med ; 35(10): 3036-3039, 2020 10.
Article in English | MEDLINE | ID: covidwho-662446

ABSTRACT

As the COVID-19 pandemic continues to unfold, payers across the USA have stepped up to alleviate patients' financial burden by waiving cost-sharing for COVID-19 testing and treatment. However, there has been no substantive discussion of potential long-term effects of COVID-19 on patient health or their financial and policy implications. After recovery, patients remain at risk for lung disease, heart disease, frailty, and mental health disorders. There may also be long-term sequelae of adverse events that develop in the course of COVID-19 and its treatment. These complications are likely to place additional medical, psychological, and economic burdens on all patients, with lower-income individuals, the uninsured and underinsured, and individuals experiencing homelessness being most vulnerable. Thus, there needs to be a comprehensive plan for preventing and managing post-COVID-19 complications to quell their clinical, economic, and public health consequences and to support patients experiencing delayed morbidity and disability as a result.


Subject(s)
Coronavirus Infections/complications , Health Expenditures/statistics & numerical data , Pneumonia, Viral/complications , Survivors , Betacoronavirus , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques/economics , Coronavirus Infections/diagnosis , Coronavirus Infections/economics , Health Policy/economics , Health Policy/legislation & jurisprudence , Humans , Insurance, Health/economics , Insurance, Health/legislation & jurisprudence , Pandemics/economics , Pneumonia, Viral/economics , SARS-CoV-2 , United States/epidemiology
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