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Us health insurance

Gordon Gong, Cassandra C Huey, Coleman Johnson, Debra Curti, Billy U Philips
One of the goals of the Affordable Care Act aims to provide affordable health insurance through the health insurance exchange marketplace (the Marketplace). This study explores enrollments in the Marketplace in Texas and in rural vs urban areas in the East, South, and West regions of the state. Data are derived from the US Census Bureau and the Department of Health and Human Services. A total of 92.7% of eligible non-elderly adult Texans (NEATs) had enrolled in Marketplace insurance as of February 2015. Rural residents were less likely than urban residents to use the Marketplace...
October 1, 2016: Texas Medicine
James Weatherall, Lisa Bloudek, Sarah Buchs
OBJECTIVE: To quantify the annual budget impact if all United States (US) commercially insured type 1 diabetes mellitus patients on basal-bolus therapy (T1DMBBT), type 2 diabetes mellitus patients on basal-oral therapy (T2DMBOT), and type 2 diabetes mellitus patients on basal-bolus therapy (T2DMBBT) switched from insulin glargine (IGlar) to insulin degludec (IDeg). METHODS: A short-term (1-year) budget impact model was developed to evaluate the costs of IDeg vs...
October 21, 2016: Current Medical Research and Opinion
Christina Ludema, Stephen R Cole, Joseph J Eron, Andrew Edmonds, G Mark Holmes, Kathryn Anastos, Jennifer Cocohoba, Mardge Cohen, Hannah L F Cooper, Elizabeth T Golub, Seble Kassaye, Deborah Konkle-Parker, Lisa Metsch, Joel Milam, Tracey E Wilson, Adaora A Adimora
BACKGROUND: Implementation of the Affordable Care Act motivates assessment of health insurance and supplementary programs, such as the AIDS Drug Assistance Program (ADAP) on health outcomes of HIV-infected people in the United States. We assessed the effects of health insurance, ADAP, and income on HIV viral load suppression. METHODS: We used existing cohort data from the HIV-infected participants of the Women's Interagency HIV Study. Cox proportional hazards models were used to estimate the time from 2006 to unsuppressed HIV viral load (>200 copies/mL) among those with Medicaid, private, Medicare, or other public insurance, and no insurance, stratified by the use of ADAP...
November 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Khaled J Saleh, William O Shaffer
In 2015, the US Congress passed legislation entitled the Medicare Access and CHIP [Children's Health Insurance Program] Reauthorization Act (MACRA), which led to the formation of two reimbursement paradigms: the merit-based incentive payment system (MIPS) and alternative payment models (APMs). The MACRA effectively repealed the Centers for Medicare and Medicaid Services (CMS) sustainable growth rate (SGR) formula while combining several CMS quality-reporting programs. As such, MACRA represents an unparalleled acceleration toward reimbursement models that recognize value rather than volume...
November 2016: Journal of the American Academy of Orthopaedic Surgeons
Kristi Reynolds, Daichi Shimbo, C Barrett Bowling, Luqin Deng, Adam Bress, John Sim, Paul Muntner
OBJECTIVE: To identify risk factors for serious fall injuries following initiation of antihypertensive medication among older adults. DESIGN AND METHOD: We conducted a retrospective cohort study using a 5% random sample of people with Medicare health insurance, a government program for older US adults. The analysis was restricted to patients with a diagnosis of hypertension who initiated antihypertensive medication between 2007 and 2011. Initiation was defined by the first antihypertensive medication fill in this time period preceded by 365 days with no antihypertensive medication fills...
September 2016: Journal of Hypertension
Lawrence Appel
With the exception of a few isolated populations, elevated blood pressure is a worldwide pandemic with staggering consequences for individuals, care givers, health care delivery systems, and insurers, including governments. It is well-recognized that the burden of hypertension and its adverse consequences is greater in low- and middle-income countries than economically developed countries. BP-related outcomes also differ by region, with a predominance of stroke in southeast Asian countries and a predominance of ischemic heart disease in the US and Western Europe...
September 2016: Journal of Hypertension
Bruce C M Wang, Ping-Ning Hsu, Wesley Furnback, John Ney, Ya-Wen Yang, Chi-Hui Fang, Chao-Hsiun Tang
BACKGROUND: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation and destruction of the joints. OBJECTIVES: This research aims to estimate the economic burden of RA in Taiwan. METHODS: The National Health Insurance Research Database (NHIRD), a claims-based dataset encompassing 99 % of Taiwan's population, was applied. We used a micro-costing approach for direct healthcare costs and indirect social costs by estimating the quantities and prices of cost categories...
March 2016: Drugs—Real World Outcomes
Juan Yang, Katherine E Atkins, Luzhao Feng, Mingfan Pang, Yaming Zheng, Xinxin Liu, Benjamin J Cowling, Hongjie Yu
BACKGROUND: To explore the current landscape of seasonal influenza vaccination across China, and estimate the budget of implementing a national "free-at-the-point-of-care" vaccination program for priority populations recommended by the World Health Organization. METHODS: In 2014 and 2016, we conducted a survey across provincial Centers for Disease Control and Prevention to collect information on regional reimbursement policies for influenza vaccination, estimated the national uptake using distributed doses of influenza vaccines, and evaluated the budget using population size and vaccine cost obtained from official websites and literatures...
October 13, 2016: Vaccine
Elaine W Flagg, Elizabeth A Torrone, Hillard Weinstock
OBJECTIVES: To examine prevalence of low- and high-grade cervical lesions over time in a large cohort of US female adolescents and women. METHODS: We used health care claims data from 9 million privately insured female patients aged 15 to 39 years to estimate annual prevalence of cytologically detected cervical low-grade (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and high-grade histologically detected cervical intraepithelial neoplasia grades 2 and 3 (CIN2+) during 2007 through 2014...
October 13, 2016: American Journal of Public Health
Sharon H Giordano, Jiangong Niu, Mariana Chavez-MacGregor, Hui Zhao, Daria Zorzi, Ya-Chen Tina Shih, Benjamin D Smith, Chan Shen
BACKGROUND: One goal for high-quality patient care is communicating treatment costs to patients, yet cost information can be elusive. This is especially relevant for breast cancer care, for which numerous guideline-concordant adjuvant chemotherapy regimens exist. The objective of the current study was to generate cost estimates for such regimens from payers' and patients' perspectives in a large, insured US population. METHODS: Adult women who had incident breast cancer diagnosed between 2008 and 2012 (from the MarketScan database), had no secondary malignancy within 1 year of diagnosis, and received chemotherapy within 3 months of diagnosis were included (n = 14,643)...
October 10, 2016: Cancer
Cori Lorts, Punam Ohri-Vachaspati
INTRODUCTION: The US Preventive Services Task Force recommends that all patients be screened for obesity and, if needed, be provided weight-loss advice. However, the prevalence of such advice is low and varies by patient demographics. This study aimed to describe the determinants of receiving weight-loss advice among a sample with a high proportion of low-income, racial/ethnic minority individuals. METHODS: Data were collected from a telephone survey of 1,708 households in 2009 and 2010 in 5 cities in New Jersey...
October 6, 2016: Preventing Chronic Disease
Jeremy A Franklin, Evan J Anderson, Xionghua Wu, Christopher S Ambrose, Eric A F Simões
Background.  Database studies have identified that public health insurance status is associated with an increased risk of severe respiratory syncytial virus (RSV) disease in US infants. However, these studies did not adjust for the presence of other risk factors and did not evaluate the risk in preterm infants. Methods.  In this study, we evaluate the independent association between public insurance and severe RSV disease outcomes adjusting for other risk factors. The prospective, observational RSV Respiratory Events among Preterm Infants Outcomes and Risk Tracking (REPORT) study was conducted over 2 consecutive RSV seasons at 188 US clinical sites that enrolled preterm infants born at 32-35 wGA who had not received RSV immunoprophylaxis with palivizumab...
September 2016: Open Forum Infectious Diseases
Young-Eun Kim, Ye-Rin Lee, So-Youn Park, Kyung Suk Lee, In-Hwan Oh
Background. Otitis media (OM) is a common communicable disease that is associated with a substantial economic burden. However, no Korean studies have evaluated OM-related trends after the introduction of the pneumococcal conjugate vaccines. Purpose. This study aimed to estimate the prevalence and economic burden of OM in Korea using nationally representative data. Methods. The burden of OM was estimated nationally representative data such as national health insurance claims data from 2012, based on the prevalence approach and the societal perspective...
2016: BioMed Research International
Macarius M Donneyong, Katsiaryna Bykov, Pauline Bosco-Levy, Yaa-Hui Dong, Raisa Levin, Joshua J Gagne
OBJECTIVE:  To compare differences in mortality between women concomitantly treated with tamoxifen and selective serotonin reuptake inhibitors (SSRIs) that are potent inhibitors of the cytochrome-P450 2D6 enzyme (CYP2D6) versus tamoxifen and other SSRIs. DESIGN:  Population based cohort study. SETTING:  Five US databases covering individuals enrolled in private and public health insurance programs from 1995 to 2013. PARTICIPANTS:  Two cohorts of women who started taking tamoxifen...
September 30, 2016: BMJ: British Medical Journal
Ruth Pitt
Hawai'i had high insurance coverage rates even before the Affordable Health Care Act and continues to have a high percentage of the population with health insurance today. However, high insurance rates can disguise wide variation in what is covered and what it costs. In this essay, an Australian Masters in Public Health student from the University of Hawai'i considers the strengths and weaknesses of insurance coverage in the US health-care system when her friend "Peter" becomes seriously ill.
September 2016: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
Aaron S Kesselheim, Katsiaryna Bykov, Joshua J Gagne, Shirley V Wang, Niteesh K Choudhry
OBJECTIVE: With more antiepileptic drugs (AED) becoming available in generic form, we estimated the risk of seizure-related events associated with refilling generic AEDs and the effect of switching between different manufacturers of the same generic drug. METHODS: We designed a population-based case-crossover study using the Medicaid Analytic eXtract and a US commercial health insurance database. We identified 83,001 generic AED users who experienced a seizure-related hospital admission or emergency room visit between 2000 and 2013 and assessed whether they received a refill of the same AED from the same manufacturer or a different manufacturer...
September 28, 2016: Neurology
Brian C Lund, Mary E Charlton, Alan N West
BACKGROUND: Utilization of private sector healthcare services among dual enrolled veterans with private healthcare insurance plans (PHIP) has not been well-characterized. Concurrent use of Veterans Health Administration (VHA) and non-VHA pharmacies may increase risk for adverse outcomes. Thus, the objectives of this study were to determine the extent to which dual VHA-PHIP enrollees obtain medications through VHA and non-VHA pharmacies and to characterize medications obtained through non-VHA pharmacies...
2016: BMC Health Services Research
Stephanie Alimena, Mary E Air, Caitlin Gribbin, Elizabeth Manejias
This study examines the current utilization of primary and preventive health care services among dancers in order to assess their self-reported primary care needs. Participants were 37 dancers from a variety of dance backgrounds who presented for a free dancer health screening in a large US metropolitan area (30 females, 7 males; mean age: 27.5 ± 7.4 years; age range: 19 to 49 years; mean years of professional dancing: 6.4 ± 5.4 years). Dancers were screened for use of primary care, mental health, and women's health resources using the Health Screen for Professional Dancers developed by the Task Force on Dancer Health...
2016: Journal of Dance Medicine & Science
Valery Risson, Bhaskar Ghodge, Ian C Bonzani, Jonathan R Korn, Jennie Medin, Tanmay Saraykar, Souvik Sengupta, Deepanshu Saini, Melvin Olson
BACKGROUND: An enormous amount of information relevant to public health is being generated directly by online communities. OBJECTIVE: To explore the feasibility of creating a dataset that links patient-reported outcomes data, from a Web-based survey of US patients with multiple sclerosis (MS) recruited on open Internet platforms, to health care utilization information from health care claims databases. The dataset was generated by linkage analysis to a broader MS population in the United States using both pharmacy and medical claims data sources...
2016: Journal of Medical Internet Research
Pamela A Shaw, William S Yancy, Lisa Wesby, Victoria Ulrich, Andrea B Troxel, David Huffman, Gary D Foster, Kevin Volpp
BACKGROUND: Obesity continues to be a serious public health challenge. Rates are increasing worldwide, with nearly 70% of the US adults overweight or obese, leading to increased clinical and economic burden. While successful approaches for achieving weight loss have been identified, techniques for long-term maintenance of initial weight loss have largely been unsuccessful. Financial incentive interventions have been shown in several settings to be successful in motivating participants to adopt healthy behaviors...
September 19, 2016: Clinical Trials: Journal of the Society for Clinical Trials
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