ACA and Medicaid Expansion Increased Breast Pump Claims and Breastfeeding for Women with Public and Private Insurance

2021 ◽  
Author(s):  
Summer Sherburne Hawkins ◽  
Krisztina Horvath ◽  
Alice Noble ◽  
Christopher F. Baum
Keyword(s):  
Private Insurance ◽  
Medicaid Expansion ◽  
Public And Private ◽  
Breast Pump

Medicaid IBCLC Service Coverage following the Affordable Care Act and the Center for Medicare and Medicaid Services Update

2015 ◽  
Vol 32 (1) ◽  
pp. 89-94 ◽  
Author(s):  
Rachel A. Herold ◽  
Karen Bonuck
Keyword(s):  
Exclusive Breastfeeding ◽  
Private Insurance ◽  
Preventive Health Services ◽  
Medicaid Expansion ◽  
Public And Private ◽  
Electronic Survey ◽  
Lactation Consultants ◽  
Private And Public ◽  
Legislative Changes ◽  
Duration Of Breastfeeding

Background: International Board Certified Lactation Consultants (IBCLCs) are associated with increased rates and duration of breastfeeding. Recent US legislation offers opportunities for private and public insurers to include IBCLC services as a covered benefit. Objective: To explore US states’ Medicaid coverage of IBCLC services following January 2014 legislative expansions of coverage for preventive health services. Methods: To assess IBCLC reimbursement practices, 20 states, stratified by Medicaid expansion (yes/no) and 3-month exclusive breastfeeding rates, were selected to participate. An electronic survey was sent to Medicaid and Maternal Health Directors, breastfeeding coordinators, and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) coordinators between July and December 2014. Email follow-ups clarified missing or ambiguous responses. Results: Of the 15 states responding, 9 had Medicaid expansion. None of the states permitted IBCLCs to bill for services autonomously. In 9 states, IBCLC services were covered with some type of stipulation, for example, billing under a physician. Of the 9 states with IBCLC coverage, 7 had accepted Medicaid expansion. States with higher rates of exclusive breastfeeding were also more likely to provide IBCLC coverage. Conclusion: Recent legislative changes to public and private insurance that could expand coverage of IBCLCs have not yielded appreciable changes, particularly in states without Medicaid expansion. There is a need for research on the effects of adopting expanded coverage for IBCLCs and advocacy to do so.

scholarly journals The impact of public coverage of newer hepatitis C medications on utilization, adherence, and costs in British Columbia

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247843
Author(s):  
Harriet Ho ◽  
Naveed Z. Janjua ◽  
Kimberlyn M. McGrail ◽  
Mark Harrison ◽  
Michael R. Law ◽  
...  
Keyword(s):  
British Columbia ◽  
Hepatitis C ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Drug Coverage ◽  
Administrative Claims ◽  
Public And Private ◽  
Treatment Uptake ◽  
Private Expenditure ◽  
The Impact

Background Sofosbuvir and ledipasvir-sofosbuvir are both newer direct-acting antiviral agents for the treatment of hepatitis C. The high list prices for both drugs have led to concern about the budget impact for public drug coverage programs. Therefore, we studied the impact of public prescription drug coverage for both drugs on utilization, adherence, and public and private expenditure in British Columbia, Canada. Methods We used provincial administrative claims data from January 2014 to June 2017 for all individuals historically tested for either hepatitis C and/or human immunodeficiency virus. Using interrupted time series analysis, we examined the impact of public insurance coverage on treatment uptake, adherence (proportion of days covered), and public and private expenditures. Results Over our study period, 4,462 treatment initiations were eligible for analysis (1,131 sofosbuvir and 3,331 ledipasvir-sofosbuvir, which include 19 patients initiated on both treatments). We found the start of public coverage for sofosbuvir and ledipasvir-sofosbuvir increased treatment uptake by 154%. Adherence rates were consistently high and did not change with public coverage. Finally, public expenditure increased after the policy change, and crowded out some private expenditure. Conclusion Public coverage for high-cost drugs for hepatitis C dramatically increased use of these drugs, but did not reduce adherence. From a health policy perspective, public payers should be prepared for increased treatment uptake following the availability of public coverage. However, they should not be concerned that populations without private insurance coverage will be less adherent and not finish their treatment course.

scholarly journals A STUDY ON PREFERENCE OF POLICYHOLDERS ABOUT PUBLIC AND PRIVATE LIFE INSURANCE COMPANIES IN TIRUNELVELI DISTRICT

2018 ◽  
Vol 6 (4) ◽  
pp. 105-110
Author(s):  
I. Meenakshi
Keyword(s):  
Public Sector ◽  
Life Insurance ◽  
Private Insurance ◽  
Marketing Strategies ◽  
Private Life ◽  
Insurance Companies ◽  
Insurance Company ◽  
Life Insurance Company ◽  
Public And Private ◽  
New Policies

There are currently, a total of 24 life insurance companies in India. Of these, Life Insurance Corporation of India (LIC) is the only public sector insurance company. All others are private insurance companies. The Life Insurance Corporation of India (LIC) is the largest life insurance company in India and also the country's largest investor. More and more new private insurance companies are coming up year after year. And, these new and private life insurance companies adopt aggressive marketing strategies to introduce their products and to tap the potential policyholders. It is witnessed that new policies like ULIPs are introduced by these new private life insurance companies. It is in this concept this study has been undertaken to assess and analyze the preference of policyholders towards insurance services offered by public and private life insurance companies in Tirunelveli district.

Insurance coverage and care affordability in cancer survivors in 2016-2019.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1520-1520
Author(s):  
Justin Michael Barnes ◽  
Eric Adjei Boakye ◽  
Mario Schootman ◽  
Evan Michael Graboyes ◽  
Nosayaba Osazuwa-Peters
Keyword(s):  
United States ◽  
Cancer Survivors ◽  
Low Socioeconomic Status ◽  
Private Insurance ◽  
Insurance Coverage ◽  
The United States ◽  
Mediating Effect ◽  
Medicaid Expansion ◽  
Poverty Level ◽  
Linear Probability

1520 Background: The Affordable Care Act (ACA) led to improvements in insurance coverage and care affordability in cancer patients. However, the uninsured rate for the general US reached its nadir in 2016 and has been increasing since. We aimed to quantify the changes in insurance coverage and rate of care unaffordability in cancer survivors from 2016 to 2019. Methods: We queried data from the Behavioral Risk Factor Surveillance System (2016-2019) for cancer survivors ages 18-64 years. Outcomes of interest were the percentage of cancer survivors reporting insurance coverage and the percentage reporting cost-driven lack of care in the previous 12 months. Survey-weighted linear probability models adjusted for covariates (age, sex, race/ethnicity, income, education, marital status, and state Medicaid expansion status) were utilized to estimate the average yearly change (AYC) in the outcomes across 2016-2019. Mediation analyses evaluated the mediating effect of insurance coverage changes on changes in cost-driven lack of care. Results: A total of 178,931 cancer survivors were identified among the survey respondents. The percentage of insured cancer survivors between 2016 and 2019 decreased from 92.4% to 90.4% (AYC: -0.54, 95% CI = -1.03 to -0.06, P =.026). This translates to an estimated 164,638 cancer survivors in the United States who lost insurance coverage in the study period. There were decreases in private insurance coverage (AYC: -1.66, 95% CI = -3.1 to -0.22, P =.024) but increases in Medicaid coverage (AYC: 1.14, 95% CI = 0.03 to 2.25, P =.043). The decreases in any coverage were largest in individuals with income < 138% federal poverty level (FPL) (AYC: -1.14, 95% CI = -2.32 to 0.04, P =.059; compared to > 250% FPL, Pinteraction=.03). Cost-driven lack of care in the preceding 12 months among cancer survivors increased from 17.9% in 2016 to 20% in 2019 (AYC: 0.67, 95% CI = 0.06 to 1.27, P =.03), which translates to an estimated 167,184 survivors in the US who skipped care due to costs. Changes in insurance coverage mediated 27.5% of the observed change in care unaffordability overall (p =.028) and 65.7% in individuals with income < 138% FPL relative to > 250% FPL (p =.045). Conclusions: Between 2016 and 2019, about 165,000 cancer survivors in the United States lost their insurance coverage and a similar number may have skipped needed care due to cost. Loss of insurance coverage was mostly among individuals with low socioeconomic status. Interventions to improve health insurance coverage among cancer survivors, such as the recent executive order to strengthen the ACA and further efforts promoting Medicaid expansion in additional states, may be important factors to mitigate these trends.

Effectiveness of Customer Relationship Management Program in Insurance Companies

2013 ◽  
pp. 219-234
Author(s):  
Vikas Gautam
Keyword(s):  
Customer Relationship Management ◽  
Life Insurance ◽  
Insurance Industry ◽  
Private Insurance ◽  
Relationship Management ◽  
Management Program ◽  
Customer Relationship ◽  
Insurance Companies ◽  
Public And Private ◽  
Before And After

Customer relationship management in the insurance industry is in the nascent stage. Firms are framing new strategies to combat stiff competition. Public and private insurance companies are implementing customer relationship programs to attract more customers and retain existing customers. The objectives of this study are (1) to study the customer relationship management program of the Life Insurance Corporation of India, and (2) to assess the effectiveness of this customer relationship management program. The study is based on the opinion scores of 182 policyholders of Life Insurance Corporation of India, who have been with the company for more than the last five years. Based on the average opinion scores before and after the implementation of the Customer Relationship Management program, it was concluded that the program is effective, which was evidenced by the results obtained from statistical analysis (Paired sample t-test).

Utilization of Primary Health Services in Hong Kong

2015 ◽  
pp. 1159-1176
Author(s):  
Raymond K. H. Chan ◽  
Kang Hu
Keyword(s):  
Health Care ◽  
Hong Kong ◽  
Health Insurance ◽  
Health Services ◽  
Private Insurance ◽  
Public Health Services ◽  
Public And Private ◽  
The Public ◽  
Primary Health ◽  
Primary Health Services

This chapter analyzes the issue of primary health care utilization in Hong Kong and introduces the case of Hong Kong where a special division between public and private sectors has developed in the field of primary health services. The chapter argues that in the foreseeable future, it is likely that the division of health care between the public and private sector will be maintained. In recent years, more and more individuals and families have purchased private health insurance so as to gain more options. The idea of universal health insurance was rejected by the public in recent consultations; the current alternative is government-regulated private insurance. Although private primary health services will continue as usual in the near future, public primary health services should be maintained or even expanded. Given the costliness of private services (especially specialist services), it is recommended that more resources should be invested in corresponding public health services.

Health Care Policy in Argentina

2019 ◽  
Author(s):  
Giuseppe M. Messina
Keyword(s):  
Health Care ◽  
Health Care Policy ◽  
Private Insurance ◽  
Complex Structure ◽  
Occupational Status ◽  
Insurance Companies ◽  
Care Policy ◽  
Public And Private ◽  
Private Providers ◽  
Unequal Access

In Argentina, the provision of health care is divided into three components: a highly decentralized universal public sector, funded from general taxation; a constellation of compulsory collective insurance schemes, financed by contributions withdrawn from the salaries of workers in the formal labor market; and a system of private insurance companies used primarily by the middle and upper classes. Regarding the delivery of medical services, the configuration is mixed, as the weight of public and private providers is roughly equal. This complex structure, which derives from the historical development of particular institutions, produces high costs and unequal access to care according to a person’s geographical residence, occupational status, and purchasing power.

scholarly journals Prevalence of HIV and Treponema pallidum infections in pregnant women in Campinas and their association with socio-demographic factors

1996 ◽  
Vol 114 (2) ◽  
pp. 1108-1116 ◽  
Author(s):  
Eliana Amaral ◽  
Anibal Faúndes ◽  
Neiva Sellan Lopes Gonçales ◽  
Jordão Pellegrino Jr. ◽  
Carmino Antonio de Souza ◽  
...  
Keyword(s):  
Social Security ◽  
Private Insurance ◽  
Treponema Pallidum ◽  
Public Hospitals ◽  
Private Institutions ◽  
University Hospitals ◽  
Private Hospitals ◽  
Public And Private ◽  
Public And Private Hospitals ◽  
Socio Demographic Factors

The anonymous seroprevalence of HIV and syphilis was studied by collecting umbilical cord blood samples from 5,815 women who gave birth in Campinas' hospitals throughout a six-month period. ELISA and Western blot were used for HIV, and VDRL and TPHA for Treponema pallidum screening. While maintaining the anonymity of the women, information was recorded on the hospital of origin, divided into university (public) and private hospitals, as well as on the form of payment (social security, private insurance or direct payment), age, marital status, education, employment and place of residence. Seroprevalence was 0.42 percent for HIV and 1.16 percent for syphilis. There was a significant correlation between a positive reaction to the two infections (p=0.02). After univariate and logistic regression analysis, only university hospitals were shown to be associated with seropositivity for HIV, whereas the same variable and an older age were associated with syphilis. All positive reactions were found either in public hospitals or among social security patients treated at private institutions. The conclusion was that HIV infection is becoming almost as prevalent as syphilis among this population, and affects primarily the lower socio-economic strata. This suggests that routine, voluntary HIV serology should be considered and discussed with patients during prenatal or delivery care whenever a population shows a seroprevalence close to or greater than 1 percent.

‘User pays’ and other approaches to the funding of long-term care for older people in Australia

2000 ◽  
Vol 20 (1) ◽  
pp. 5-32 ◽  
Author(s):  
MICHAEL FINE ◽  
JENNY CHALMERS
Keyword(s):  
Older People ◽  
Private Insurance ◽  
Aged Care ◽  
Future Generations ◽  
Term Care ◽  
Public And Private ◽  
Alternative Funding ◽  
Care Services ◽  
The Cost

It has been argued that without some system in which future generations of users are able to pay for their care the cost of services for an increasingly large group of older people will be borne by a declining base of economically active younger people. Is the answer a user pays approach to the financing of aged care, as promoted by recent changes to aged care financing? This paper reviews this concept and its recent history in Australia. On the basis of a brief review of alternative funding systems, it also considers the potential of public and private insurance schemes to increase funding by potential service users and underwrite the long-term viability of funding for aged care services.

scholarly journals Primary health care pharmacists and vision for community pharmacy and pharmacists in Chile

2020 ◽  
Vol 18 (3) ◽  
pp. 2142
Author(s):  
Francisco Martinez-Mardones ◽  
Antonio Ahumada-Canale ◽  
Loreto Gonzalez-Machuca ◽  
Jose C. Plaza-Plaza
Keyword(s):  
Primary Care ◽  
Public Perception ◽  
Private Insurance ◽  
Pharmaceutical Services ◽  
Community Pharmacies ◽  
Care Model ◽  
Public And Private ◽  
Public System ◽  
Non Profit ◽  
The Public

The Chilean healthcare system is composed of public and private sectors, with most of the higher-income population being covered privately. Primary healthcare in the public system is provided in more than 2,500 public primary care centers of different sizes with assigned populations within territories. Private insurance companies have their own healthcare networks or buy services from individual health providers. Patients from the public system receive most medications free of charge in primary care pharmacies embedded in each care center. Private patients must purchase their medicines from community pharmacies. Some government policies subsidize part of the cost of medications, but original medicines remain as the most expensive of Latin America. Three chain pharmacies have more than 90% of the market share, and these pharmacies have negative public perception because of price collusion court sentences. A non-profit, municipal pharmacy model was developed but has limited implementation. Most privately owned independent and chain community pharmacies do not provide pharmaceutical services as there is no remuneration or cover by insurers. The limited number of publicly owned Municipal pharmacies could implement pharmaceutical services in community settings as they are non-profit establishments and have full-time pharmacists but are not resourced for these services. A limited number of pharmaceutical services are almost exclusively provided in public primary care, including medication reviews, pharmaceutical education, home visits and pharmacovigilance services, but several barriers to their implementation remain. A risk-based multimorbidity care model was implemented in 2020 for public primary care with additional employment of part-time pharmacists to provide services. We believe that this model will help pharmacists to optimize their time by prioritizing the much-needed clinical tasks. We propose within this multimorbidity care model that the more time-consuming services are provided to higher risk patients. Pharmacy prescribing i.e. amending or approving changes in medications in primary care for chronic conditions could also be useful for the health system, but pharmacists would require additional training. The landscape for pharmaceutical services for primary care in Chile is promising, but the integration with community pharmacies will not be possible until they are funded by public and private insurance, and the public perception of these establishments is improved.

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