carolyn engelhard - Academia.edu (original) (raw)
Papers by carolyn engelhard
Gynecologic Oncology, Aug 1, 2013
This installment of Law and the Public's Health provides an overview of the Patient Protection an... more This installment of Law and the Public's Health provides an overview of the Patient Protection and Affordable Care Act, signed into law on March 23, 2010. The Act represents a watershed in U.S. public health policy. When fully implemented, its insurance reforms are expected to lead to coverage of 94% of the population, and its health-care provisions lay the groundwork for the fundamental transformation of the health-care system.
Gynecologic Oncology, Aug 1, 2013
This installment of Law and the Public's Health provides an overview of the Patient Protection an... more This installment of Law and the Public's Health provides an overview of the Patient Protection and Affordable Care Act, signed into law on March 23, 2010. The Act represents a watershed in U.S. public health policy. When fully implemented, its insurance reforms are expected to lead to coverage of 94% of the population, and its health-care provisions lay the groundwork for the fundamental transformation of the health-care system.
INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2011
Stuart Altman is the dean of American health policy scholars. For more than 40 years he has refle... more Stuart Altman is the dean of American health policy scholars. For more than 40 years he has reflected, written, and taught about American health policy, working from his home at the Heller School at Brandeis University. He also, however, has played major roles in shaping our nation’s policy through his chairmanship of the Prospective Payment Advisory Commission, his membership in the Bipartisan Commission on the Future of Medicare, and his advising of a series of presidents, both formally and informally, as they led health reform efforts. This book, which Altman has written with his collaborator and colleague at Brandeis, writer David Shactman, is part history, part memoir, and part economic and political analysis. Though written somewhat awkwardly in the third person, it is in large part an account of Altman’s personal experiences in shaping and analyzing health policy since the 1970s. Altman brings to the book his extensive knowledge of the relevant literature, as well as his glea...
Copyright © 2013 Kathleen A. McManus et al. This is an open access article distributed under the ... more Copyright © 2013 Kathleen A. McManus et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. AIDS Drug Assistance Programs, enacted through the Ryan White Comprehensive AIDS Resources Emergency Act of 1990, are the “payer of last resort ” for prescription medications for lower income, uninsured, or underinsured people living with HIV/AIDS. ADAPs face declining funding from the federal government. State funding of ADAP is discretionary, but some states increased their contributions to meet the gap in funding. The demand for ADAP support is increasing as people living with HIV are living longer; the antiretroviral therapy (ART) guidelines have been changed to recommend initiation of treatment for all; the United States is increasing HIV testing goals; and the recession continues. In the setting of increased demand and lim...
Choice Reviews Online, 2007
Some people may be laughing when looking at you reading in your spare time. Some may be admired o... more Some people may be laughing when looking at you reading in your spare time. Some may be admired of you. And some may want be like you who have reading hobby. What about your own feel? Have you felt right? Reading is a need and a hobby at once. This condition is the on that will make you feel that you must read. If you know are looking for the book enPDFd health care half truths too many myths not enough reality american political challenges as the choice of reading, you can find here.
Journal of Pediatric Nursing, 1996
Address reprint requests to Stephanies L. Ferguson, PhD, RN, 2029 Golf Course Drive, Reston, VA 2... more Address reprint requests to Stephanies L. Ferguson, PhD, RN, 2029 Golf Course Drive, Reston, VA 20191-1968. ... No abstract is available. To read the body of this article, please view the PDF online. ... Visit SciVerse ScienceDirect to see if you have access via your ...
Open Forum Infectious Diseases
Background For year 1 of the Affordable Care Act (ACA), Virginia AIDS Drug Assistance Program (AD... more Background For year 1 of the Affordable Care Act (ACA), Virginia AIDS Drug Assistance Program (ADAP) clients with Qualified Health Plans (QHPs) achieved a higher rate of viral suppression. This study characterizes the demographic and health care delivery factors associated with QHP enrollment in year 2 and assesses the relationship between 2015 QHP coverage and HIV viral suppression. Methods The cohort included Virginia ADAP clients who were eligible for ADAP-funded QHPs. Data were collected from 2014 to 2015. Multivariable binary logistic regression was conducted to assess the association of demographic and health care delivery factors with QHP enrollment and viral suppression. Results In year 2, 63% of the cohort (n = 4631) enrolled in QHPs; 2015 ADAP-funded QHP enrollment was associated with 2014 ADAP-funded QHP (adjusted odds ratio [aOR], 111.11; 95% confidence interval [CI], 90.91–166.67), 2014 engagement in care (aOR, 2.16; 95% CI, 1.65–2.82), age (P < .001), race/ethnicity...
Southern Medical Journal
People living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS... more People living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) often are uninsured or underinsured, and they may benefit from the Patient Protection and Affordable Care Act (PL 111-148) and its improved access to medical care. Safety net programs, such as AIDS Drug Assistance Programs (ADAP) funded through the Ryan White HIV/AIDS Program, which serve low-income people living with HIV, are incorporating Patient Protection and Affordable Care Act Marketplace-qualified health plans (QHPs) and helping to fund patients' participation. This changing landscape differs from state to state, and one main element contributing to the differing situations is whether a state elected to expand Medicaid. This review examines QHP enrollment of ADAP clients in Virginia, a Medicaid nonexpansion state, and explores some issues that affect people living with HIV in other Medicaid nonexpansion states. Virginia is a leader in the shift of ADAP healthcare delivery from direct medication provision to purchasing QHPs. Virginia ADAP clients accounted for approximately 2% of ADAP clients nationally, but they represent 17% of ADAP clients enrolled in QHPs nationwide. Ensuring good HIV care of the ADAP population is important to each patient's personal longevity, the public health, and the efficient use of healthcare dollars. As healthcare delivery models shift, the effects on patients and health outcomes achieved should be monitored, particularly for chronic diseases such as HIV.
Open Forum Infectious Diseases
Clinical Infectious Diseases, 2016
Berry et al on pages 387-95, and the Editorial Commentary by Eaton and Mugavero on pages 404-6.) ... more Berry et al on pages 387-95, and the Editorial Commentary by Eaton and Mugavero on pages 404-6.) Background. With the Patient Protection and Affordable Care Act, many state AIDS Drug Assistance Programs (ADAPs) shifted their healthcare delivery model from direct medication provision to purchasing qualified health plans (QHPs). The objective of this study was to characterize the demographic and healthcare delivery factors associated with Virginia ADAP clients' QHP enrollment and to assess the relationship between QHP coverage and human immunodeficiency virus (HIV) viral suppression. Methods. The cohort included persons living with HIV who were enrolled in the Virginia ADAP (n = 3933). Data were collected from 1 January 2013 through 31 December 2014. Multivariable binary logistic regression was conducted to assess for associations with QHP enrollment and between QHP coverage and viral load (VL) suppression. Results. In the cohort, 47.1% enrolled in QHPs, and enrollment varied significantly based on demographic and healthcare delivery factors. In multivariable binary logistic regression, controlling for time, age, sex, race/ethnicity, and region, factors significantly associated with achieving HIV viral suppression included QHP coverage (adjusted odds ratio, 1.346; 95% confidence interval, 1.041-1.740; P = .02), an initially undetectable VL (2.809; 2.174-3.636; P < .001), HIV rather than AIDS disease status (1.377; 1.049-1.808; P = .02), and HIV clinic (P < .001). Conclusions. QHP coverage was associated with viral suppression, an essential outcome for individuals and for public health. Promoting QHP coverage in clinics that provide care to persons living with HIV may offer a new opportunity to increase rates of viral suppression.
Virginia medical quarterly: VMQ
AWHONN Lifelines
The Art of Legislating QuaIitzj an JEconomy T f 1996 goes down on record as the year consumers ra... more The Art of Legislating QuaIitzj an JEconomy T f 1996 goes down on record as the year consumers rallied benefits were limited or reduced. In against managed care company practices of rationing health fact, est increase in aggregate growth in 30 care, then nurses will continue to see attempts at tempering are showing the low-(Levit. 1996).
Inquiry: a journal of medical care organization, provision and financing
Trends in health care, law & ethics
1. Trends Health Care Law Ethics. 1995 Winter-Spring;10(1-2):11-4, 71-2. Caveat emptor: the cost ... more 1. Trends Health Care Law Ethics. 1995 Winter-Spring;10(1-2):11-4, 71-2. Caveat emptor: the cost of managed care. Engelhard CL, Childress JF. PMID: 7655220 [PubMed - indexed for MEDLINE]. MeSH Terms. Choice Behavior; ...
AIDS Research and Treatment, 2013
AIDS Drug Assistance Programs, enacted through the Ryan White Comprehensive AIDS Resources Emerge... more AIDS Drug Assistance Programs, enacted through the Ryan White Comprehensive AIDS Resources Emergency Act of 1990, are the “payer of last resort” for prescription medications for lower income, uninsured, or underinsured people living with HIV/AIDS. ADAPs face declining funding from the federal government. State funding of ADAP is discretionary, but some states increased their contributions to meet the gap in funding. The demand for ADAP support is increasing as people living with HIV are living longer; the antiretroviral therapy (ART) guidelines have been changed to recommend initiation of treatment for all; the United States is increasing HIV testing goals; and the recession continues. In the setting of increased demand and limited funding, ADAPs are employing cost containment measures. Since 2010, emergency federal funds have bailed out ADAP, but these are not sustainable. In the coming years, providers and policy makers associated with HIV care will need to navigate the implementa...
The American Heart Hospital Journal, 2007
AWHONN Lifelines, 2006
The Art of Legislating QuaIitzj an JEconomy T f 1996 goes down on record as the year consumers ra... more The Art of Legislating QuaIitzj an JEconomy T f 1996 goes down on record as the year consumers rallied benefits were limited or reduced. In against managed care company practices of rationing health fact, est increase in aggregate growth in 30 care, then nurses will continue to see attempts at tempering are showing the low-(Levit. 1996).
New England Journal of Medicine, 2010
1. N Engl J Med. 2010 Jul 21. [Epub ahead of print] Truth and Consequences -- Insurance-Premium R... more 1. N Engl J Med. 2010 Jul 21. [Epub ahead of print] Truth and Consequences -- Insurance-Premium Rate Regulation and the ACA. Mills A, Engelhard CL, Tereskerz PM. From the Program in Ethics and Policy in Healthcare Systems ...
Gynecologic Oncology, Aug 1, 2013
This installment of Law and the Public's Health provides an overview of the Patient Protection an... more This installment of Law and the Public's Health provides an overview of the Patient Protection and Affordable Care Act, signed into law on March 23, 2010. The Act represents a watershed in U.S. public health policy. When fully implemented, its insurance reforms are expected to lead to coverage of 94% of the population, and its health-care provisions lay the groundwork for the fundamental transformation of the health-care system.
Gynecologic Oncology, Aug 1, 2013
This installment of Law and the Public's Health provides an overview of the Patient Protection an... more This installment of Law and the Public's Health provides an overview of the Patient Protection and Affordable Care Act, signed into law on March 23, 2010. The Act represents a watershed in U.S. public health policy. When fully implemented, its insurance reforms are expected to lead to coverage of 94% of the population, and its health-care provisions lay the groundwork for the fundamental transformation of the health-care system.
INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2011
Stuart Altman is the dean of American health policy scholars. For more than 40 years he has refle... more Stuart Altman is the dean of American health policy scholars. For more than 40 years he has reflected, written, and taught about American health policy, working from his home at the Heller School at Brandeis University. He also, however, has played major roles in shaping our nation’s policy through his chairmanship of the Prospective Payment Advisory Commission, his membership in the Bipartisan Commission on the Future of Medicare, and his advising of a series of presidents, both formally and informally, as they led health reform efforts. This book, which Altman has written with his collaborator and colleague at Brandeis, writer David Shactman, is part history, part memoir, and part economic and political analysis. Though written somewhat awkwardly in the third person, it is in large part an account of Altman’s personal experiences in shaping and analyzing health policy since the 1970s. Altman brings to the book his extensive knowledge of the relevant literature, as well as his glea...
Copyright © 2013 Kathleen A. McManus et al. This is an open access article distributed under the ... more Copyright © 2013 Kathleen A. McManus et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. AIDS Drug Assistance Programs, enacted through the Ryan White Comprehensive AIDS Resources Emergency Act of 1990, are the “payer of last resort ” for prescription medications for lower income, uninsured, or underinsured people living with HIV/AIDS. ADAPs face declining funding from the federal government. State funding of ADAP is discretionary, but some states increased their contributions to meet the gap in funding. The demand for ADAP support is increasing as people living with HIV are living longer; the antiretroviral therapy (ART) guidelines have been changed to recommend initiation of treatment for all; the United States is increasing HIV testing goals; and the recession continues. In the setting of increased demand and lim...
Choice Reviews Online, 2007
Some people may be laughing when looking at you reading in your spare time. Some may be admired o... more Some people may be laughing when looking at you reading in your spare time. Some may be admired of you. And some may want be like you who have reading hobby. What about your own feel? Have you felt right? Reading is a need and a hobby at once. This condition is the on that will make you feel that you must read. If you know are looking for the book enPDFd health care half truths too many myths not enough reality american political challenges as the choice of reading, you can find here.
Journal of Pediatric Nursing, 1996
Address reprint requests to Stephanies L. Ferguson, PhD, RN, 2029 Golf Course Drive, Reston, VA 2... more Address reprint requests to Stephanies L. Ferguson, PhD, RN, 2029 Golf Course Drive, Reston, VA 20191-1968. ... No abstract is available. To read the body of this article, please view the PDF online. ... Visit SciVerse ScienceDirect to see if you have access via your ...
Open Forum Infectious Diseases
Background For year 1 of the Affordable Care Act (ACA), Virginia AIDS Drug Assistance Program (AD... more Background For year 1 of the Affordable Care Act (ACA), Virginia AIDS Drug Assistance Program (ADAP) clients with Qualified Health Plans (QHPs) achieved a higher rate of viral suppression. This study characterizes the demographic and health care delivery factors associated with QHP enrollment in year 2 and assesses the relationship between 2015 QHP coverage and HIV viral suppression. Methods The cohort included Virginia ADAP clients who were eligible for ADAP-funded QHPs. Data were collected from 2014 to 2015. Multivariable binary logistic regression was conducted to assess the association of demographic and health care delivery factors with QHP enrollment and viral suppression. Results In year 2, 63% of the cohort (n = 4631) enrolled in QHPs; 2015 ADAP-funded QHP enrollment was associated with 2014 ADAP-funded QHP (adjusted odds ratio [aOR], 111.11; 95% confidence interval [CI], 90.91–166.67), 2014 engagement in care (aOR, 2.16; 95% CI, 1.65–2.82), age (P < .001), race/ethnicity...
Southern Medical Journal
People living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS... more People living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) often are uninsured or underinsured, and they may benefit from the Patient Protection and Affordable Care Act (PL 111-148) and its improved access to medical care. Safety net programs, such as AIDS Drug Assistance Programs (ADAP) funded through the Ryan White HIV/AIDS Program, which serve low-income people living with HIV, are incorporating Patient Protection and Affordable Care Act Marketplace-qualified health plans (QHPs) and helping to fund patients' participation. This changing landscape differs from state to state, and one main element contributing to the differing situations is whether a state elected to expand Medicaid. This review examines QHP enrollment of ADAP clients in Virginia, a Medicaid nonexpansion state, and explores some issues that affect people living with HIV in other Medicaid nonexpansion states. Virginia is a leader in the shift of ADAP healthcare delivery from direct medication provision to purchasing QHPs. Virginia ADAP clients accounted for approximately 2% of ADAP clients nationally, but they represent 17% of ADAP clients enrolled in QHPs nationwide. Ensuring good HIV care of the ADAP population is important to each patient's personal longevity, the public health, and the efficient use of healthcare dollars. As healthcare delivery models shift, the effects on patients and health outcomes achieved should be monitored, particularly for chronic diseases such as HIV.
Open Forum Infectious Diseases
Clinical Infectious Diseases, 2016
Berry et al on pages 387-95, and the Editorial Commentary by Eaton and Mugavero on pages 404-6.) ... more Berry et al on pages 387-95, and the Editorial Commentary by Eaton and Mugavero on pages 404-6.) Background. With the Patient Protection and Affordable Care Act, many state AIDS Drug Assistance Programs (ADAPs) shifted their healthcare delivery model from direct medication provision to purchasing qualified health plans (QHPs). The objective of this study was to characterize the demographic and healthcare delivery factors associated with Virginia ADAP clients' QHP enrollment and to assess the relationship between QHP coverage and human immunodeficiency virus (HIV) viral suppression. Methods. The cohort included persons living with HIV who were enrolled in the Virginia ADAP (n = 3933). Data were collected from 1 January 2013 through 31 December 2014. Multivariable binary logistic regression was conducted to assess for associations with QHP enrollment and between QHP coverage and viral load (VL) suppression. Results. In the cohort, 47.1% enrolled in QHPs, and enrollment varied significantly based on demographic and healthcare delivery factors. In multivariable binary logistic regression, controlling for time, age, sex, race/ethnicity, and region, factors significantly associated with achieving HIV viral suppression included QHP coverage (adjusted odds ratio, 1.346; 95% confidence interval, 1.041-1.740; P = .02), an initially undetectable VL (2.809; 2.174-3.636; P < .001), HIV rather than AIDS disease status (1.377; 1.049-1.808; P = .02), and HIV clinic (P < .001). Conclusions. QHP coverage was associated with viral suppression, an essential outcome for individuals and for public health. Promoting QHP coverage in clinics that provide care to persons living with HIV may offer a new opportunity to increase rates of viral suppression.
Virginia medical quarterly: VMQ
AWHONN Lifelines
The Art of Legislating QuaIitzj an JEconomy T f 1996 goes down on record as the year consumers ra... more The Art of Legislating QuaIitzj an JEconomy T f 1996 goes down on record as the year consumers rallied benefits were limited or reduced. In against managed care company practices of rationing health fact, est increase in aggregate growth in 30 care, then nurses will continue to see attempts at tempering are showing the low-(Levit. 1996).
Inquiry: a journal of medical care organization, provision and financing
Trends in health care, law & ethics
1. Trends Health Care Law Ethics. 1995 Winter-Spring;10(1-2):11-4, 71-2. Caveat emptor: the cost ... more 1. Trends Health Care Law Ethics. 1995 Winter-Spring;10(1-2):11-4, 71-2. Caveat emptor: the cost of managed care. Engelhard CL, Childress JF. PMID: 7655220 [PubMed - indexed for MEDLINE]. MeSH Terms. Choice Behavior; ...
AIDS Research and Treatment, 2013
AIDS Drug Assistance Programs, enacted through the Ryan White Comprehensive AIDS Resources Emerge... more AIDS Drug Assistance Programs, enacted through the Ryan White Comprehensive AIDS Resources Emergency Act of 1990, are the “payer of last resort” for prescription medications for lower income, uninsured, or underinsured people living with HIV/AIDS. ADAPs face declining funding from the federal government. State funding of ADAP is discretionary, but some states increased their contributions to meet the gap in funding. The demand for ADAP support is increasing as people living with HIV are living longer; the antiretroviral therapy (ART) guidelines have been changed to recommend initiation of treatment for all; the United States is increasing HIV testing goals; and the recession continues. In the setting of increased demand and limited funding, ADAPs are employing cost containment measures. Since 2010, emergency federal funds have bailed out ADAP, but these are not sustainable. In the coming years, providers and policy makers associated with HIV care will need to navigate the implementa...
The American Heart Hospital Journal, 2007
AWHONN Lifelines, 2006
The Art of Legislating QuaIitzj an JEconomy T f 1996 goes down on record as the year consumers ra... more The Art of Legislating QuaIitzj an JEconomy T f 1996 goes down on record as the year consumers rallied benefits were limited or reduced. In against managed care company practices of rationing health fact, est increase in aggregate growth in 30 care, then nurses will continue to see attempts at tempering are showing the low-(Levit. 1996).
New England Journal of Medicine, 2010
1. N Engl J Med. 2010 Jul 21. [Epub ahead of print] Truth and Consequences -- Insurance-Premium R... more 1. N Engl J Med. 2010 Jul 21. [Epub ahead of print] Truth and Consequences -- Insurance-Premium Rate Regulation and the ACA. Mills A, Engelhard CL, Tereskerz PM. From the Program in Ethics and Policy in Healthcare Systems ...