Kaiser Permanente Announces HIV Challenge

Jan30 by D Gregory Smith

When healthcare gets it right, I think it’s important to notice.
Contrary to the HMO stereotype, Kaiser Permanente has taken on the challenge of HIV and instituted policies and guidelines for the effective care and treatment of persons with HIV- to dramatic effect:

English: The Ordway Building, One Kaiser Plaza...

Image via Wikipedia

Kaiser Permanente announced (January 26th) the Kaiser Permanente HIV Challenge to help health care providers nationwide improve health equity for people living with HIV by increasing access to HIV care and improving health outcomes.

The HIV Challenge was announced at the Center for Medicare & Medicaid Innovation Care Innovations Summit in Washington, D.C. ( www.hcidc.org ).

Kaiser Permanente, the nation’s largest nonprofit health care provider, has treated more than 60,000 people since the HIV epidemic emerged 30 years ago, and has reduced disparities among its current HIV population of more than 20,000 people by working to meet or exceed the objectives of the U.S. National HIV / AIDS Strategy.

The crux of the HIV Challenge (kp.org/hivchallenge) is to challenge other private health care providers and public and community health clinics to increase the number of HIV-positive people getting effective treatment by sharing Kaiser Permanente’s toolkit of clinical best practices, provider and patient education materials, mentoring, training and health IT expertise.

(Watch the excellent video series about Kaiser’s HIV Challenge here)

HIV is still an epidemic in the United States, with 56,000 people becoming infected each year and more than 1.1 million Americans living with HIV, but one in five people with HIV don’t know they are infected.

“The organizations presenting challenges here today are pushing the best minds in the country to create a better health care system. They represent exciting solutions to help address some of the nation’s most urgent health needs,” said CMS Acting Administrator Marilyn Tavenner.

Health care disparities are gaps in the quality of care associated with inequities encountered by racial, ethnic, poor and marginalized groups. The HIV Challenge is part of Kaiser Permanente’s larger work to identify, measure, research and eliminate disparities in health and health care in the United States. To learn more go to kp.org/healthdisparities.

“Too many people are unaware they have HIV because access to effective prevention and care is insufficient,” said Michael Horberg, MD, director of HIV/AIDS for Kaiser Permanente, executive director of research for Mid-Atlantic Permanente Medical Group, and a member of the Presidential Advisory Council on HIV/AIDS. “People with HIV need to get into treatment because quality HIV treatment prevents others from getting infected. Patients on effective therapy and better case management are living longer and more productive lives. However, quality HIV treatment requires effort.”

Kaiser Permanente has demonstrated excellence in HIV clinical care outcomes with:

HIV mortality rates that are half the national average
94 percent median treatment adherence among patients regularly in care and on antiretroviral therapy
No disparities among its black and Latino HIV-positive patients for both mortality and medication rates, compared to a 15 percent higher rate in the United States for mortality and for medication
89 percent of its HIV-positive patients are in HIV-specific care within 90 days, compared to 50 percent in the U.S. within one year
69 percent of all its HIV-positive patients have maximal viral control compared to 19 percent to 35 percent nationally

As part of its HIV Challenge effort, Kaiser Permanente is sharing these best practices and tools for private health care providers and community health clinics to replicate: quality improvement programs that measure gaps in care; testing, prevention and treatment guidelines; how to set up multi-disciplinary care team models that emphasize the “medical home” so HIV specialists, care managers, clinical pharmacists and providers work together; and education for both the provider and patient.

For more details on the HIV Challenge, to download the best-practices toolkit and to watch videos of success stories in setting up HIV clinics and reducing disparities, go to: kp.org/hivchallenge

“Our success in the treatment of patients with HIV/AIDS results from the excellence of our clinicians, our advanced IT systems, our integrated delivery system and our effective coordination across specialties,” said Robert Pearl, MD, chief executive officer and executive medical director of The Permanente Medical Group and Mid-Atlantic Permanente Medical Group. “In the same way that we have reduced the chances of our patients dying from cardiovascular disease and cancer significantly below the national averages, we have achieved outstanding clinical outcomes for our patients with HIV/AIDS.”

The National HIV/AIDS Strategy ( http://www.aids.gov/federal-resources/policies/national-hiv-aids-strategy/ ) calls for increased testing so that all Americans can know their HIV status, increased access to culturally sensitive prevention messages, community-targeted prevention and condom and clean needle access. NHAS also calls for improving access to quality HIV care because HIV medications not only improve individuals’ health and extend their life expectancy, they also reduce their risk of transmitting HIV to others. A recent scientific study found that effectively treating HIV patients with antiretroviral medications reduces HIV transmission by 96 percent. The study, known as HPTN 052, found that treating people with antiretroviral drugs before they are symptomatic can reduce the amount of virus in the blood sufficiently to reduce the risk of sexual transmission of HIV to an uninfected partner.

The Kaiser Permanente HIV Challenge is part of Kaiser Permanente’s ongoing research of HIV and HIV treatment. Published Kaiser Permanente research studies include:

A study that found there are no disparities by race or ethnicity in risk of AIDS and death among HIV-infected patients in a setting of similar access to care, despite lower anti-retroviral therapy adherence among Latinos and blacks compared to whites.
A study that found HIV-infected patients are at increased risk for cancer as a result of both their impaired immune system and lifestyle factors, such as smoking.
A study that found 17 measures, such as screening and prevention for infections and monitoring of antiretroviral therapy, should be adopted uniformly to improve the quality of HIV care and treatment nationwide.
A study that found that cholesterol medications can work well among certain HIV patients who are at risk for cardiovascular disease.

About the Care Innovations Summit:

Sponsored jointly by the Department of Health and Human Services, the Centers for Medicare & Medicaid Services, Health Affairs, and the West Wireless Health Institute, the Care Innovations Summit brings together more than 1,000 health care leaders, entrepreneurs, innovators, government officials, and finance experts to stimulate investment in a high-quality, sustainable health care system. Made possible by the Affordable Care Act and the Obama Administration’s commitment to open government, the Summit represents a new opportunity for industry and government to work together to help spur innovation in the public and private sectors to improve health care quality as never before and lower costs through improvement.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 8.9 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: http://www.kp.org/newscenter .

For more information:
Danielle Cass, danielle.x.cass@kp.org, 510-267-5354
Farra Levin, farra.r.levin@kp.org, 510-267-7364

SOURCE Kaiser Permanente

Kaiser Plays Key Role In Nationwide AIDS Treatment Challenge (sanfrancisco.cbslocal.com)
AIDS: “The Unnecessary Epidemic” (dgsma.wordpress.com)
Kaiser study: Cancers more likely for HIV-positive (sfgate.com)
Earlier antiretroviral therapy might reduce the burden of cancer in those with HIV (eurekalert.org)

Lesbian Healthcare Study

Jan28 by D Gregory Smith

I like to help students out- especially when it involves greater understanding of our community. Please pass along to others who may qualify.

LESBIAN RESEARCHER SEEKING PARTICIPANTS FOR STUDY ON LESBIANS’ EXPERIENCES WITH HEALTHCARE PROFESSIONALS
My name is Melissa St. Pierre and I am a lesbian doctoral student from the University of Windsor (ON, Canada). I am looking for women who are interested in participating in a research study. You can participate if:

You are a lesbian.

You are 16 years or older and live in Canada
OR
You are 18 years or older and live in the United States

Chance to win 1 of 5 $100 cash prizes!

This study has received clearance from the University of Windsor’s Research Ethics Board.

To find out more, go to: http://www.uwindsor.ca/lesbianhealthstudy. Questions? Prefer to fill out a paper survey? Contact me at stpier4@uwindsor.ca or at 519-253-3000 ext. 4703.

Lesbo-Care: A Viable Healthcare Option That Also Fights Terrorism (sweetmotherlover.wordpress.com)
Lesbians And Bi-Sexual Women Show Increased Breast Cancer Risk (medicalnewstoday.com)
Study: Adolescent Children Of Lesbian Parents Are Just As Well-Adjusted As Peers From Opposite-Sex Couples (thinkprogress.org)
New Study Proves Lesbians To Be Better Parents (practikel.com)

Rehberg Supports Raising Medicare Premiums

Dec14 by D Gregory Smith

Millionaire Congressman Dennis Rehberg is throwing his support behind a controversial proposal that will raise Medicare premiums for one out of four seniors.

Image by DonkeyHotey via Flickr

After voting twice this year to force major cuts to Medicare, Rehberg falsely claimed he was the “only member of Montana’s delegation who has consistently voted to protect Medicare and Social Security.” [Lee Newspapers, 12/4/2011]

Now he’s poised to hurt Medicare again by supporting the controversial House payroll tax holiday.

According to the Associated Press, Rehberg’s plan will be paid for by raising Medicare premiums on seniors, a proposal that would “expand over time to include the highest-earning one-fourth of seniors.”

Both Senators Jon Tester and Max Baucus have voted for alternative plans to extend the payroll tax holiday for middle class families, through higher taxes on only millionaires.

According to the Associated Press:

“Raising taxes on millionaires may be a non-starter for Republicans, but they seem to have no problem hiking Medicare premiums for retirees making a lot less.” [Associated Press, 12/13/2011]

“This couldn’t be a more clear example of Dennis Rehberg sticking up for his fellow multimillionaires while sticking it to middle-class Montana seniors,” said Ted Dick, Executive Director of the Montana Democratic Party. “Dennis Rehberg has forgotten who he’s working for, and it’s clear whose side he’s on: the special interests who have bankrolled his 35-year career in politics.”

Rehberg recently touted the controversial House payroll tax plan after he inserted a rider in the legislation, despite his promise last year to abandon the practice of inserting irrelevant riders to bills.

MT Democrats: Rehberg’s Long Record Of Taxpayer Handouts To CEO’s (dgsma.wordpress.com)
World AIDS Day in Montana (dgsma.wordpress.com)

Rehberg’s Ridiculous Healthcare Bill: Resurrecting Non-Science-Based Prevention Policies

Oct3 by D Gregory Smith

Rehberg’s apparently not swayed by the people in his state affected by HIV. Nor is he swayed by science.

From The AIDS Institute:

“If ever passed, this spending bill would set back the progress we are making in preventing HIV and providing basic care and treatment for those who have HIV/AIDS in our country,” commented Carl Schmid, Deputy Executive Director of The AIDS Institute.

House Labor, HHS, Education and Related Agencies Appropriations Subcommittee Chairman Denny Rehberg (R-MT) introduced a fiscal year 2012 spending bill that guts many programs, including health reform, and resurrects non-science based prevention policies.

Most disappointing is how the bill would impede prevention. Rehberg’s bill would cut by nearly $33 million funding for the Centers for Disease Control and Prevention’s (CDC) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. This is despite an estimated 50,000 new HIV infections each year and over 230,000 people unaware of their infection. The U.S. government invests only about 3 percent of its HIV funding in prevention. The lifetime cost of caring and treating one person with HIV is approximately $360,000. In order to help achieve the goals of the National HIV/AIDS Strategy to reduce the number of new infections and increase testing levels by 2015, the President has proposed an increase of $57 million for HIV prevention in FY12.

On top of cutting CDC’s budget, the bill would ban federal funding of syringe exchange programs, a scientifically proven method to prevent HIV and other infections while not increasing drug use, and would resurrect failed abstinence only until marriage programs. Additionally, the bill would decimate the Teen Pregnancy Prevention Program by cutting its budget from $105 million to $20 million, eliminate all Title X spending, which funds HIV testing programs for women, and the entire Prevention and Public Health Fund.

The House bill proposes to flat fund the entire Ryan White HIV/AIDS Program, which provides care and treatment to over 550,000 low-income people with HIV/AIDS. It fails to address the crisis in the Ryan White AIDS Drug Assistance Program (ADAP). There are currently over 8,500 people in nine states on ADAP waiting lists and over 445 people in six states who have been disenrolled from the program due to budget constraints and growing enrollment. The AIDS Institute and its partners have been advocating for an increase of at least $106 million. The President has requested a $55 million increase. In order to address the current wait list, an increase of approximately $98 million would be required.

Chairman Rehberg’s bill also prevents implementation of much of the Affordable Care Act, which once fully implemented, would both bring many people with HIV/AIDS into lifesaving care and treatment for the first time and help to prevent HIV.

The one bright spot in the bill is Rehberg’s proposal to increase medical research spending at the National Institutes of Health by $1 billion.

“While we realize we are living in very difficult fiscal times, this bill is not just about making difficult funding decisions, but about resurrecting many controversial policies that will never pass the Congress nor be signed by the President,” commented Michael Ruppal, Executive Director of The AIDS Institute. “As Congress finalizes its FY12 spending bill, The AIDS Institute will work with the House, Senate and the Administration to increase, rather than cut funding for prevention and adequately fund all parts of the Ryan White Program, including ADAP. Additionally, we will work to defeat all extreme policy riders.

The bill (HR 3070) has not been formally considered by the House Appropriations Subcommittee. The Senate Appropriations Committee already has passed its own version of the bill. Since Congress has not passed any spending measures, the government is currently operating under a short term continuing resolution.

This schmuck is completely unwilling to listen to facts- or to believe that HIV is in Montana, and it poses particular problems for his constituents. Maybe it’s time to educate him.

Call his office: (202) 225-3211

ADAP Waiting List Passes 9,000

Aug13 by D Gregory Smith

As of August 4th – and for the first time ever – the number of people lingering on AIDS Drug Assistance Program wait lists passed 9,000. A total of 9,039 people in 13 states are now unable to access their medications via the programs, which provide drugs to under and un-insured individuals who are not eligible for other programs such as Medicaid. What’s more, Alabama, which already had a wait list, has reduced its program’s formulary, while Illinois, which already had expenditure caps, has lowered its program’s financial eligibility to 300% the Federal Poverty Level. This brings the total number of states that have enacted “cost-containment” measures to eighteen, plus Puerto Rico.

For more information on the nation’s ADAP crisis, visit www.ADAPaction.org.