ACP offers recommendations to support LGBTQ+ health care equity

Embargoed for release until 5:00 p.m. ET on Monday 24 June 2024     

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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.     
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1. ACP Offers Recommendations to Support LGBTQ+ Health Care Equity 

Abstract: https://www.acpjournals.org/doi/10.7326/M24-0636  

URL goes live when the embargo lifts        

Although progress has been made in addressing health disparities and reducing social inequality for lesbian, gay, bisexual, transgender, queer and other sexual or gender minority (LGBTQ+) populations, new challenges have surfaced that harm the health and well-being of those populations, says the American College of Physicians (ACP). A new policy paper published today in Annals of Internal Medicine reaffirms and updates ACP’s policies on LGBTQ+ health.  

 

The authors suggest that ACP is extremely concerned about discrimination against LGBTQ+ individuals. They say that health is a human right that entails an ethical obligation of society to provide access to health care, according to its resources and means, to its members. ACP says physicians and other health professionals should be aware of the complex social and health issues that uniquely and disproportionately affect LGBTQ+ populations. 

 

Research and medical understanding of LGBTQ+ health issues have evolved since ACP’s last position paper on the topic. The updated policy paper offers recommendations about how to improve health care equity and reduce social stigma. It voices ACP’s support for access to evidence-based gender-affirming care, coverage for that care, and research into improving care for transgender and gender-diverse individuals. The recommendations also include incorporating LGBTQ+ health into medical education and support for programs to help recruit LGBTQ+ persons into the practice of medicine. The paper further recommends implementing public policies that protect the civil rights of LGBTQ+ peoples and uphold one’s ability to take part in all aspects of public life consistent with their gender identity, including access to governmental services, public facilities, and basic human facilities.  

 

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with someone from ACP, please contact Andy Hachadorian at ahachadorian@acponline.org.  

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2. Medicare Advantage enrollment does not necessarily improve financial outcomes for enrollees 

Abstract: https://www.acpjournals.org/doi/10.7326/M23-2480     

Editorial: 

URL goes live when the embargo lifts        

A study of both traditional Medicare (TM) and Medicare Advantage (MA) enrollees found enrolling in the MA plan did not necessarily lead to cost savings, especially among vulnerable populations. The finding suggest that substantial federal payments going to MA over TM do not translate into improved financial outcomes for patients. Regulatory measures may be required to ensure that funding benefits enrollees .The study is published in Annals of Internal Medicine.  

 

Researchers from Korea University and Brown University studied data from the Medical Expenditure Panel Survey, which surveys respondents over 2 years, to examine whether the financial burden of care decreased for persons switching from TM to MA relative to those remaining in TM. From the data, researchers identified a cohort of individuals covered by TM in year 1, of whom 18% switched to MA in year 2. They compared financial outcomes in year 2—including out-of-pocket spending and patient-reported measures of health care-related financial burdens—of those staying in TM versus MA switchers. To account for potential differences in sample characteristics between TM stayers and TM-to-MA switchers the authors constructed a regression model assessing the associations between switching to MA in year 2 and multiple characteristics in year 1, including demographics, health status, use of specific services like hospitalization, subjective financial burdens, and out-of-pocket costs. They found that those who switched to MA had similar costs to those who stayed with TM and protection was worse, especially among vulnerable populations, such as those with low incomes. The authors say their findings contrast with the notion that MA’s apparently more generous health insurance benefits lead to financial savings for enrollees. However, MA plans still may provide more generous benefits than TM for those requiring standard care and inexpensive medications, including out-of-pocket spending limits, low costs for in-network services, and supplemental benefits. 

The authors of an accompanying editorial from City University of New York and Hunter College suggest that the privatization of Medicare through MA has been costly for taxpayers while offering enrollees little benefit as evidenced by the findings of this study. The authors suggest redeploying MA overpayments to improve TM coverage would better serve seniors and impede the accretion of medical resources by investors whose profit seeking too often overrides patient care priorities. 

 

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with the corresponding author, Sungchul Park, PhD, please contact sungchul_park@korea.ac.kr.  

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