Blog & News
SHADAC Analysis Tracks ACA Impact in Kentucky
November 30, 2016:Foundation for a Healthy Kentucky released a report today evaluating the impact of the Affordable Care Act (ACA) implementation in Kentucky. This analysis was conducted by SHADAC with funding from the Foundation for a Healthy Kentucky and evaluates Kentucky’s progress in five areas: coverage, access, cost, quality, and health outcomes.
The analysis, which provides an update to baseline data from 2012, uses data from federal and state data resources and compares Kentucky metrics to the U.S. as a whole and to other states.
“Kentucky has made significant gains in health insurance coverage and access to needed care through its commitment to implementation of the Affordable Care Act. The Commonwealth has been at the forefront in designing effective strategies to get and keep people covered providing lessons for the rest of the country. As change continues in KY’s health reform agenda it will be important to monitor and document the impact on Kentuckians and their families over time,” notes Lynn Blewett, SHADAC Director and Principal Director of the Kentucky ACA impact study.
The following are highlights from the report.
COVERAGE
Kentucky has substantially improved coverage rates across most race, gender, age, and income groups since 2012.
Kentucky’s overall rate of uninsurance fell to 8.7% in 2014--a 4.9 percentage-point drop from 2012. This rate is statistically significantly lower than the overall U.S. and a number of neighboring states (Figure 1.2).
People with lower incomes saw greatest declines in uninsurance.
Kentuckians with household incomes at or below 138 percent of the Federal Poverty Level (FPL) saw a 11.2 percentage-point decline in uninsurance from 2012 to 2014, and those with household incomes from 139 percent FPL to 200 percent FPL saw a 5.3 percentage-point decline. Kentuckians with incomes above these levels saw no significant change in uninsurance from 2012 to 2014 (Figure 1.5).
Disparities in insurance coverage still persist, especially by Race/Ethnicity.
The uninsurance rate for the Hispanic/Latino population, at 28.9 percent (Figure 1.3), is more than triple the state’s overall uninsurance rate of 8.7 percent.
ACCESS
Access to health care in Kentucky has remained relatively stable since 2012.
The share of the population reporting a usual source of care increased from 83.6 percent to 88.4 percent from 2012 to 2013. During this same time period, emergency department visits dropped from 30.4% to 24.9% a statistically significant decrease.
COST
In 2013, Kentucky citizens had a harder time paying medical bills compared to the U.S.
Overall, 42.8 percent of Kentuckians had trouble paying medical bills, well above national rate of 30.2 percent. The rate of Kentuckians having trouble paying bills was also higher than the rate in several neighboring states , including Illinois (28.5%), Missouri (36.9%), Ohio (31.1%), and Virginia (29.5%; Figure 3.2).
QUALITY
Among neighboring states, Kentucky was the only one that had a significant increase in the percentage of respondents who reported having a colorectal cancer screening from 2012 to 2014 (62.4% to 66.4%); however, the ACA is likely not the only factor for this increase—Kentucky has programs promoting colorectal cancer screening.
Racial disparities continue in low birth weight, wiith non-Hispanic blacks continuing to have the highest rate of low birth weight (13.2 percent) in 2014.
OUTCOMES
Overall, health status measures were relatively stable from 2012 to 2014.
At 31.6 percent, Kentucky’s adult obesity rate in 2014 remained unchanged from 2012.
The percentage of adult Kentuckians who reported having one or more chronic conditions did increase from 26.8 percent in 2012 to 29.1 percent in 2014, but it is important to note that increases in chronic disease prevalence can be expected with increases in coverage and access to care.
Blog & News
SHADAC at the Minnesota Health Services Research Conference
March 7, 2016:The 2016 Minnesota Health Services Research Conference took place last week in St. Paul, MN, with the goal of showcasing innovative research across public, private, and academic arenas. We are pleased to highlight several SHADAC-sponsored presentations.
Health Insurance Coverage and Access: The Minnesota Experience Before and After ACA Implementation
SHADAC Investigator Kathleen Call, together with Stefan Gildemeister of the Health Economics Program (HEP) at the Minnesota Department of Health, convened a panel that highlighted the work of both SHADAC and HEP researchers. The panel opened with a discussion of the Minnesota Health Access (MNHA) Survey and what it tells us about both the short and long-term uninsured population, as well as where disparities in access exist. Research Assistant Giovann Alarcon explored trends in the newly released 2015 MNHA data. Among notable results - Respondents with public insurance coverage felt the most financially protected and the most satisfied with their coverage of any insurance group.
Angie Fertig of Medica Research Institute discussed the most recent findings from her SHARE-funded analysis of pent-up demand for health care among newly-adults who were newly-enrolled in Medicaid. Dr. Fertig’s analysis of claims data provides evidence of pent-up demand among new enrollees based on a higher percentage of new patient visits in the first six months compared with existing Medicaid enrollees. New Medicaid enrollees also had lower overall utilization over the first six months suggesting that the long-term costs of insuring new enrollees may be lower than expected.
Minnesota State Innovation Model Evaluation
SHADAC is currently under contract with the Minnesota Department of Human Services to evaluate Minnesota’s State Innovation Model (SIM), which is a federally funded (Centers for Medicare and Medicaid Services’ Center for Medicare and Medicaid Innovation) effort to develop and test multi-payer health care payment and service delivery reform models. Two presentations at the conference were centered on preliminary evaluation results:
SIM-Minnesota Continuum of Accountability Assessment Tool: Evaluation Data Source and More
The MN Department of Human Services and MN Department of Health jointly collaborated with external stakeholders to develop an assessment tool to not only track organizational progress through SIM, but to also educate participating organizations on the functions and capabilities contained within the Model aims. Senior Research Fellow Christina Worrall and Research Assistant Oliver-John Bright presented preliminary assessment tool data to give a snapshot of where organizations were at the beginning of SIM.
Minnesota’s Accountable Communities for Health: Lessons from the First Year
Senior Research Fellow Dr. Donna Spencer convened a panel that opened with a short description of the Accountable Communities for Health (ACHs) grant program, followed by presentations from 3 ACHs from around the state. Grantees discussed their different models for community engagement and how this augments their efforts to address health issues in their target populations. Success stories from care coordination clients were also shared.
Other SHADAC presentations included: The Changing Demographics of the Uninsured in Minnesota and the Nation (Elizabeth Lukanen), Changing Trends in Employer-Sponsored Insurance After the Affordable Care Act (Carrie Suplick Benton), and Adding Complexity to an Already Difficult Task: Monitoring the Impact of the ACA on the Misreporting of Medicaid Coverage (Brett Fried).
Publication
Adding complexity to an already difficult task Monitoring the impact of the Affordable Care Act (ACA) on the Misreporting of Medicaid Coverage
Presentation by Brett Fried at the 2016 Minnesota Health Services Research Conference, March 1, 2016, in St. Paul, MN.