How Accessible and Affordable has Health Care been in Minnesota
previous to the ACA?
Giovann Alarcón
MN Health Services Re...
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Provide an up-to-date and State specifi...
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• MNHA 2007, 2009, 2011, and 2013
• Non...
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Access indicators that the ACA is expec...
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• Most Minnesotans have a usual source ...
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90.4%
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86.3%
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* Indicates statistically significant...
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Affordability indicators that the ACA i...
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• Although, in 2013 Minnesotans were le...
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• Despite high insurance rates, some me...
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www.shadac.org
@shadac
Giovann Alarcón
...
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Establishing a Baseline for the Affordable Care Act: How Accessible and Affordable has health care been in Minnesota previous to the ACA?

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Establishing a Baseline for the Affordable Care Act: How Accessible and Affordable has health care been in Minnesota previous to the ACA?

  1. 1. How Accessible and Affordable has Health Care been in Minnesota previous to the ACA? Giovann Alarcón MN Health Services Research Conference March 4th, 2014
  2. 2. Click to edit Master text styles Second level Third level Fourth level Fifth level Provide an up-to-date and State specific overview of two important outcomes to monitor under the ACA: health care access and affordability. • How accessible is care in MN? • How affordable is care in MN? • How do the Uninsured compare to other groups? 2
  3. 3. Click to edit Master text styles Second level Third level Fourth level Fifth level • MNHA 2007, 2009, 2011, and 2013 • Non-elderly population • Sample size • 2007: 7,316 • 2009: 9,749 • 2011: 9,499 • 2013: 9,935 3
  4. 4. Click to edit Master text styles Second level Third level Fourth level Fifth level 4
  5. 5. Click to edit Master text styles Second level Third level Fourth level Fifth level Access indicators that the ACA is expected to impact include: • reports of having a usual source of care (2007-2013), • use of the emergency department (2009-2013), • the ability -and confidence- in getting care when needed (2011-2013), and • provider supply issues where potential patients are told by a doctor’s office or clinic that they do not accept their health care coverage or they are not accepting new patients (2013). 5
  6. 6. Click to edit Master text styles Second level Third level Fourth level Fifth level • Most Minnesotans have a usual source of care and are confident in getting care when needed, but only about half of the uninsured report the same characteristics. • Health Care Utilization is high for most (around 80% for doctor’s visits) but the uninsured (47%). • One out of ten Minnesotans could not get a doctor’s appointment as soon as needed, with those enrolled in public programs doubling the rates of others. • Minnesotans with public coverage were more likely to face problems with providers than people with other types of insurance or the uninsured. 6
  7. 7. Click to edit Master text styles Second level Third level Fourth level Fifth level 7 90.4% 83.6%^* 88.5% 54.6%^ 86.3% 50% 60% 70% 80% 90% 100% Group Coverage Individual Coverage Public Coverage Uninsured Total 2007 2009 2011 2013 * Indicates statistically significant difference (p≤.05) from previous year shown ^ Indicates statistically significant difference (p≤.05) from Group within year
  8. 8. Click to edit Master text styles Second level Third level Fourth level Fifth level 8 * Indicates statistically significant difference (p≤.05) from previous year shown ^ Indicates statistically significant difference (p≤.05) from Group within year 96.1% 89.8%^ 90.6%^ 58.4%^ 91.1% 50% 60% 70% 80% 90% 100% Group Coverage Individual Coverage Public Coverage Uninsured Total 2007 2009 2011 2013
  9. 9. Click to edit Master text styles Second level Third level Fourth level Fifth level 9 ^ Indicates statistically significant difference (p≤.05) from Group within year Total Very confident 83.4% 73.1% ^ 67.5% ^ 30.0% ^ 74.5% Somewhat confident 12.8% 16.7% 23.1% ^ 28.3% ^ 16.6% A little confident 2.5% 5.4% ^ 5.0% ^ 23.0% ^ 5.1% Not confident at all 1.4% 4.8% ^ 4.4% ^ 18.6% ^ 3.8% PublicGroup Individual Uninsured
  10. 10. Click to edit Master text styles Second level Third level Fourth level Fifth level 10 ^ Indicates statistically significant difference (p≤.05) from Group within year 83.0% 76.2%^ 82.4% 47.3%^ 79.2% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Group Coverage Individual Coverage Public Coverage Uninsured Total
  11. 11. Click to edit Master text styles Second level Third level Fourth level Fifth level 11 * Indicates statistically significant difference (p≤.05) from previous year shown ^ Indicates statistically significant difference (p≤.05) from Group within year 13.5% 11.7% 27.2%^ 18.0% 16.7% 0% 5% 10% 15% 20% 25% 30% 35% Group Coverage Individual Coverage Public Coverage Uninsured Total 2009 2011 2013
  12. 12. Click to edit Master text styles Second level Third level Fourth level Fifth level 12 ^ Indicates statistically significant difference (p≤.05) from Group within year 8.9% 5.7%^ 15.9%^ 7.9% 10.1% 0% 3% 6% 9% 12% 15% 18% Group Coverage Individual Coverage Public Coverage Uninsured Total
  13. 13. Click to edit Master text styles Second level Third level Fourth level Fifth level 13 ^ Indicates statistically significant difference (p≤.05) from Group within year 1.3% 2.2% 7.2%^ 5.2%^ 2.9% 2.2% 2.1% 6.1%^ 4.0% 3.2% 0% 2% 4% 6% 8% Group Coverage Individual Coverage Public Coverage Uninsured Total Doctor did not accept their health care coverage Doctor was not accepting new patients
  14. 14. Click to edit Master text styles Second level Third level Fourth level Fifth level 14
  15. 15. Click to edit Master text styles Second level Third level Fourth level Fifth level Affordability indicators that the ACA is expected to impact include: • forgone and delayed care due to costs (2011 & 2013), • problems paying medical bills (2013), • needing to establish a payment plan with a hospital or doctor’s office (2013), or • having trouble paying other basic bills (e.g. food, heat, or rent) due to care costs (2013). 15
  16. 16. Click to edit Master text styles Second level Third level Fourth level Fifth level • Although, in 2013 Minnesotans were less likely to forgo care due to costs than in 2011, about one out of five people faced this situation. • One out of four Minnesotans who used some form of care reported having financial burdens related to these services. • Almost one out of two uninsured Minnesotans had problems paying medical bills, and for 32% of the uninsured these affected their ability to pay other basic bills 16
  17. 17. Click to edit Master text styles Second level Third level Fourth level Fifth level 17 * Indicates statistically significant difference (p≤.05) from previous year shown ^ Indicates statistically significant difference (p≤.05) from Group within year 9.2% 17.4% 9.8% 9.2% 7.3%* 12.4%* 6.9%* 4.1% 4.9%* 0% 3% 6% 9% 12% 15% 18% 21% Prescription Dental Care Routine Care Mental Health Care Specialist Care 2011 2013
  18. 18. Click to edit Master text styles Second level Third level Fourth level Fifth level 18 * Indicates statistically significant difference (p≤.05) from previous year shown ^ Indicates statistically significant difference (p≤.05) from Group within year Group Coverage 4.5% * 8.3% * 3.7% * 2.4% 3.2% * Individual Coverage 7.5% 15.1% ^ 7.8% ^ * 3.6% 4.4% * Public Coverage 11.1% ^ 15.2% ^ * 5.5% ^ * 4.1% ^ 4.9% ^ * Uninsured 17.7% ^ 32.4% ^ * 32.2% ^ 17.1% ^ 17.6% ^ * Total 7.3% * 12.4% * 6.9% * 4.1% 4.9% * Prescription Dental Care Routine Care Mental Health Specialist Care
  19. 19. Click to edit Master text styles Second level Third level Fourth level Fifth level 19 ^ Indicates statistically significant difference (p≤.05) from Group within year 19.3% 19.3% 25.3%^ 40.0%^ 22.5%21.3% 22.1% 28.1%^ 60.6%^ 25.1% 0% 10% 20% 30% 40% 50% 60% 70% Group Coverage Individual Coverage Public Coverage Uninsured Total Overall population Those who used health care
  20. 20. Click to edit Master text styles Second level Third level Fourth level Fifth level 20 ^ Indicates statistically significant difference (p≤.05) from Group within year 12% 16% 20%^ 48%^ 16%17% 16% 18% 46%^ 19% 6% 7% 14%^ 32%^ 10% 0% 10% 20% 30% 40% 50% 60% Group Coverage Individual Coverage Public Coverage Uninsured Total Problems paying medical bills Set up a payment plan for medical bills Had trouble with basic bills due to medical costs
  21. 21. Click to edit Master text styles Second level Third level Fourth level Fifth level 21
  22. 22. Click to edit Master text styles Second level Third level Fourth level Fifth level 22 ^ Indicates statistically significant difference (p≤.05) from comparison group (Insured) within year 83.0% 76.2% 82.4% 60.1%^ 54.9%^ 40.6%^ 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Group coverage Individual coverage Public coverage Insured Uninsured
  23. 23. Click to edit Master text styles Second level Third level Fourth level Fifth level 23 ^ Indicates statistically significant difference (p≤.05) from comparison group (Insured) within year 8.9% 5.7% 15.9% 7.6% 10.4% 7.2%^ 0% 10% 20% Group coverage Individual coverage Public coverage Insured Uninsured
  24. 24. Click to edit Master text styles Second level Third level Fourth level Fifth level 24 ^ Indicates statistically significant difference (p≤.05) from comparison group (Insured) within year 13.4% 22.3% 23.3% 44.0%^ 49.7%^ 43.6%^ 0% 10% 20% 30% 40% 50% 60% Group coverage Individual coverage Public coverage Insured Uninsured
  25. 25. Click to edit Master text styles Second level Third level Fourth level Fifth level 25 ^ Indicates statistically significant difference (p≤.05) from comparison group (Insured) within year 19.3% 19.3% 25.3% 43.2%^ 34.7%^ 43.0%^ 0% 10% 20% 30% 40% 50% Group coverage Individual coverage Public coverage Insured Uninsured
  26. 26. Click to edit Master text styles Second level Third level Fourth level Fifth level 26
  27. 27. Click to edit Master text styles Second level Third level Fourth level Fifth level • Despite high insurance rates, some measures of health care access and affordability are low. • This especially affects Minnesotans with public coverage and the uninsured. • Under ACA, most changes are expected to occur in the individual market and public programs. 27
  28. 28. Click to edit Master text styles Second level Third level Fourth level Fifth level www.shadac.org @shadac Giovann Alarcón alar0013@umn.edu

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