HEALTH INSURANCE COVERAGE AND HEALTH CARE ACCESS AND AFFORDABILITY - - PowerPoint PPT Presentation

▶
health insurance coverage and health care access and
SMART_READER_LITE
LIVE PREVIEW

HEALTH INSURANCE COVERAGE AND HEALTH CARE ACCESS AND AFFORDABILITY - - PowerPoint PPT Presentation

Jul 03, 2023 226 likes •515 views

HEALTH INSURANCE COVERAGE AND HEALTH CARE ACCESS AND AFFORDABILITY FINDINGS FROM THE 2018 MASSACHUSETTS HEALTH REFORM SURVEY December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE 1 MASSACHUSETTS HEALTH

slide-1
SLIDE 1

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

HEALTH INSURANCE COVERAGE AND HEALTH CARE ACCESS AND AFFORDABILITY FINDINGS FROM THE 2018 MASSACHUSETTS HEALTH REFORM SURVEY

1

slide-2
SLIDE 2

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

MASSACHUSETTS HEALTH REFORM SURVEY (MHRS)

  • Survey of nonelderly adults ages 19 to 64 in Massachusetts
  • Telephone (landline and cell phone) interviews
  • Core questions on health insurance coverage, health care access and use, and health

care affordability for individuals and their families in all years

  • New questions on mental health and substance use disorders (MH/SUDs) added in 2018
  • Conducted most years since 2006
  • As with all telephone surveys, a declining response rate over time
  • Reporting on data for 2006-2018
  • For consistency with prior years, summary measures for 2018 do not include data from

new MH/SUDs questions for this part of the presentation

2

slide-3
SLIDE 3

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

PREVIEW OF KEY FINDINGS FROM 2018 MHRS

  • Massachusetts has maintained near-universal health insurance coverage since

the 2006 reforms

  • However, gaps in health care access and affordability persist despite the

sustained high levels of health insurance coverage

  • Low- and moderate-income adults face the greatest challenges, with

affordability issues most prevalent for moderate-income adults

3

slide-4
SLIDE 4

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

MASSACHUSETTS HAS MAINTAINED NEAR-UNIVERSAL HEALTH INSURANCE COVERAGE FOR MORE THAN 10 YEARS

86.0 94.9** 94.7** 95.7** 96.0** 80.0 89.8** 87.9** 88.6** 87.6**

0% 20% 40% 60% 80% 100%

2006 2009 2012 2015 2018

Insured at the time of the survey Insured for past 12 months

SOURCE: 2006–2018 Massachusetts Health Reform Survey

*(**) Significantly different from value in 2006 at the .05 (.01) level, two-tailed test. 4

slide-5
SLIDE 5

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

NEAR-UNIVERSAL COVERAGE CONTINUES FOR BOTH HIGHER- AND LOWER-INCOME ADULTS, ALTHOUGH A GAP IN COVERAGE PERSISTS

93.8 98.0** 98.5** 98.1** 98.1** 75.9 90.8** 90.4** 93.2** 93.7**

0% 20% 40% 60% 80% 100%

2006 2009 2012 2015 2018

Income at or above 300% of federal poverty level (FPL) Income below 300% FPL

SOURCE: 2006–2018 Massachusetts Health Reform Survey

*(**) Significantly different from value in 2006 at the .05 (.01) level, two-tailed test. 5

slide-6
SLIDE 6

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

DESPITE NEAR-UNIVERSAL COVERAGE, GAPS IN ACCESS TO HEALTH CARE PERSISTED IN 2018

  • Will focus on two measures of health care access:

–Difficulty finding providers and/or getting appointments for needed health care –Going without needed health care

6

slide-7
SLIDE 7

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

49.1 25.2 39.0

0% 20% 40% 60% 80% 100%

Had difficulty obtaining health care in the past 12 months Difficulty finding a provider Difficulty getting an appointment for care as soon as needed

SOURCE: 2018 Massachusetts Health Reform Survey. NOTE: These are unadjusted estimates. “Difficulty finding a provider” includes being told by doctor’s office or clinic that they were not accepting the respondent’s health insurance type, any health insurance or new patients. “Problem getting an appointment” is defined as “sometimes” or

“never” getting an appointment as soon as needed.

ALMOST HALF OF ADULTS REPORTED DIFFICULTY OBTAINING HEALTH CARE IN 2018

7

slide-8
SLIDE 8

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

60.1 33.9 46.3 56.2 32.5 45.8 40.9**^^ 18.0**^^ 32.7**^^

0% 20% 40% 60% 80% 100%

Had difficulty obtaining health care in the past 12 months Difficulty finding a provider Difficulty getting an appointment for care as soon as needed Income at or below 138% of the federal poverty level (FPL) Income between 138 and 300% FPL Income at or above 300% FPL

SOURCE: 2018 Massachusetts Health Reform Survey.

*(**) Significantly different from value for low-income adults at the .05 (.01) level, two-tailed test. ^(^^) Significantly different from value for moderate-income adults at the .05 (.01) level, two-tailed test.

LOW- AND MODERATE-INCOME ADULTS WERE MOST LIKELY TO HAVE DIFFICULTY OBTAINING HEALTH CARE IN 2018

8

slide-9
SLIDE 9

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

MORE THAN 1 IN 3 ADULTS HAD UNMET NEED FOR HEALTH CARE IN 2018, MOST OFTEN FOR REASONS OTHER THAN COST

SOURCE: 2018 Massachusetts Health Reform Survey. NOTE: “Unmet need for reasons other than costs” includes problems with the availability of care, the accessibility of care, or personal issues.

38.1 18.6 25.6

0% 20% 40% 60% 80% 100%

Any unmet need for health care in past 12 months Unmet need due to cost Unmet need for reasons other than cost

9

slide-10
SLIDE 10

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

LOW- AND MODERATE-INCOME ADULTS WERE MORE LIKELY TO HAVE UNMET NEED FOR CARE IN 2018

SOURCE: 2018 Massachusetts Health Reform Survey.

*(**) Significantly different from value for low-income adults at the .05 (.01) level, two-tailed test. ^(^^) Significantly different from value for moderate-income adults at the .05 (.01) level, two-tailed test.

46.1 22.8 32.9 46.6 27.9 28.1 30.7**^^ 12.2**^^ 21.2**

0% 20% 40% 60% 80% 100%

Any unmet need for health care in past 12 months Unmet need due to cost Unmet need for reasons other than cost Income at or below 138% of the federal poverty level (FPL) Income between 138 and 300% FPL Income at or above 300% FPL

10

slide-11
SLIDE 11

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

DESPITE NEAR-UNIVERSAL COVERAGE, PROBLEMS WITH AFFORDABILITY OF HEALTH CARE PERSISTED IN 2018

  • Will focus on problems with health care affordability that includes:

–Going without needed health care due to cost –Problems paying family medical bills –Medical debt (defined as paying family medical bills off over time)

11

slide-12
SLIDE 12

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

MORE THAN ONE-THIRD OF ADULTS HAD PROBLEMS WITH HEALTH CARE AFFORDABILITY IN 2018

SOURCE: 2018 Massachusetts Health Reform Survey.

35.0 18.6 17.5 19.4

0% 20% 40% 60% 80% 100%

Any problems with health care affordability in past 12 months Unmet need due to cost Problems paying family medical bills Paying off family medical bills over time

12

slide-13
SLIDE 13

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

LOW- AND MODERATE-INCOME ADULTS WERE MORE LIKELY TO HAVE PROBLEMS WITH HEALTH CARE AFFORDABILITY IN 2018, WITH MODERATE-INCOME ADULTS FACING THE GREATEST CHALLENGE

SOURCE: 2018 Massachusetts Health Reform Survey.

*(**) Significantly different from value for low-income adults at the .05 (.01) level, two-tailed test. ^(^^) Significantly different from value for moderate-income adults at the .05 (.01) level, two-tailed test.

37.8 20.8 12.2 48.0* 29.6** 24.9** 27.6*^^ 10.2**^^ 19.6**^^

0% 20% 40% 60% 80% 100%

Any problems with health care affordability in past 12 months Problems paying family medical bills Paying off family medical bills over time Income at or below 138% of the federal poverty level (FPL) Income between 138 and 300% FPL Income at or above 300% FPL

13

slide-14
SLIDE 14

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

KEY FINDINGS FROM 2018 MHRS

  • Massachusetts has maintained near-universal health insurance coverage since

the 2006 reforms

  • However, gaps in health care access and affordability persist despite the

sustained high levels of health insurance coverage

  • Low- and moderate-income adults face the greatest challenges, with

affordability issues most prevalent for moderate-income adults

14

slide-15
SLIDE 15

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

HEALTH CARE ACCESS AND AFFORDABILITY FOR ADULTS SEEKING CARE FOR MENTAL HEALTH AND/OR SUBSTANCE USE DISORDERS (MH/SUDs) NEW DATA FROM THE 2018 MASSACHUSETTS HEALTH REFORM SURVEY

15

slide-16
SLIDE 16

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

NEW MH/SUDs QUESTIONS IN THE 2018 MASSACHUSETTS HEALTH REFORM SURVEY (MHRS)

  • Use of MH/SUDs care over the past year

– MH/SUDs services and MH/SUDs prescription drugs

  • Unmet need for MH/SUDs care over the past year

– Unmet need due to costs – Unmet need due to reasons other than costs

  • Difficulty obtaining MH/SUDs care over the past year

– Difficulty finding a MH/SUDs provider – Problem getting an appointment for MH/SUDs care as soon as needed

  • Reporting on data for 2018

– Summary measures include data from new MH/SUDs questions for this part of the presentation

16

slide-17
SLIDE 17

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

PREVIEW OF KEY FINDINGS FROM THE 2018 MHRS ON MH/SUDs CARE

  • The need for MH/SUDs care affects many in Massachusetts and crosses all

age, sex, race/ethnicity, and income groups

  • But is more common among younger, female, white/non-Hispanic, and lower-

income adults

  • Adults who seek care for MH/SUDs face significant barriers to obtaining health

care overall and, especially, for MH/SUDs services and prescription drugs

  • Health insurance coverage does not eliminate those barriers to care

17

slide-18
SLIDE 18

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

15.9 15.3 2.2

0% 10% 20% 30% 40% 50%

Sought care for MH/SUDs in past 12 months Sought care for a MH condition Sought care for a SUD

SOURCE: 2018 Massachusetts Health Reform Survey. NOTE: "Sought care" is defined as obtained MH/SUDs care or tried to obtain MH/SUDs care.

MORE THAN 1 IN 7 ADULTS SOUGHT MH/SUDs CARE OVER THE PAST YEAR IN 2018

18

slide-19
SLIDE 19

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

ADULTS WHO SOUGHT MH/SUDs CARE IN 2018 CROSSED ALL INCOME GROUPS, BUT WERE DISPROPORTIONATELY LOWER-INCOME

SOURCE: 2018 Massachusetts Health Reform Survey.

*(**) Significantly different from value for adults who sought MH/SUDs care at the .05(.01) level, two-tailed test.

36.2 35.2 28.7 19.4** 23.7** 56.9**

0% 20% 40% 60% 80% 100%

Income at or below 138% of the federal poverty level (FPL) Income between 138 and 300% FPL Income at or above 300% FPL Adults who sought MH/SUDs care Adults who did not seek MH/SUDs care

19

slide-20
SLIDE 20

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

ADULTS WHO SOUGHT MH/SUDs CARE WERE MORE LIKELY TO HAVE DIFFICULTY OBTAINING HEALTH CARE OVERALL AND TO GO WITHOUT NEEDED CARE IN 2018

SOURCE: 2018 Massachusetts Health Reform Survey.

*(**) Significantly different from value for adults who sought MH/SUDs care at the .05(.01) level, two-tailed test.

73.0 61.7 47.8** 35.0**

0% 20% 40% 60% 80% 100%

Had difficulty obtaining health care (including MH/SUDs care) in the past 12 months Any unmet need for health care (including MH/SUDs care) in past 12 months Adults who sought MH/SUDs care Adults who did not seek MH/SUDs care

20

slide-21
SLIDE 21

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

ADULTS WHO SOUGHT MH/SUDs CARE WERE MORE LIKELY TO FACE HEALTH CARE AFFORDABILITY ISSUES IN 2018

SOURCE: 2018 Massachusetts Health Reform Survey. NOTE: "Sought care" is defined as obtained MH/SUDs care or tried to obtain MH/SUDs care.

*(**) Significantly different from value for adults who sought MH/SUDs care at the .05(.01) level, two-tailed test.

54.6 33.5 36.0 26.0 31.4** 16.5** 14.0** 18.1*

0% 20% 40% 60% 80% 100%

Any problem with health care affordability (including MH/SUDs care) in past 12 months Unmet need due to cost Problems paying family medical bills Paying off family medical bills over time Adults who sought MH/SUDs care Adults who did not seek MH/SUDs care

21

slide-22
SLIDE 22

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

MORE THAN HALF OF ADULTS WHO SOUGHT MH/SUDs CARE REPORTED DIFFICULTY OBTAINING MH/SUDs CARE IN 2018

SOURCE: 2018 Massachusetts Health Reform Survey.

*(**) Significantly different from value for adults who sought MH/SUDs care at the .05(.01) level, two-tailed test.

56.8 46.4 43.5

0% 20% 40% 60% 80% 100%

Had difficulty obtaining MH/SUDs care in the past 12 months Difficulty finding a MH/SUDs provider Difficulty getting an appointment for MH/SUDs care as soon as needed

22

slide-23
SLIDE 23

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

DIFFICULTY FINDING A MH/SUDs PROVIDER IN 2018 OFTEN DUE TO PROVIDERS NOT ACCEPTING TYPE OF INSURANCE OR NOT ACCEPTING NEW PATIENTS

SOURCE: 2018 Massachusetts Health Reform Survey.

*(**) Significantly different from value for adults who sought MH/SUDs care at the .05(.01) level, two-tailed test.

46.4 10.8 35.7 35.5

0% 20% 40% 60% 80% 100%

Had difficulty finding a MH/SUDs provider in past 12 months Told MH/SUDs provider not accepting any insurance Told MH/SUDs provider not accepting insurance type Told MH/SUDs provider not accepting new patients

23

slide-24
SLIDE 24

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

MORE THAN A THIRD OF ADULTS WHO SOUGHT MH/SUDs CARE HAD UNMET NEED FOR MH/SUDs CARE IN 2018, MOST OFTEN FOR REASONS OTHER THAN COST

SOURCE: 2018 Massachusetts Health Reform Survey.

38.7 14.1 30.8

0% 20% 40% 60% 80% 100%

Any unmet need for MH/SUDs care in past 12 months Unmet need for MH/SUDs care due to cost Unmet need for MH/SUDs care for reasons other than cost

24

slide-25
SLIDE 25

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

UNMET NEED FOR MH/SUDs CARE INCLUDED UNMET NEED FOR MH/SUDs SERVICES AND FOR MH/SUDs PRESCRIPTION DRUGS IN 2018

SOURCE: 2018 Massachusetts Health Reform Survey. NOTE: “MH/SUDs care” includes MH/SUDs services and MH/SUDs prescription drugs.

38.7 32.3 12.2

0% 20% 40% 60% 80% 100%

Any unmet need for MH/SUDs care in past 12 months Unmet need for MH/SUDs services Unmet need for MH/SUDs prescription drugs

25

slide-26
SLIDE 26

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

HEALTH INSURANCE COVERAGE HAD LITTLE AFFECT ON ACCESS TO MH/SUDs CARE IN 2018

SOURCE: 2018 Massachusetts Health Reform Survey.

56.8 38.7 54.6 33.3

0% 20% 40% 60% 80% 100%

Had difficulty obtaining MH/SUDs care in past 12 months Any unmet need for MH/SUDs care in past 12 months All adults who sought MH/SUDs care Full-year insured adults who sought MH/SUDs care

26

slide-27
SLIDE 27

December 11, 2018 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION and URBAN INSTITUTE

FINDINGS FROM THE 2018 MHRS ON MH/SUDs CARE

  • The need for MH/SUDs care affects many in Massachusetts and crosses all

age, sex, race/ethnicity, and income groups

  • But is most common among younger, female, white/non-Hispanic, and lower-

income adults

  • Adults who seek care for MH/SUDs face significant barriers to obtaining health

care overall and, especially, for MH/SUDs services and prescription drugs

  • Health insurance coverage does not eliminate those barriers to care

27