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Title: 2004 Medicaid enrollment survey
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Title: 2004 Medicaid enrollment survey
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Language: English
Creator: Steingraber, Heather
Publisher: Florida Center for Medicaid & the Uninsured, College of Public Health and Health Professions
Place of Publication: Gainesville, Fla.
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Table of Contents
    Title Page
        Page 1
    Introduction
        Page 2
        Page 3
    Main
        Page 4
        Page 5
        Page 6
        Page 7
        Page 8
        Page 9
        Page 10
        Page 11
        Page 12
        Page 13
        Page 14
        Page 15
        Page 16
        Page 17
        Page 18
        Page 19
        Page 20
        Page 21
Full Text




2004 Medicaid Enrollment Survey


Heather Steingraber, MAC (ABT)
Allyson Hall, PhD




















Florida Center for Medicaid & the Uninsured
College of Public Health and Health Professions
University of Florida
352/273-5059

Sponsored by
The Agency for Health Care Administration


Florida Center for Medicaid and the Uninsured
Shaping Healithca e m Policy


June, 2004







Introduction
This report presents an analysis of the characteristics and
experiences of Medicaid enrollees who have recently enrolled
or re-enrolled in the Florida Medicaid program. The data
presented were gathered by means of a telephone survey,
and, thus, are based on the self-report of the respondent.
Subjects included enrollees who were new to the Medicaid
program, and those who had been previously enrolled and
had experienced a break in their enrollment, and were now re-
enrolling.

Purpose Several issues germane to the administration of the Florida
Medicaid program will be examined in this report. These issues
include:
Determining the demographic characteristics of new
enrollees and re-enrollees in the Florida Medicaid program,
Determining satisfaction with the enrollment process
Reasons why people churn
Health insurance coverage prior to enrollment in Medicaid
or during lapses in Medicaid coverage
Determining satisfaction with the plan selection process in
Medicaid

Background
The Enrollment Process The Medicaid enrollment process can be difficult and
intimidating for many new enrollees. Filling out the Medicaid
application and gathering the necessary documentation can
be a daunting task, and can prevent some eligible people
from applying. Beneficiaries in many Florida counties must
choose a managed care organization shortly after becoming
enrolled, and must "lock-in" their choice by calling an 800
number. Enrollees may receive information from numerous
health plans during their choice period, and must be able to
interpret the information presented to them.

The redetermination process is similarly challenging, and
studies from multiple states have shown that many Medicaid
enrollees lose coverage because they fail to complete the
necessary redetermination process, even if they are, in fact, still
eligible.

Understanding enrollees' perceptions of the Medicaid
enrollment process can be a first step to identifying barriers to
enrollment. Likewise, it can be a step toward understanding
why some beneficiaries drop off the Medicaid rolls, only to
Intermittent Coverage reemerge later.

It is estimated that 38 million non-elderly Americans have some
degree of instability in their health insurance coverage.
Studies show that those who have unstable or "intermittent"
spells of uninsurance are less likely to get preventive health
care services, more likely to have difficulty paying medical bills,
and are less satisfied with the care they receive when







compared with those who have stable health insurance
coverage. However, few studies exist that focus specifically on
the effects of intermittent insurance coverage for the
Medicaid population, or the chronically ill. This report, along
with the companion report by Harman et al, is meant to be a
first step in determining those effects.

In this report, we explore the demographic characteristics of
the population of Medicaid enrollees who have been
intermittently covered by Medicaid. We also describe the
experiences these enrollees have had in the enrollment/re-
enrollment process, and we assess the enrollees' satisfaction
with their health care







Methodoloya
Sampling Data for this report were gathered by means of a telephone
survey with Medicaid enrollees who met the inclusion criteria.
The random sample for the telephone survey was drawn from
Medicaid administrative data in early April, 2004. Enrollees
eligible to be sample included those who were:

1. 21 years of age or older,
2. TANF or SSI recipients,
3. Enrolled during the month of February 2004 (the most
current month available in QueryPath at the time the
sample was drawn), and,
4. Recent enrollees or re-enrollees in Medicaid. This
criterion was operationally defined as a period of at
least 2 consecutive months during the prior 6 months
(September, 2003 through January, 2004) in which they
did not have Medicaid coverage.

The query showed 10,142 Medicaid enrollees who met these
criteria.

Survey Administration
The telephone surveys were conducted by the Survey
Research Center at the University of Florida's Warrington
College of Business Administration. The surveys were
conducted between April and June of 2004.

The database of telephone numbers provided in the sample
from AHCA proved to be incomplete, with 8% of the sample
containing no telephone number at all. In order to obtain
valid telephone numbers for these non contacts, a
commercial firm that provides contact information for
telemarketers and survey researchers was contacted. Further,
the Center's Driver License/Medicaid database was matched
with the non contacts to find valid numbers. This database
was extracted from the State's Department of Highway Safety
and Motor Vehicles' master database of all licensed drivers in
the State. The Center's database contains the address of
record for every licensed driver in the state who is also enrolled
in Medicaid. Once the address is obtained from this source,
the match with the commercial firm can be more reliable,
since the address can also be used as a match field in their
database. Despite these efforts, over 28% (a of the sample
proved to be unreachable due to inaccurate contact
information. Nonetheless, the target number of completed
surveys (372) was reached. This target was based on statistical
power calculations showing the number of surveys needed to
attain a 5% confidence interval and a 95% confidence level.
Outcome Rates

An important aspect in determining whether survey results are
truly representative of the population in question is to







determine whether "non-response effects" exist. Non-
response effects occur when non respondents from the
original sample differ from those who did respond in
significant ways which might affect results of the study.
One important step in determining whether non-response
effects exist is to calculate outcome rates.

The American Association for Public Opinion Research
(AAPOR) recognizes the use of a number of different types
of outcome rates, and a number of different methods for
calculating each of those types'. One type of outcome
rate is the Response Rate, which takes into account the
number of interviews in proportion to the number of eligible
respondents. Numerous methods exist to calculate
Response Rates, with major differences being in the way in
which the number of eligibles is determined and the way
partial interviews are allocated. Another type of outcome
rate is the Cooperation Rate, which takes into
consideration the number of interviews in proportion to all
eligibles ever contacted. Cooperation Rates exclude from
calculation those respondents who could not be located.
Like Response Rates, there are numerous ways to calculate
Cooperation Rates, with the major differences being in the
way that the number of eligibles is determined and the way
partial interviews are allocated. Researchers consider
various criteria in determining which outcome method to
use, with the quality of the sample being a major criterion in
their decision.

Outcome rates for the Medicaid surveys are as follows:

RR1 =55.3%
RR6 = 76.3%
COOP1 = 75.2%
COOP4 = 90.5%

Four different AAPOR-approved outcome measures are
given. Response Rate (RR) 1 is the most stringent method
given, and RR6 is the least restrictive of the response rate
methods. Cooperation Rate(COOP) 1 is less stringent than
either RR method, and COOP4 is the least stringent of all
methods presented. Overall, the outcome rates are quite
good, especially considering that the Medicaid population
in Florida is traditionally very difficult-to-reach. These rates
Data A s are comparable to or better than those attained in large
Data Analysis
administrative surveys such as the CDC's BRFSS.


The data from the surveys was analyzed using SAS.
Descriptive statistics were calculated for the overall sample
as well as for various sub populations. Complete results are
given in the Appendix, and selected results are discussed in

1 The American Association for Public Opinion Research. 2000. Standard Definitions: Final Dispositions of Case Codes and Outcome Rates
for Surveys. Ann Arbor, Michigan: AAPOR







Demographics
Demographic characteristics of recently enrolled and re-
enrolled Medicaid beneficiaries are explored in the
paragraphs below. The characteristics of the group overall
are presented, and, where possible, are compared with the
characteristics of long-term Medicaid enrollees. The data for
the long term enrollees was collected in a separate survey
conducted in the fall of 2003. These enrollees had been
enrolled in Medicaid for at least 6 consecutive months, and
were enrolled in Medicaid at the time of interview.
Significant differences between the recent enrollee/re-
enrollee group and the long term enrollee group are
highlighted and discussed.
Gender & Age The recent enrollee group is comprised of 86% females and
14% males. Half of the group (50%) is comprised of young
adults, aged 21 to 34 years. Another 27% is composed of 35
to 44 year olds. The remaining 23% of the sample is
composed of those 45 years old or older.
Race & Ethnicity
Survey respondents were asked whether they belonged to
any of a list of race categories, including White, Black, Asian,
and others. An open-ended "other" category was also
included. Respondents could choose as many categories as
they felt applied to them. Forty-six percent of the
respondents reported that they were White, while 39% said
they were Black, and less than 4% reported being in any of
the other fixed race categories. However, 17% reported
belonging in the "other" category. An analysis of the open-
ended responses to this "other" category revealed that most
of these responses included reference to Hispanic ancestry.
The methodology used in this survey, modeled after that
used in the 2000 Census, included Hispanic ancestry in a
separate question, called "ethnicity," which was asked prior
to the race question, and which showed 29% of the sample
to be "Hispanic."

The large number of respondents in the "other" race
category suggests that the separate treatment of race and
ethnicity is not salient for many respondents. Thus, the two
categories were combined into a single variable. The first
category included those who described their race as "white"
and did not indicate belonging to any of the other race
categories. They also indicated that they were not of
Hispanic ethnicity. The next category was for those who
indicated that their race was "Black" and no other racial
category was indicated. These respondents also responded
that they were not of Hispanic ancestry. A third category
included anyone who indicated that they were of Hispanic
ethnicity, regardless of the race category or categories
indicated. A final category included all respondents not
captured in any of the previous categories. Thus, this







category thus includes individuals of mixed race, or of a
racial category other than white or black. As shown in Figure
1, results of this recoding indicate that 28% of respondents
were White and non-Hispanic, 35% were Black and non-
Hispanic, 28% were Hispanic, and 8% were of some other
racial/ethnic group.


Figure 1. Racial/Ethnic


Makeup of Recent Enrollee


35.2%
White, non Hispanic U Black, non Hispanic
O Hispanic E Other




Forty percent of the recent enrollee population indicated
that they had a high school diploma or its equivalent, while
33% had education beyond high school, and the remaining
27% had less than a high school education.

The largest group of recent enrollees indicated that they
were in "good" health. This group made up 35% of the
population. A further 34% indicated being in "fair" or "poor"
health and 31% were in "very good" or "excellent" health.


The first question asked of respondents in the recent enrollee
survey was whether they had ever been enrolled in Medicaid
before their current span of enrollment. Sixty-two percent
indicated that they had been enrolled at some point before,
while 37% indicated that they had not (see Figure 2). It is
important to remember that this figure is based on the self-
report of survey respondents. An analysis of claims data may
reveal different figures.

Those who had been enrolled before were asked how long
ago their last enrollment span occurred. Responses varied,
with the largest group of respondents (38%) indicating that
their last enrollment span was 2 or more years ago. Seven
percent of respondents indicated that their last enrollment
span was between 1 and 2 years ago, twenty-three percent
indicated it was 7 months to one year ago, and thirty-two
,~, ,,\v ,;- ;, I IA --,L -l- -- 1T -\ rr


8.3%


28.2%


Education


Health Status





Previous Medicaid Enrollment






Figure 2. Previous Enrollment in Medicaid


Those who had been enrolled at some point prior were
asked why they lost their Medicaid coverage. Over one-
third said that they lost that previous enrollment because
they became ineligible. Another 20% said that they
became eligible for employer-based coverage, and thus,
voluntarily disenrolled. Fourteen percent indicated that
they failed to complete the recertification process, and
12% said that they moved from the State, and thus, lost
their coverage. Seven percent of respondents indicated
that they did not know why they lost their coverage, and
another 13% indicated some other reason why they lost
coverage.

Figure 3. Reasons for Losing Previous Medicaid Coverage

13%

34%
14%



12%
7%
20%
0 Lost eligibility
0 Don't know
O Became eligible for employer-based coverage
Moved
0 Didn't recertify
0 Other


When asked how they found out their coverage was
discontinued, most respondents indicated that they
received a letter from Medicaid, while 18% were first
informed by their health care provider. Thirteen percent
found out when they spoke to someone from DCF or
AHCA, either by telephone or in person. Two percent
found out when they received an unpaid medical claim


37.4%


62.6%


* First Time Enrolled in Medicaid
E Enrolled in Medicaid Before







or bill. About half of respondents indicated that they
knew ahead of time that their Medicaid enrollment was
going to end, while the other half did not find out until
after the fact.


Experiences Prior to Current
Enrollment Span


The vast majority (80%) of survey respondents reported
that they were uninsured during at least on month prior to
becoming enrolled in Medicaid (Figure 4), and 46%
indicated that they "went without" needed medical care
at some point during the 6 months prior to their current
Medicaid enrollment span. Thirty percent of respondents
indicated that they had no usual source of care during
the time prior to their reenrollment, and a further 25% used
the Emergency Room as their usual source of care. Once
enrolled in Medicaid, however, only 12% of respondents
indicated that they had no usual source of care and 14%
used the Emergency Room for primary care.

Figure 4. Insurance Coverage in the Month Prior to
Medicaid Enrollment


19.7%


80.3%


Application Process


Respondents were asked about the length of time to
complete the Medicaid application process. They were
instructed to include all time elapsed from when they first
acquired the application, until they submitted it.
Responses varied considerably, with some respondents
indicating that it took only a few hours, while other
indicated it took more than 6 months to gather the
documentation and complete the process. Twenty-eight
percent of respondents indicated that it took 15 to 30
days to complete the process. Fifteen percent indicated
that it took between one and two months, while another
14% indicated it took 8 to 14 days. Twenty-three percent
of respondents reported that it took 2 to 7 days to
complete the process.


Roughly 21% of respondents said that they got help in
filling out the application, and, among those, 58%
reported that it was a friend or relative who gave that
assistance. Another 21% got assistance from someone at


" Uninsured in month prior
to current enrollment


* Had insurance coverage
in month prior to current
enrollment







a State Agency while 12% got assistance from someone
at a private Agency. Eleven percent got help from
someone at a doctor or health care provider's office.

Respondents reported that they received notification of
their enrollment in Medicaid very promptly, with with more
than 40% indicating that they were notified within 2
weeks. Another 40% found out by the end of 4 weeks,
and all but 3% had heard back by the end of eight
weeks.


Plan Choice


Respondents were asked whether they had received
written information about their choices of health plans.
Seventy-three percent indicated that they had received
information, and 85% of those indicated that they had
reviewed the information. Those who had reviewed the
information were asked a series of questions about the
information and its quality. When asked whether the
information was clear and easy to understand, 89%
indicated that they "agreed" or "strongly agreed" that it
was easy to comprehend. Eighty-nine percent of
respondents said that they received the information in
time to make their health plan choice. And a vast
majority (93%) of respondents said that the information
they received was complete and accurate.

Forty-four percent of respondents indicated that they
called the Medicaid Options 888 number to get
information or help in choosing their Medicaid plan.
Interestingly, exactly 44% of respondents indicated that
they had heard of the Medicaid Options 888 number prior
to interview. Of those who had called, 63% reported that
the Medicaid Options staff were "very helpful" in assisting
them. A further 27% of respondents called the Medicaid
Options staff "somewhat helpful." Ten percent of those
interviewed felt that the staff were "somewhat unhelpful"
or "very unhelpful."

Twenty percent of respondents indicated that they had
sought help in making plan choices from some source
other than Medicaid Options. The most common source
of assistance was a health care provider or provider's
staff, with 30% of respondents indicating that they sought
help from this source. Another 28% sought help from a
friend or family member. Twenty-two percent sought help
from someone at a State Agency, and 9% looked to
someone at a private Agency for assistance.
Respondents were asked about their experiences with the
Medicaid plan, and about how satisfied they were with
the Medicaid program and their health plan.






Experiences and Satisfaction with
Medicaid









Unmet Need


Specialist Care


Respondents were asked to rate the choice of primary care
providers on Medicaid, using a scale of 0 to 10, with 0 being
the worst choice of doctors possible, and 10 being the best
choice possible. The mean rating was 7.61 2.56. Eighty-four
percent of respondents had selected their primary care
provider at the time of interview, and, of these, 79% had
been to see their PCP since enrolling. Those who had seen
their PCP were asked to rate their provider on a 0 to 10 scale.
The average rating was 8.24 2.34.

Twenty-four percent of respondents said that there had been
a time since they enrolled in Medicaid when they had
needed to see a doctor, but could not. The most common
reason cited for this unmet need, cited by 36% of those
surveyed, was that they could not get an appointment with
the specific PCP they wanted to see. Another 22% reported
that they couldn't get an appointment soon enough. Twelve
percent indicated that they had not been certain whether
the visit would be covered under Medicaid, and another 12%
indicated that they did not have a PCP at the time they
experienced the need, and they did not know whom to see
at that time (see Figure 5).

Figure 5. Reasons for Unmet Need for Primary Care Since
Enrolling in Medicaid


Thirty-seven percent of respondents indicated that they had
seen a specialist since enrolled in Medicaid, and, of these,
the average rating of the choice of specialists in Medicaid
was 8.14 2.57. The average rating of the specialist that was
seen was 8.72 2.10. The majority of those who saw a
specialist indicated that it was "not a problem" to get a
referral to see a specialist, while 12% said it was "a small
problem" and 16% said it was "a big problem." The reader
should note that this question was only asked of those who
had seen a specialist. Presumably, these would be enrollees


40%
35%
30%
25%
20%
15%
10%
5%
0%


OE 0 z,-
0 =
.0CL- L r IC-0 o
0 < LU C L) 0A E L)
L) M ) L)a 3: 0. 2 L
C 'C oo
P w v, g .






who had successfully gotten a referral to see the specialist.
Twenty-one percent of respondents indicated that they had
needed to see a specialist but could not. The most common
reason cited for not seeing a specialist was that they could
not get an appointment, cited by 36%. Twenty-nine percent
said that they were not certain whether or not the visit would
be covered by Medicaid. Another 21% could not get a
referral, and 10% could not get in to see the specialist soon
enough.


Dental Care


Overall Satisfaction with
Medicaid


Twenty-three percent of respondents said that they had seen
a dentist since becoming enrolled in Medicaid. The mean
rating of the choice of dentists in the program was quite low,
at 5.86 3.89. The mean rating of the dentists themselves
was 7.13 3.60. Unmet need for dental services was a
significant problem for this population, with 43% indicating
that, since they became enrolled in Medicaid, they had
needed to see a dentist but could not (Figure 6). The most
common reason cited for this unmet need was that the
beneficiary was not certain whether the visit would be
covered by Medicaid. This reason was cited by 44% of
respondents. Thirty-six percent of respondents said that did
not know whom to see or could not find a Medicaid dentist.

Figure 6. Unmet Need for Dental Care in Medicaid


43.3%


56.7


I Experience
d Unmet
Need for
Dental Care

I No Unmet
Need


The final satisfaction question in the survey was a global
rating question concerning the Medicaid program overall.
Respondents were asked to rate the program using the 0 to
10 scale used previously. The average rating was 7.77 2.29.







Summary and Conclusions


Demographics


Previous Experiences in
Medicaid









Experiences Prior to Medicaid
Enrollment


The population of Medicaid recent enrollees is mostly female
(86%) and relatively young (77% are less than 45 years old).
The racial makeup of the program includes 35% black, non-
Hispanics, 28% white, non-Hispanics, 28% Hispanics, and 8%
who are multi-racial/ethnic or fit into another race category.
One-third of the group has education beyond high school,
and another 40% has a high school diploma or GED. Thirty-
one percent indicate that their health is "excellent' or "very
good," while another 35% describe their health as "good"
and the remaining 34% is in "fair" or "poor" health.

Preliminary comparisons between the demographic
characteristics of the recent enrollee population and the
established enrollee population reveal that the recent
enrollees may be significantly younger and more educated,
and there may be a larger percentage of blacks and
Hispanics in this group. Statistical analyses are ongoing, and
more definitive results of the comparisons are forthcoming.


Most recent enrollees in Medicaid (63%) have been enrolled
in the program before. The reasons they lost their Prior
Medicaid coverage vary greatly. Thirty-four percent lost
eligibility, while 20% became eligible for employer-based
coverage. Fourteen percent of the population lost their
coverage simply because they did not complete the
recertification process. Twelve percent moved, and seven
percent do not know why they lost their coverage.


The majority of Medicaid recent enrollees (80%) were
uninsured during at least one month before their current
enrollment span in Medicaid began, and 54% "went without"
needed medical care at some point in the 6 months prior to
Medicaid enrollment. Fifty-five percent of recent enrollees
reported that, during the 6 months prior to enrollment, they
had no regular source of health care, or they used the
hospital emergency room as their regular source of care.

Enrollees reported that the process of completing their
Medicaid application, including time for filling out forms,
gathering documentation, etc., was quite time-consuming,
with half of the respondents indicated that it took more than
2 weeks to complete the process. Many respondents (21%)
sought help in filling out the application, and that source of
help tended to be a friend or family member in 58% of cases.
Assistance from someone at a State Agency was sought 21%
of the time, and help from someone at a private organization
was reported 12% of the time. Health providers helped in
11% of cases.







Respondents were notified of their enrollment into Medicaid
quite quickly, with 41% reporting that they were notified
within 2 weeks. Another 40% were notified by the end of 4
weeks, and all but 3% of the population was notified by the
end of 8 weeks.


Plan Choice


Experiences and Satisfaction
with Medicaid


Respondents by-and-large indicated that they received
written information about their choice of health plans (73%)
in Medicaid, and that they reviewed that information (85%).
Enrollees found the information to be clear and easy to
understand (89%), complete and accurate (93%), and they
received it in time to make their choice (89%).

Forty-four percent of enrollees called the Medicaid Options
888 number to get help or info on choosing a health plan,
and 90% of those found the Medicaid Options staff to be
helpful. Twenty percent of respondents sought help in
making their plan choices from a source other than Medicaid
options, and 30% of these enrollees reported that it was a
health provider or his/her staff who provided this assistance.
This finding is not particularly surprising, considering that
enrollees may choose their health plan based on which plans
his/her providers accept. Friends or family members
provided assistance in 28% of cases, and State Agency staff
provided help for 22% of the population.


Twenty-four percent of respondents indicated that they had
experiences a time, since being enrolled in Medicaid, when
they had needed to see a doctor, but could not. The reason
for this unmet need tended to be that the respondents
couldn't get an appointment with the PCP of choice (36%) or
that he/she couldn't get an appointment soon enough
(22%). Another common response was that the enrollee did
not have a PCP yet or did not know whom to see (12%) or
was uncertain whether the visit would be covered by
Medicaid (12%). These results seem to indicate two possible
problems for recent Medicaid enrollees. First, it is possible
that recent enrollees are experiencing difficulty getting care
because the PCP of choice is not accepting new patients or
is so busy that appointments cannot be made promptly.
Second, it is possible that, although the period from
application to enrollment is short, a great deal of need may
exist for some enrollees during this period of time.


Respondents who had seen a specialist physician since
enrolling in Medicaid were asked about whether they had
difficulty getting a referral to see a specialist. Sixteen percent
indicated they had "a big problem" and 12% had "a small
problem." Twenty one-percent of respondents overall
indicated that they had needed to see a specialist but could
not. Twenty one percent of those respondents indicated







that the reason they could not see the specialist was
because they could not get a referral.
Unmet need in the area of dental care was a particularly
prominent finding, with 43% of respondents indicating that,
at some point since becoming enrolled in Medicaid, they
needed to see a dentist but could not. Forty-four percent
of those who experience unmet need indicated that they
did not see a dentist because they were not certain
whether the visit would be covered by Medicaid, while 36%
indicated that they did not have a dentist to see or could
not find a Medicaid dentist.


Ratings Survey respondents were asked to rate some of their
experiences and choices in the Medicaid program using a
0 to 10 scale, with 0 being the poorest possible rating and
10 being the highest possible rating. Results for all such
ratings are listed below:

Choice of PCPs in Medicaid: 7.61 2.56
Overall Rating of Respondents' PCP: 8.24 2.34
Choice of Specialist in Medicaid: 8.14 2.57
Overall Rating of Respondents' Specialist: 8.72 2.10
Choice of Dentists in Medicaid: 5.86 3.89
Overall Rating of Respondents' Dentist: 7.13 3.60
Rating of Medicaid Program Overall: 7.77 2.29


Key Issues for AHCA to Most recent enrollees have already enrolled in Medicaid
Consider before. In a companion report, Harman et al report that
the PMPM expenditures for chronically ill beneficiaries are
higher in the 3 months after a lapse in coverage than in the
3 months before a lapse. Thus, it may be more cost-
effective to keep people enrolled continuously.

Consider streamlining and shortening the application and
recertification process. Respondents spent many days
completing their Medicaid application, and the complexity
of the application may act as a barrier to enrollment.

Address issues of unmet need and PCP access for the
newly enrolled. Enrollees may experience particular
difficulty accessing care when they are new to Medicaid.






Experiences Prior to Current Enrollment in Medicaid


Survey Responses
Overall

N % ors
First-time Medicaid enrollee
Yes 139 37.37%
No 233 62.63%

Had health insurance during the month prior to enrolling in Medicaid
Yes 72 19.67%
No 294 80.33%

(If insured prior to enrolling)
Insurance type
Private health insurance through an employer 35 50.00%
Private health insurance not through an employer 6 8.57%
Medicare 6 8.57%
Other* 23 32.86%

(If previously privately insured)
Still Enrolled in This Private Insurance?
Yes 24 34.78%
No 45 65.22%

(If previously privately insured)
Reason for Losing Private Health Insurance (Choose all that apply)
Lost Job Due to Illness 2 4.35%
Lost Job- other 17 36.96%
Could No Longer Afford to Pay 4 8.70%
Lost Coverage Due to Divorce/Child Custody 3 6.52%
Other (record verbatim) 16 34.78%
Moved 7 15.22%

(If not insured prior to enrolling)
Mean time uninsured in MONTHS

Respondent "went without" needed medical care at some point in 6 months prior to
Medicaid enrollment
Yes 169 45.80%
No 200 54.20%

Usual source of care in the 6 months prior to Medicaid enrollment
Doctor's Office or Private Clinic 83 22.37%
Community Health Center or Public Clinic 54 14.56%
Public Health Department 41 11.05%
Hospital Outpatient Dept. 32 8.63%
Hospital Emergency Room 93 25.07%
Some Other Place (specify) 10 2.70%
No Regular Place of Care 111 29.92%

Kept same usual source of care upon enrolling in Medicaid?
Yes 122 50.21%
No 121 49.79%






Experiences Prior to Current Enrollment in Medicaid


Survey Responses
Overall

N % ors
(If respondent changed usual source of care upon enrolling in Medicaid)
Usual source of care in Medicaid
Doctor's Office or Private Clinic 157 62.80%
Community Health Center or Public Clinic 27 10.80%
Public Health Department 13 5.20%
Hospital Outpatient Dept. 20 8.00%
Hospital Emergency Room 34 13.60%
Some Other Place (specify_ 7 2.80%
No Regular Place of Care 29 11.60%

Length of Time to Complete Medicaid Application Process
1 day or less 41 12.5%
2 to 7 days 76 23.2%
8 to 14 days 47 14.4%
15 to 30 days 92 28.1%
31 to 60 days 48 14.7%
61 days to 6 months 17 5.2%
More than 6 Months 6 1.8%

Received help with application form?
Yes 77 20.75%
No 294 79.25%

Source of help with application form
Someone at State Agency 16 20.78%
Someone at Private Charity of Social Services Agency 9 11.69%
Friend or Family Member 45 58.44%
Someone from a Doctor or Provider's office 8 10.39%
Other 0 0.00%



Length of time from submission of application to notification of enrollment
1 week or less 70 22.15%
8 to 14 days 58 18.35%
15 to 21 days 47 14.87%
22 to 28 days 79 25.00%
29 days to 8 weeks 51 16.14%
More than a weeks 11 3.48%

*The open-ended responses of the respondents in this category were examined and were not able to be classified into
any of the other categories. Examples of responses include, "Humana," and "Blue Cross." In these cases, the






Managed Care Plan Choice Process


Survey Responses
Overall

N % ors
At time of application, enrollee was aware that he/she would have a choice of health
plans
Yes 143 62.45%
No 86 37.55%

Received Written Info about Choices of Medicaid Health Plans
Yes 165 73.33%
No 60 26.67%

(Of those who received information) Reviewed Written Information
Yes 141 85.45%
No 24 14.55%

Information was clear and easy to understand
Strongly Agree 36 25.53%
Agree 90 63.83
Disagree 11 7.80%
Strongly Disagree 4 2.84%

Received info in time to make health plan choice
Strongly Agree 46 32.62%
Agree 79 56.03
Disagree 13 9.22%
Strongly Disagree 3 2.13%

Info was complete and correct
Strongly Agree 44 31.43%
Agree 86 61.43%
Disagree 9 6.43%
Strongly Disagree 1 0.71%

Called Medicaid Options 888 for info/help in choosing plan
Yes 102 44.35%
No 128 55.65%

(For those who did not call Medicaid Options)
Respondent had heard of the Medicaid Options 888 number before interview
Yes 57 44.88%
No 70 55.12%

Medicaid Options was helpful
Very Helpful 63 63.00%
Somewhat Helpful 27 27.00%
Somewhat Unhelpful 6 6.00%
Very Unhelpful 4 4.00%

Sought help in making plan choice from sources other than Medicaid Options
Yes 46 20.09%
No 183 79.91%






Managed Care Plan Choice Process


Survey Responses
Overall

N %ors
(For those who sought help other than Medicaid Options)
Source of help
Someone at a State Agency 10 21.74%
Someone at Private Charity of Social Services Agency 4 8.70%
Friend or Family Member 13 28.26%
Someone from a Doctor or Provider's office 14 30.43%
Other 8 17.02%

Respondent had decided which plan to choose, as of time of interview
Yes 172 77.83%
No 49 22.17%

(Of those who had decided on a plan)
Respondent has called choice hotline to select plan
Yes 110 65.48%
No 58 34.52%






Plan Experiences and Satisfaction


Survey Responses
Overall

N % ors
Selected Primary Care Doctor 263 84.29%
Yes 49 15.71%
No

Mean Rating of the Choice of Primary Care Doctors in Medicaid (0-10 scale) 7.61 2.56

Been To See Primary Care Doctor 207 79.31%
Yes 54 20.69%
No

Mean Rating of Primary Care Doctor 8.24 2.34

Needed to See Doctor But Couldn't 73 23.70%
Yes 235 76.30%
No

Reason for not Seeing Doctor
Didn't nave a HPU yet or didn't Know whom to see 9 12.33%
Couldn't get time ot worK 4 5.48%
Couldn't get transportation 6 8.22%
Couldn't get child care 3 4.11%
Couldn't get an appointment with the PUP you wanted 26 35.62%
Not certain whether visit would be covered by Medicaid 9 12.33%
Utner (record verbatim) 10 13.70%
Couldn't get an appointment soon enough 16 21.92%

Seen a specialist while enrolled
Yes 117 37.38
NO 196 62.62

Mean Rating of Choice of Specialists in Medicaid (0 to 10 scale) 8.14 2.57

Mean Rating of Specialist (0 to 10 scale) 8.72 2.10

Problem Getting Referral for Specialist
A big problem 18 15.52%
A small problem 14 12.07%
Not a problem 84 72.41%

Needed to See Specialist But Couldn't
Yes 67 21.34%
No 247 78.66%

Reason for not Seeing Specialist
Couldn't get a reterral 14 20.90%
Couldn't get time ott worK 1 1.49%
Couldn't get transportation 3 4.48%
Couldn't get cild care 1 1.49%
Couldn't get an appointment 24 35.82%
Not certain wneter visit would be covered by Medicaid 19 28.36%
Utner (record verbatim) 6 8.96%
Couldn't Get an appointment soon enough 7 10.45%







Plan Experiences and Satisfaction


Survey Responses
Overall

N % ors
Seen a Dentist while enrolled
Yes 72 22.93
NO 242 77.07

Mean Rating of Choice of Dentists in Medicaid (0 to 10 scale) 5.86 3.89

Mean Rating of Dentist (0 to 10 scale) 7.13 3.60

Needed to See Dentist But Couldn't
Yes 135 43.27%
NO 177 56.73%

Reason for Not Seeing Dentist
Didn't Know whom to see or couldn't find a Medicaid dentist 48 35.56%
Couldn't get time ot worK 3 2.22%
Couldn't get transportation 3 2.22%
Couldn't get clild care 1 0.74%
Couldn't get an appointment 11 8.15%
Not certain whether visit would be covered by Medicaid 59 43.70%
Utner (record verbatim) 27 20.00%

Ivietn uI u ve[ratl rd g uT lly U IVIU dIU u U iu scale) -.// : 2.29




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