Health insurance, LGBT health disparities and health-related needs assessment all part of the latest Commonwealth Institute efforts

Susan Buchino, Ph.D. candidate

Susan Buchino, Ph.D. candidate

Ryam Combs, Ph.D., M.A.

Ryam Combs, Ph.D., M.A.

Liza Creel, Ph.D., M.P.H.

Liza Creel, Ph.D., M.P.H.

Researchers of the Commonwealth Institute Kentucky, based in the School of Public Health and Information Sciences, presented results of the their latest work at the Kentucky Voices for Health 2016 Annual Meeting on February 2, 2016 in Frankfort, Kentucky.

Consumer Kynect Experience

Ph.D. candidate Susan Buchino presented on the experiences of Kentuckians who enrolled in health insurance through kynect. The qualitative study, sponsored by Kentucky Voices for Health, investigated the motivations for signing up for insurance, the process of using the kynect system, and Kentuckians’ use of their new health insurance.

Participants reported on a variety of reasons for signing up for health insurance, and the majority of participants had positive experiences with enrollment through kynect. Although they were generally positive about their new coverage, the enrollees identified persistent challenges related to understanding information about their insurance, navigating the health care system, and increasing costs under private plans.

Kynect users generally expressed peace-of-mind found in having health insurance and the ability to receive needed care without the added stress from financial burden.

LGBT Health Disparities

Ryan Combs, Ph.D., M.A., presented on health disparities in the lesbian, gay, bisexual, and transgender (LGBT) population - discussing the social determinants of health, stigma, discrimination, and bias in health care. He reported the findings of a qualitative study, sponsored by Kentucky Voices for Health, investigating the experiences of LGBT Kentuckians who signed up for health insurance.

The research found that LGBT people also experienced issues such as low health insurance literacy, difficulty navigating bureaucracy, frustrations with technology, and concerns about cost. Unique difficulties, however, included systemic barriers such as transgender health exclusions in insurance policies and billing errors due to gender marker mismatches. Participants in the study also discussed poor treatment by office staff and health care providers, which eroded their trust in the health care system. Recommendations include increasing the cultural competency of care providers and the inclusivity of health care services, as well as enhancing policies and regulations to remedy these problems such as the civil rights provision of the Affordable Care Act, Section 1557.

Health-related Needs Assessment

Liza M. Creel, Ph.D., M.P.H., presented on a recent project through the State Innovation Model (SIM) Design Grant. The Commonwealth Institute of Kentucky (CIK) was contracted by the Cabinet for Health and Family Services to assess Kentuckians’ current health-related needs and to make recommendations for engaging consumers and their advocates in the SIM Testing Grant, if funded.

Kentuckians participating in the project identified systemic challenges including long wait times, increasing costs, low health literacy, and adequate time with their providers. The SIM Design plan linked proposed health system transformation efforts to consumer feedback.

Finally, the CIK project team made recommendations for consumer engagement following those outlined by FamiliesUSA. The complete Kentucky State Health System Innovation Plan, including the consumer engagement findings and recommendations, can be found online.



March 18, 2016

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