Health Affairs

The dramatic expansions in health insurance coverage included in the Patient Protection and Affordable Care Act (ACA) will give millions of low-income Americans greater choice in where and how they receive their health care. Until now, most of the discussion around our changing healthcare landscape has focused on the goals of payers and providers, rather than the needs and desires of patients. Although policymakers have emphasized the importance — and necessity — of engaging patients differently under reform, there have been few data to inform these discussions.

Against this backdrop, Blue Shield of California Foundation commissioned a series of representative, random-sample surveys of Californians aged 19 to 64 with household incomes less than 200 percent of the federal poverty level. The ultimate goal of these surveys is to bring the voices of low-income Californians into the conversation about how best to deliver care in the ACA-shaped future in order to inform policy choices and help providers prepare for a reformed healthcare system.

Resetting Expectations

The first report, On the Cusp of Change: The Healthcare Preferences of Low-Income Californians, based on a spring 2011 survey, revealed that fewer than half of low-income residents feel satisfied with their current health care and six in ten report being interested in switching to a new facility if they had the insurance to cover it. With full implementation of the ACA rapidly approaching in 2014, providers serving low-income Californians will have to change the way that they practice in order to retain their current patients, and attract those who are newly eligible for coverage.

The author is the president and CEO of the Blue Shield of California Foundation, a statewide funder located in San Francisco. Since the passage of the Affordable Care Act , there has been a persistent, urgent call to produce more primary care physicians. With many provisions of the health reform law to be implemented less... Read the rest of this entry »