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Findings from the Field: Medicaid Delivery Systems and Access to Care in Four States in Year Three of the ACA

The findings in this brief are based on structured interviews with key stakeholders and focus groups with Medicaid and Marketplace enrollees conducted by the Kaiser Commission on Medicaid and the Uninsured and PerryUndem Research/Communications in four states, Colorado, Connecticut, Kentucky, and Washington, in May 2016. In total, we conducted 28 in-person and phone interviews with a range of stakeholders in each state, including Medicaid and Marketplace officials, consumer advocates, assisters, and hospital and community health center (CHC) representatives. Two focus groups were held in each state, one with individuals enrolled in Medicaid coverage and the other with individuals with income less than 300% of the federal poverty level ($35,640 for an individual in 2016) enrolled in coverage through the Marketplace. The focus groups were held in Denver, Colorado; Hartford, Connecticut; Lexington, Kentucky; and Seattle, Washington. Each focus group consisted of 8 participants with a total of 64 participants, including 32 enrolled in Medicaid and 32 enrolled in Marketplace coverage. Focus group participants were selected to provide a mix of demographic characteristics, including age, race/ethnicity, and health status. Most individuals had used services since obtaining their current coverage.

The authors gratefully acknowledge Michael Perry, Sean Dryden, and Naomi Mulligan Kolb with PerryUndem Research/Communication for their work managing the fieldwork logistics, conducting the interviews, and moderating the focus groups. They also extend their deep appreciation to all the participants for sharing their perspectives and experiences to inform this project.

Issue Brief

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.