scholarly journals Barriers to Primary Care After the Affordable Care Act: A Qualitative Study of Los Angeles Safety-Net Patients’ Experiences

Health Equity ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. 423-430
Author(s):  
Sonali Saluja ◽  
Danny McCormick ◽  
Michael R. Cousineau ◽  
Janina Morrison ◽  
Lisa Shue ◽  
...  
Keyword(s):  
Primary Care ◽  
Los Angeles ◽  
Qualitative Study ◽  
Affordable Care Act ◽  
Safety Net ◽  
The Affordable Care Act

scholarly journals 2250 Barriers to healthcare after the Affordable Care Act: A qualitative study of Los Angeles safety net patients’ experiences with insurance and healthcare

2018 ◽  
Vol 2 (S1) ◽  
pp. 64-65
Author(s):  
Sonali Saluja ◽  
Danny McCormick ◽  
Michael Cousineau ◽  
Janina Morrison ◽  
Michael Hochman
Keyword(s):  
Primary Care ◽  
Los Angeles ◽  
Qualitative Study ◽  
Affordable Care Act ◽  
Safety Net ◽  
Urgent Care ◽  
Poverty Level ◽  
Care Clinic ◽  
Safety Net Hospital ◽  
The Affordable Care Act

OBJECTIVES/SPECIFIC AIMS: N/A. METHODS/STUDY POPULATION: Over a million people gained insurance in Los Angeles (LA) County under the Affordable Care Act (ACA). The vast majority gained Medicaid—government sponsored insurance with low-cost sharing. LA County also made significant investments in the safety net including a program called MyHealthLA, which provides primary and tertiary care for the residually uninsured including poor undocumented individuals at specific sites. Despite this insurance expansion, approximately 3 quarters of a million people in the county remain uninsured. Regardless of insurance status, nearly a quarter of LA County residents reported having difficulty obtaining needed medical care, and among those making less than the poverty level, 43% had difficulties. There is still much to understand about barriers to obtaining insurance and accessing healthcare in Los Angeles in the post-ACA era. Our primary objective was to understand how safety net patients are obtaining, maintaining and using their insurance after the ACA. Specifically we hope to understand the barriers and drivers of these three processes. RESULTS/ANTICIPATED RESULTS: We conducted a qualitative study of 34 safety net patients with 3 different insurance types in LA County. We conducted in-person interviews with adult patients (ages 18–64 years), who had either MediCal, MyHealthLA, or were unsinsured. Our interview guide was based on existing literature, a previous qualitative study conducted in Massachusetts and input from experts in the field. We pilot tested our interviews in English and Spanish and then recruited our participants from 3 sites: LAC+USC (a publically funded county hospital), The Wellness Center (a resource center for safety net patients), and White Memorial Medical Center (a private safety net hospital). We approached patients in the ED and urgent care waiting rooms and obtained informed consent for this IRB approved study. We excluded patients who were non-English and non-Spanish speaking or too ill to interview. We recorded interviews, which were then transcribed and translated into English by a contracted agency. We analyzed our interviews using a framework approach, which included a set of a priori codes from the literature as well as emerging codes from patient responses. We will check a sample of our transcripts for coding consistency (aiming for an inter-rater reliability of >80%). DISCUSSION/SIGNIFICANCE OF IMPACT: We recruited a diverse group of patients that were demographically representative of those who gained insurance under the ACA (childless adults making less than 138% of the Federal Poverty Level). Our preliminary results (based on 17 transcripts), suggest that patients, regardless of insurance type have difficulty accessing primary care. We identified seven domains under the broader theme of barriers to accessing primary care: finding a primary care clinic or physician (PCP), getting timely appointments, geography and transportation, continuity of care, using the Emergency Department (ED) or urgent care as a PCP, switching PCPs or clinics, and cost or coverage.

scholarly journals Creating a safety net for patients with depression in primary care; a qualitative study of care managers’ experiences

2018 ◽  
Vol 36 (4) ◽  
pp. 355-362 ◽  
Author(s):  
Irene Svenningsson ◽  
Camilla Udo ◽  
Jeanette Westman ◽  
Shabnam Nejati ◽  
Dominique Hange ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Safety Net ◽  
Care Managers

After the Affordable Care Act: Health Reform and the Safety Net

2016 ◽  
Vol 44 (4) ◽  
pp. 585-588
Author(s):  
Peter Shin ◽  
Marsha Regenstein
Keyword(s):  
Health Care ◽  
Community Health ◽  
Affordable Care Act ◽  
Health Reform ◽  
Community Health Centers ◽  
Safety Net ◽  
Public Hospitals ◽  
Health Centers ◽  
Safety Net Providers ◽  
The Affordable Care Act

Two major safety net providers – community health centers and public hospitals – continue to play a key role in the health care system even in the wake of coverage reform. This article examines the gains and threats they face under the Affordable Care Act.

scholarly journals The Impact of the Affordable Care Act (ACA) Medicaid Expansion on Visit Rates for Diabetes in Safety Net Health Centers

2018 ◽  
Vol 31 (6) ◽  
pp. 905-916 ◽  
Author(s):  
Nathalie Huguet ◽  
Rachel Springer ◽  
Miguel Marino ◽  
Heather Angier ◽  
Megan Hoopes ◽  
...  
Keyword(s):  
Affordable Care Act ◽  
Safety Net ◽  
Health Centers ◽  
Medicaid Expansion ◽  
The Affordable Care Act ◽  
The Impact

Community-Oriented Primary Care (COPC) and the Affordable Care Act

2014 ◽  
Vol 6 (2) ◽  
pp. 128-133 ◽  
Author(s):  
Jaime Gofin ◽  
Rosa Gofin ◽  
Jim P. Stimpson
Keyword(s):  
Primary Care ◽  
Affordable Care Act ◽  
The Affordable Care Act
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