For many low-income Californians, enrolling in health insurance is just one hurdle to overcome in getting the care they want. A new report says better communication with doctors and obtaining clearer information is also high on their wish lists.
California is home to nearly 7 million uninsured people – 15 percent of the national total, according to the Kaiser Family Foundation. About 3 million are eligible for the state’s Medi-Cal program, largely because they earn up to 138 percent of the federal poverty level. (Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.)
The study by the Blue Shield of California Foundation of 1,018 Californians with incomes less than 200 percent of the federal poverty level found that more than half wanted more information to make decisions about their medical care. Their interest in receiving more information jumped to 71 percent if that information was clear and accessible. (The Blue Shield foundation helps fund KHN coverage in California.)
“We must bring patients into the conversation if we want to transform health care in California and across the country,” said Peter Long, president and chief executive officer of the Blue Shield of California Foundation.
At a panel discussion Wednesday in Washington, Long said the health care system needs to look more carefully into patient-focused treatment models. These can include group doctor visits and team-based medical practices, which often bring doctors, nurses and health coaches under one roof to address each patient.
According to the report, patients in team-based care models were more likely to feel “very informed about their health.” But within these newer structures, panelists said the system also needed to address gaps between patients and their care, such as transportation needs, better use of technology, and effective education for patients.
“We don’t have to worry so much about clubbing patients with behavioral changes,” said Sara Rosenbaum, a health policy professor at George Washington University. She said many low-income individuals were already open to more information from their providers.
And while connecting the population to the right care was a central theme of both the report and discussion, there was also the question of who would be available to deliver the care in the face of doctor shortages and varying financial issues.
Dr. Kavita Patel, a physician and fellow at the Brookings Institution, said that insurance plans don’t always pay for services that help patients stay involved with their care, like transportation and certain nurse-led services. “Where this patient engagement is – that’s not where we’re paying for care,” she said.