The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan...
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![Page 1: The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan Catherine Hamilton, Ph.D. New York University Blue Cross.](https://reader036.fdocuments.in/reader036/viewer/2022062503/5a4d1b0c7f8b9ab05998b895/html5/thumbnails/1.jpg)
The Power of Health Insurance On the Lives of
The effectiveness of the Vermont Health Access Plan
Catherine Hamilton, Ph.D.New York University
Blue Cross and Blue Shield of Vermont
![Page 2: The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan Catherine Hamilton, Ph.D. New York University Blue Cross.](https://reader036.fdocuments.in/reader036/viewer/2022062503/5a4d1b0c7f8b9ab05998b895/html5/thumbnails/2.jpg)
Overview• Background• Research Design• Findings• Implications
![Page 3: The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan Catherine Hamilton, Ph.D. New York University Blue Cross.](https://reader036.fdocuments.in/reader036/viewer/2022062503/5a4d1b0c7f8b9ab05998b895/html5/thumbnails/3.jpg)
0%
5%
10%
15%
20%
Vermont
United States
UninsuredVermont vs. US
1990 1998
![Page 4: The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan Catherine Hamilton, Ph.D. New York University Blue Cross.](https://reader036.fdocuments.in/reader036/viewer/2022062503/5a4d1b0c7f8b9ab05998b895/html5/thumbnails/4.jpg)
Research Model
Individual Factors
Evaluation of Costs/Benefits
Enrollment Decision
(-) Access Barriers
(+) Perceived Access
(+/-) Utilization
(+) Health Outcomes
(+) Satisfaction
Year before VHAP
enrollment
UNINSURED
Year after VHAP
enrollment INSURED
(+)
(-)
![Page 5: The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan Catherine Hamilton, Ph.D. New York University Blue Cross.](https://reader036.fdocuments.in/reader036/viewer/2022062503/5a4d1b0c7f8b9ab05998b895/html5/thumbnails/5.jpg)
Selection Bias
11%
5%
19%
9%
Disabled Hospitalized
Enrollees Non-enrollees
![Page 6: The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan Catherine Hamilton, Ph.D. New York University Blue Cross.](https://reader036.fdocuments.in/reader036/viewer/2022062503/5a4d1b0c7f8b9ab05998b895/html5/thumbnails/6.jpg)
Access Barriers
53%
18% 15%
3%
Cost Knowledge
Uninsured
Insured
![Page 7: The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan Catherine Hamilton, Ph.D. New York University Blue Cross.](https://reader036.fdocuments.in/reader036/viewer/2022062503/5a4d1b0c7f8b9ab05998b895/html5/thumbnails/7.jpg)
15.0%
33.0%
31.0%
55.0%Uninsured
Delayed needed care
Did not get needed care
Insured
Access to Needed Care
![Page 8: The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan Catherine Hamilton, Ph.D. New York University Blue Cross.](https://reader036.fdocuments.in/reader036/viewer/2022062503/5a4d1b0c7f8b9ab05998b895/html5/thumbnails/8.jpg)
Preventive Care Access
29%
11%
Preventive care
Went without needed preventive care
Uninsured After insured for 12 months
![Page 9: The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan Catherine Hamilton, Ph.D. New York University Blue Cross.](https://reader036.fdocuments.in/reader036/viewer/2022062503/5a4d1b0c7f8b9ab05998b895/html5/thumbnails/9.jpg)
Access & Use Members:• unable to find doctors accepting insurance
less likely to seek preventive care
• with long appointment waits and unmet health care needs twice as likely to end up in the hospital
• with unmet needs 1.4 times as likely to visit the ER
![Page 10: The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan Catherine Hamilton, Ph.D. New York University Blue Cross.](https://reader036.fdocuments.in/reader036/viewer/2022062503/5a4d1b0c7f8b9ab05998b895/html5/thumbnails/10.jpg)
Hospitalization & ER DropDentist and Doctors’ Rise
19%11%
81%84%
28%21%
52%57%
Hospital** Doctor ER* Dentist
(-14%) (+12%) (-16%) (+30%)
![Page 11: The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan Catherine Hamilton, Ph.D. New York University Blue Cross.](https://reader036.fdocuments.in/reader036/viewer/2022062503/5a4d1b0c7f8b9ab05998b895/html5/thumbnails/11.jpg)
Increase in mental health visits
(for those with at least one visit)
10.7
21.1
Visits
Uninsured After insured for 12 months
Average change is 1.44 (.016)
![Page 12: The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan Catherine Hamilton, Ph.D. New York University Blue Cross.](https://reader036.fdocuments.in/reader036/viewer/2022062503/5a4d1b0c7f8b9ab05998b895/html5/thumbnails/12.jpg)
33%
43%UninsuredInsured
Average change is -22% (.000)
Health StatusReported a health
problem
![Page 13: The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan Catherine Hamilton, Ph.D. New York University Blue Cross.](https://reader036.fdocuments.in/reader036/viewer/2022062503/5a4d1b0c7f8b9ab05998b895/html5/thumbnails/13.jpg)
Lessons• Initiating insurance in a rural setting improved
psychological & physical well-being.– Could be cheaper, too!
• Program successfully targeted uninsured with the greatest needs.– Benefit design, enrollment process influence selection
• Inverse relationship between perceived access and hospital use.
• Mental health status of males improved significantly.
![Page 14: The Power of Health Insurance On the Lives of The effectiveness of the Vermont Health Access Plan Catherine Hamilton, Ph.D. New York University Blue Cross.](https://reader036.fdocuments.in/reader036/viewer/2022062503/5a4d1b0c7f8b9ab05998b895/html5/thumbnails/14.jpg)
Final Thoughts…Vermont’s
Opportunities• Sustaining the financing of the program
over time and reaching the final 10% uninsured
• Rethinking– how to pay for and manage the care of acutely
ill members– how to promote access within the individual
market– how to finance health care for the uninsured