Robert Wood Johnson Foundation
Marginalized communities of color, members of the LGBTQ+ community, and people with disabilities who are eligible or enrolled in Medicaid experience the impact of health inequities at a high rate. In order to create more informed policies, the Robert Wood Johnson Foundation wanted to conduct research into the unique challenges that may cause some of these inequities in the Medicaid community.
Goal + Objective
The goal of this project was to conduct a national research study of multicultural Medicaid enrolled and eligible individuals to better understand how they think Medicaid currently serves and could better serve them for the program as a whole, and as it relates to specific social needs: food insecurity, housing insecurity, and social isolation.
The research aimed to create a repository of data and insights about the Medicaid consumer journey that will drive improvements in health equity, policy, and advocacy.
HOW WE DID IT
The research study included three phases, beginning with a discovery phase with a literature review of the space, as well as stakeholder interviews with Policy Advisory Group (PAG) members; a group made up of experts across Medicaid, advocacy, and policy; who weighed in throughout the process.
The study utilized a combination of qualitative focus groups and in-depth interviews and a qualitative questionnaire survey, issued online and through CACI technology. Participants for this study were recruited via social media campaigns, email marketing, and advertising using a double opt-in process. There were 3,080 participants that represented Medicaid enrolled and eligible people of color, individuals with disabilities, and LGBTQ+ from across a range of age and gender groups. The sample was not weighted or nationally representative, based on our desire to oversample, and thus amplify, minority segments of the U.S. population.
Approach
Our study utilized a combination of qualitative Focus Groups and In-depth, interviews and an online questionnaire survey.
Recruitment
Participants in the study were recruited via email campaigns, social media, and advertisements using a double opt-in process.
Sampling/Weighting
Our sample was not weighted or nationally representative based on our desire to oversample, and thus amplify, minority segments of the U.S. population.
Select key findings
Searching for Information
Medicaid eligibles and enrollees (MEEs) learn about Medicaid from a variety of sources because of the lack of a central, comprehensive source for information.
Understanding Enrollment and Renewal
39% of Medicaid eligibles and 26% of Medicaid enrollees find the overall process of applying to Medicaid to be difficult.
Examining Delivery of Care
Nearly a quarter of respondents report a negative experience finding a provider who accepts Medicaid (24%). Medicaid enrollees say their options are limited because many doctor’s offices do not accept Medicaid, and the clinics that do accept Medicaid insurance are not in locations accessible to their communities.
There is a high level of interest in telehealth among MEE audiences. 71% have an interest in using telehealth services, with nearly half of the respondents having used it during the COVID-19 pandemic (45%).
Rethinking Social Needs
Food
Over half (54%) of MEEs surveyed have experienced concerns about having enough food, with 78% being “somewhat interested” in the Medicaid program helping them get nutritious food.
Housing
MEEs struggle with costs associated with housing rather than finding housing. 61% say it would be helpful for the program to offer assistance in the form of cash payments to help with utility bills and rent payments.
Social Isolation
Social isolation and loneliness are the most commonly experienced social need among MEEs. 62% surveyed say they, or their families, have been concerned about being lonely and away from friends at some point.
Report + fact sheet
Download a full report detailing the findings of this research as well as key recommendations for policymakers to consider.
The following focused facts sheets were developed for use by policymakers and advocacy groups: