Nationally, consumer worry about healthcare affordability is well documented but now—for the first time—a new survey reveals how affordability concerns and ideas for action play out in Kentucky. A survey of more than 900 Kentucky adults conducted from Feb. 7-Feb. 23, 2018, found that:
All told, a shocking 72% of adults in Kentucky experienced one or more of the following healthcare affordability problems.
Being Uninsured Due to High Premium Costs
Delaying or Foregoing Healthcare Due to Cost
More than half (55%) of Kentucky adults who needed healthcare during the year encountered one or more cost related barriers to getting that care. In descending order of frequency, they report:
Moreover, cost was far and away the most frequently cited reason for not getting medical care, exceeding other barriers, like transportation, difficulty getting an appointment, or lack of childcare.
Of the various types of medical bills, the ones most frequently associated with an affordability barrier were dental care, doctor bills and prescription drugs, likely reflecting the frequency with which Kentucky adults seek these services—or, in the case of dental, lower rates of coverage for these services.
Many Who Received Care Struggle to Pay the Resulting Medical Bills
More than half (57%) of Kentucky adults experienced one or more of these struggles to pay their medical bills:
Kentucky adults also exhibit high levels of worry about affording healthcare in the future, reporting they were "somewhat" or "very" worried about:
Kentucky adults also exhibited high levels of worry about affording health insurance coverage—except for those with military coverage (Figure 1). Affordability concern among Medicaid beneficiaries (with low or no premium expenses) may stem from fears of losing their coverage. The survey found that 71% of Medicaid enrollees report being "somewhat" or "very" worried about losing coverage.
All told, 82% of adults in Kentucky have one or more of these worries.
The survey also explored five regions in Kentucky (Figure 2) and revealed differences in how Kentuckians experience healthcare affordability burdens.The eastern Kentucky region reported the greatest number of healthcare affordability burdens (80% of adults, see Figure 3) with the Louisville metro area showing fewest affordability burdens (although still high, affecting 64% of adults).
Perhaps reflecting these high rates of healthcare affordability burdens, residents of eastern Kentucky also report starkly higher levels of worry:
Additional detail and regional reports are available at www.HealthcareValueHub.org/KY-2018-Healthcare-Poll.
In light of these healthcare affordability concerns, it is not surprising that Kentucky residents are extremely dissatisfied with the health system. Statewide:
Of more than 20 options, the options cited most frequently as being a “major reason” for high healthcare costs were:
When it comes to tackling costs, respondents endorsed a number of strategies:
What is remarkable about the findings is high support for change regardless of the respondent’s political affiliation (Table 1)
While Kentucky residents are united in calling for a role for government in addressing high healthcare costs, they also see a role for themselves:
The high burden of healthcare affordability along with high levels of support for change suggest that elected leaders and other stakeholders should make addressing this need a top priority. Annual surveys can help assess whether or not progress is being made.
Altarum’s Consumer Healthcare Experience State Survey (CHESS) is designed to elicit respondents’ unbiased views on a wide range of health system issues, including confidence using the health system, financial burden and views on fixes that might be needed. Regional reports are available at www.HealthcareValueHub.org/KY-2018-Healthcare-Poll.
The survey used a web panel from SSI Research Now with a demographically balanced sample of approximately 1,000 respondents who live in Kentucky. The survey was conducted only in English and restricted to adults ages 18 and older. Respondents who finished the survey in less than half the median time were excluded from the final sample, leaving 924 cases for analysis. After those exclusions, the demographic composition of respondents can be found in the table below. Additional information on the survey instrument is available upon request by emailing firstname.lastname@example.org.