Donaghue and Rx Foundation Support Kentucky Medicaid Survey

Donaghue and the Rx Foundation are co-funding a survey of the Kentucky population conducted by the University of Pennsylvania about the state’s new Medicaid program intended for the Medicaid expansion population — low-income adults who are not disabled, not pregnant or not medically frail.

The program, called Kentucky HEALTH, requires that enrollees engage in a minimum of 80 hours a month of work, education or volunteer activities; make a contribution to cover the premium cost regardless of their income level; and adhere to tighter timeframes for redetermination of eligibility if coverage is lapsed. Both funders are contributing half of the $270,000 two-year award.

Because the program was approved under the Medicaid waiver policy, Kentucky HEALTH is required to have an evaluation. The Commonwealth of Kentucky has contracted with the University of Pennsylvania to do this evaluation, which will include a randomized controlled trial. The Donaghue and Rx Foundation-funded survey will complement this evaluation by asking the general Kentucky population about their awareness, understanding, attitudes and beliefs about the new program. This study will go beyond existing research that has asked only broad questions related to support for personal responsibility and will compare differences between new Medicaid enrollees and the general population regarding the role of the state in health care and in beliefs, knowledge and support for the new program.

The survey will over-sample lower income individuals who may be eligible for the new program either now or in the future. Plus, given the survey methods that are being used, it will also be possible to identify salient narratives from Medicaid beneficiaries on stigma that they feel or experience and to relate those themes with actual employment and educational activities of beneficiaries and barriers they may face to labor force participation. Because data collection will continue for two years, it will be possible to detect changes over time about people’s beliefs and knowledge of the new program.

The results of both the RCT evaluation and the population-level survey will be valuable information to the 16 states that are either implementing or developing plans with similar waivers to their Medicaid programs. The study is led by Atheendar Venkataramani, MD, PhD, at the Perelman School of Medicine, University of Pennsylvania and Kristin Underhill, JD, PhD, of Columbia Law School.

The Rx Foundation, which focuses is on funding innovative projects and people to improve healthcare quality and access in the United States, is also a co-funder of one of the Donaghue Greater Value Portfolio awards.