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Article Title

Who Is Coming to Kaiser? A Comparison of the Characteristics of Estimated Eligible to Purchase Insurance Through Colorado’s Marketplace to Kaiser Permanente Colorado New Members

Publication Date

4-30-2015

Keywords

health reform, new members

Abstract

Background/Aims: An estimated 254,000 Coloradans were eligible to purchase private insurance through Colorado’s health insurance marketplace. Many of those eligible chose Kaiser Permanente Colorado (KPCO). New member characteristics could impact both operational decisions and provision of quality care. This project compares characteristics of Coloradans estimated to be eligible (estimated eligible) to purchase insurance through the marketplace, those who enrolled through the marketplace, and those who chose KPCO.

Methods: This study included data on the estimated eligible population from the Colorado Health Institute’s 2013 Colorado Household Access Survey of 10,224 randomly digit dialed Coloradans. Preliminary data about Coloradans who enrolled through the marketplace were collected by the administrator, Connect for Health Colorado. KPCO data were from KPCO’s administrative systems and a survey of 2,570 randomly selected KPCO new members through the marketplace.

Results: As of August 2014, 145,994 Coloradans had enrolled in one of 10 carrier’s health plans available through the marketplace. As of August 2014, 59,645 (41%) enrollees chose KPCO. To date there were 1,017 (40%) respondents to the survey. When compared to the estimated eligible, Coloradans who enrolled through the marketplace were older. KPCO new members were more educated (54% vs. 27% graduated college), less likely to be Hispanic (9% vs. 24%), and appeared to have a higher household income than the estimated eligible. The KPCO new members and estimated eligible were similar in the percentage reporting having usual source of health care (51% in both groups) and seeing a provider in the previous 12 months (39% vs. 38%), but fewer KPCO members reported delaying seeking care in the previous 12 months because of costs (34% vs. 42%). KPCO enrollees had similar age distributions to all Coloradan enrollees (35% Coloradans vs. 36% KPCO 35–54 years old; 25% vs. 27% 55 years old or older).

Discussion: New members to KPCO who enrolled through Colorado’s marketplace differ from the estimated eligible, but appear to be similar to all Coloradan enrollees. New enrollee characteristics inform KPCO’s operational teams how to position themselves in the marketplace and provide quality health care. Knowing who enrolled is important for future plans of all carriers and concerned state health officials.

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