A Survey of Basic Resource Needs: Results from a Sample of Kaiser Permanente Southern California Members

Lewis CC, Thompson EE, Sharp AL
Publication Year: 2019
Patient Need Addressed: Food insecurity, Homelessness/housing, Transportation
Population Focus: Low income
Demographic Group: Adult
Study Design: Other Study Design
Type of Literature: Grey
link: http://sonnet.kaiserpermanente.org/survey.06.2019.html
Abstract

BACKGROUND:
Kaiser Permanente (KP) has offered subsidized insurance under the Affordable Care Act since 2014. Individuals and families with household incomes between 100% and 400% of the federal poverty level who legally reside in the US and lack access to affordable employer-sponsored insurance coverage are eligible for these federally-funded subsidies. While many initiatives have focused on Medicaid coverage, little is known about the basic resource needs of KP members who received subsidized insurance.

APPROACH:
To define the basic resource needs of KP members receiving subsidized insurance, the KP Social Needs Network for Evaluation and Translation (SONNET) conducted a survey in 2018-19 with support from KP National Community Health. We randomly selected over 1,000 members with a subsidy from the Southern California region. An equal number of members ages 18-30, 30-64 and 65+ were invited to participate. The majority of participants who received subsidized insurance and were aged 65 and over were transitioning to Medicare; a minority retained a subsidized plan. A subgroup is receiving a follow-up survey 3 or 6 months after their initial survey. The survey consists of up to 48 questions from the KP-developed Your Current Life Situation (YCLS) questionnaire, the Accountable Health Communities (AHC) survey developed by the Centers for Medicare and Medicaid Services, and other sources. The survey was administered by the KP Washington Health Research Institute’s Survey Research Program. Members responded between November 2018 and February 2019 (online, phone, or paper). Each respondent received a $20 cash incentive. We balanced sampling by gender and invited 20% Spanish and 80% English speakers to participate. 487 (48%) completed the survey (84% in English, 16% in Spanish). More women than men completed the survey (56% vs. 44%). In this report, we focus on four basic resource needs (housing, food, transportation, and utilities), and describe: 1) the prevalence of those needs in the last 3 months; 2) members’ desire for assistance from KP in addressing those needs; 3) and the extent to which KP has helped them address these needs.

Insights Results

Overview of article

  • This article assesses the basic resource needs of Kaiser Permanente (KP) members who received subsidized insurance. Specifically, the report focuses on 4 basic resource needs (housing, food, transportation, and utilities), and describes: 1) The prevalence of those needs in the last 3 months; 2) Members’ desire for assistance from KP in addressing those needs; 3) And the extent to which KP has helped them address these needs

Methods of article

  • KP Social Needs Network for Evaluation and Translation (SONNET) conducted a survey in 2018-19, randomly selecting over 1,000 members with a subsidy from the Southern California region
  • The survey consists of up to 48 questions from the KP-developed Your Current Life Situation (YCLS) questionnaire, the Accountable Health Communities (AHC) survey developed by the Centers for Medicare and Medicaid Services, and other sources

Results

  • The most prevalent basic resource need in the KP subsidized exchange was difficulty paying for food, followed by housing, and heat and
  • Respondents reporting liking to receive assistance with (in order) utilities, housing issues, food, transportation, and safety
  • Some members asked for help with social needs even though they didn’t have trouble paying for them. The only need members reported being asked about was transportation
  • All members reported concerns paying for healthcare services
  • Unstable housing remained a substantial concern with over 1/3 of respondents saying they had a place to live that day, but were worried about losing it in the future
  • Those who were younger, women, and English speakers tended to consider it more appropriate to be asked about their needs

Key takeaways/implications

  • Members felt it is appropriate to be asked about needs and recommended asking once a year or more
  • Training is needed to help clinical staff grow more comfortable asking about needs, and need to establish a way to respond with helpful information or referrals to community resources if a need is identified
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