Characteristics of Newly Enrolled Members of an Integrated Delivery System after the Affordable Care Act.

Context: Little is known about the health status and care needs of new enrollees in health plans since implementation of the Affordable Care Act. Objective: To describe characteristics of new members of an integrated delivery system during early phases of implementation of the act. Design: Descriptive analysis of ongoing collection of operational data. Main Outcome Measures: The 11-question Brief Health Questionnaire, which was administered to new members of Kaiser Permanente Colorado who had benefits effective on or after January 1, 2014. Bivariate analyses compared characteristics of new enrollees by benefit. Results: Of 89,289 newly enrolled non-Medicare members, 22,548 (25.3%) completed the Brief Health Questionnaire between January 1, 2014, and August 31, 2014. Of these, 3593 respondents were insured through Medicaid, 9434 through the individual health exchange, and 9521 through primarily commercial plans. Of Medicaid, exchange, and commercial members, 19.5%, 7.1%, and 5.3%, respectively, self-reported fair or poor health; 12.9%, 2.0%, and 3.3% of each group self-reported 2 or more Emergency Department visits during the previous year; and 8.1%, 4.3%, and 4.4% self-reported an inpatient admission during the previous year. During the preceding year, 31.5% of Medicaid, 30.8% of exchange, and 12.6% of commercial members were uninsured longer than 8 months. Conclusion: Systematic collection of patients’ self-reported information can enhance traditional approaches to initiating care, inform operational planning, and describe newly enrolled populations. Newly enrolled Medicaid beneficiaries may have more initial health care needs than new exchange or commercial members; however, health differences between the latter two groups are subtle.