While I was growing up, the kitchen table was the center of many important conversations for my family, whether they were practical or philosophical. We would gather at the end of a long day, and share stories about our experiences or personal opinions about tough issues that had our attention. It was a safe setting to reveal our innermost thoughts accompanied by a genuine desire to listen to each other.
Kitchen tables are where many families have important conversations and share intimate details about their lives. With this in mind, last fall, CCMU sought to recreate the kitchen table experience in order to hear directly from Medicaid patients. We convened in locations they were familiar and comfortable with, shared a meal together, and listened openly. Through our existing partnerships with Mercy Housing, Together Colorado, and the La Familia Family Resource Center, we were able to join meetings that these organizations have with their constituents and ask for honest feedback about how Medicaid is working.
Although CCMU has always been committed to engaging the medically underserved to better understand their experiences and share their stories, the reason we pursued this specific feedback was because we had a unique opportunity to drive change in Medicaid. The Colorado Department of Health Care Policy and Financing had requested feedback from stakeholders to inform the new contracts for the Medicaid Accountable Care Collaborative (ACC).
The stories we heard were very different across the groups we engaged with: single mothers in an affordable housing unit in west Denver, people with highly complex medical conditions in Aurora, and primarily Spanish-speaking families in Fort Collins. But, we came away with one lesson that remained true across all groups: Medicaid is vital to the health and well-being of those covered by it. Even though all these individuals acknowledge that the system is far from perfect, and that the challenges differ from person to person and from group to group, they recognize the value of having health insurance to meet some of their health needs.
One woman in Aurora shared her story about how she got seriously ill after she lost her private health insurance, ended up in the ER, and couldn’t afford to pay for her care. Fortunately, she was eligible for Medicaid at that point, and it saved her financial future.
Many others echoed this positive sentiment about Medicaid. They often find it covers the care they need, as one woman said: “You need it; they’ll cover it. There’s a little copay, but it’s good.” Another said it was a “piece of cake” to get care for her child, which was a priority for her as a young single mother. Others celebrated that Medicaid started to cover dental benefits for adults, saying, “Prior to July of this year, if you had oral issues all you could do was pull the tooth out, so this is great.”
However, we also consistently heard that although Medicaid provides critical help in a time of need, the system is still complicated and burdensome to navigate. One participant explained that in order to get the care you need, “You need to know the system.”
CCMU walked away from these “kitchen tables” with an authentic understanding of how some patients experience the system, and we brought a summary of these conversations to the state in order to affect change in the next iteration of the ACC. The importance of this work was summed up for us by another woman, who said, “Thank you very much for being here. Sometimes, we feel like things will never change. Maybe now they will.”