Examining the Barriers to Healthcare

 It’s a thorny issue with no easy answer: How do we ensure that all Americans receive health care? Health policy researcher Allyson Hall, Ph.D., and her colleagues are working to understand access issues and find solutions that could help more patients get needed care.

“In my work I’m concerned with issues of access to quality health care for populations that are underserved or vulnerable in some way. This can range from low socioeconomic status to lack of insurance to living with a disability,” said Hall, an associate professor in PHHP’s department of health services research, management and policy.

Hall is part of a team, along with lead investigator R. Paul Duncan, Ph.D., chair of the department, that is analyzing outcomes of Florida’s high profile Medicaid reform. Hall studies the experiences of health care consumers enrolled in the reform program, looking at everything from the patients’ experiences enrolling in the program or making a doctor’s appointment to their satisfaction with the health plan and the care they’ve received.

Florida legislators and other state governments are watching the evaluation of Florida’s Medicaid reform program with a lot of interest, largely because Medicaid is expensive, representing up to a quarter of states’ budgets, said Hall, the research director of the Florida Center for Medicaid and the Uninsured. Policymakers want to know if Florida’s reform program can save money without sacrificing quality of care or patient satisfaction.

“With national health care reform, one of the requirements is for more people to enroll in Medicaid, so states are going to have to figure out how to do that in a prudent way and in a way that is satisfying to patients,” Hall said. “I think some of our findings as a group will help inform the policy debate moving forward.”

In a second study Hall is evaluating Florida physicians’ views on providing “medical homes” for their patients enrolled in Medicaid.

“Everybody’s talking about the concept of medical homes now, but it’s really an old idea,” Hall said. “The theory is that a primary care provider coordinates a patient’s care throughout the entire health care system and tries very hard to provide what we call patient-centered care.”

Hall traces her interest in health care access and disparities to her days as a master’s student in the college.

“Dr. Duncan was my professor and he taught a class in health and society and he talked about disparities and issues related to differences in health, even back then. I think that’s how I really became involved and concerned about access,” said Hall, who still keeps a copy of the course’s textbook in her office.

As an instructor of master’s and doctoral students, Hall also hopes to inspire students.

“I think the inquisitiveness of students forces me to learn and question all the time as well,” she said. “I get a lot of feedback from students about how my classes have encouraged them to think differently or pursue a different degree or take a different job or  re-think the world in some way. I actually find that teaching is sometimes more rewarding than the research because I feel that I have a direct impact on people who are going to have a direct impact on health care and public health.”