Schultz, J., K. T. Call, R. Feldman, and J. Christianson. 2001. “Do Employees use Report Cards to Access Health Care Provider Systems?” Health Services Research 36 (3): 509-530.

OBJECTIVE: To investigate consumers' use of report cards that provide information on service quality and satisfaction at the provider group level. DATA SOURCES: In 1998 we conducted a telephone survey of randomly selected employees in firms aligned with the Buyers Health Care Action Group (BHCAG) in the Minneapolis-St. Paul market. STUDY DESIGN: Univariate probit models were used to determine report card utilization, perceived helpfulness of the report card, and ease of selecting a provider group. The characteristics used in the models included health status, age, gender, education, residency, job tenure, marital status, presence of dependent children, household income, and whether consumers changed provider groups. DATA COLLECTION: Our sample consists of survey responses from 996 single individuals (a response rate of 91 percent) and 913 families (a response rate of 96 percent). The survey was supplemented with data obtained directly from employers aligned with BHCAG. PRINCIPLE FINDINGS: Consumers who changed to a new provider group are more likely to use report card information and find it helpful, consumers employed in large firms are less likely to use the report card, and families who use information from their own health care experiences are less likely to find the report card helpful. In addition, individuals who changed to a new provider group are more likely to find the selection decision difficult. CONCLUSION: The findings show that health care consumers are using satisfaction and service-quality information provided by their employers.

Kelly, A., K. T. Call, B. Staub, B. Donald, C. L. Wisner, A. F. Nelson, and R. W. Blum. 2002. “Children with Complex Chronic Medical Conditions and Special Needs Privately Insured through an HMO.” Families, Systems, and Health 20 (3): 279-289.

Examines the managed care services provided to children with complex chronic medical conditions and special needs in the U.S. Perspectives of families on care and service delivery; Information on the cost for hospitalization; Roles of schools in providing and financing rehabilitation therapies for children with special needs.

Blewett, L. A., S. Smaida, C. Fuentes, and E. Ulrich. 2003. “Health Care Needs of the Growing Latino Population in Rural America: Focus Group Findings in One Midwestern State.” Journal of Rural Health 19 (1): 33-41.

Latinos represent nearly 13% of the U.S. population, surpassing African-Americans as the nation's largest racial/ethnic group. Many rural midwestern communities are seeing unprecedented growth in their Latino populations, creating new challenges and pressures for health and social service providers. This study is based on four focus groups conducted in three rural communities to examine concerns with health care services and access to care. Focus group analysis found several key barriers to health care access, including cost of health care services and frustration with the complexity of the U.S. health care system, as well as language and cultural issues that adversely affect patient-provider relationships. In addition, a number of impediments related to employer-sponsored health coverage were identified, including prohibitive premium costs as well as concerns about occupational injuries and access to care during work hours. The growth of the Latino population in the rural Midwest will require changes in existing health and social service systems to serve as a bridge to new systems in this country. We recommend several policy options including premium subsidies for low-wage jobs, community-based enrollment specialists for public programs, and continued research and data collection to monitor change and progress.

McAlpine, D. and K. T. Call. 2004. “Racial and Ethnic Disparities in Utilization of Preventive Services and Barriers to Care among Minnesota Health Care Program Enrollees.” MetroDoctors 6(6): 11.

Jonk, Y. C., K. T. Call, A. H. Cutting, H. O’Connor, V. Bansiya, and K. Harrison. 2005. “Health Care Coverage and Access to Care: The Status of Minnesota’s Veterans.” Medical Care 43(8):769-774.

OBJECTIVES: The primary objective of this study was to examine veterans' reliance on health care services provided by the Veterans Health Administration (VHA) within Minnesota and estimate the potential effect on uninsurance rates if all eligible veterans relied on VHA coverage. Secondary objectives were to compare veterans and nonveterans' by geographic location, demographic characteristics, health status, and health insurance coverage and to compare insured and uninsured veterans especially with regard to access to care. RESEARCH DESIGN: Data are from the 2001 Minnesota Health Access Survey of a stratified random sample of more than 27,000 respondents, of whom 3,500 were self-identified veterans. Although all veterans were eligible to obtain health care services from the VHA in 2001, veterans not reporting VHA coverage and having no other source of insurance coverage were considered uninsured. Differences in weighted population characteristics are reported. Logistic regression analysis is used to identify factors associated with veterans' reliance on VHA coverage. RESULTS: Veterans represented 13.4% of the state's adult population and 9.3% of the state's uninsured nonelderly adult population in 2001. Uninsured veterans were more likely to be single, unemployed, living in rural areas, and reporting constrained access to services than insured veterans. Veterans with a non-VHA source of insurance were less reliant on VHA services. CONCLUSIONS: The state's uninsurance rate would significantly decrease if VHA capacity constraints were alleviated and veterans relied on the VHA safety net. If veterans' insurance status matters in states with low uninsurance rates, VHA coverage has broader implications for states with higher veteran concentrations and higher uninsurance rates.