Health Care Needs among Insured Persons with Disabilities

Background:  Some persons with disabilities have health care needs that are not covered by their health insurance. This is well known; however, there is a lack of information that quantifies the need.

Methods: We examined the level of need among working-age adults with disabilities using a 2014 follow-up survey, Employment Need Survey (ENS), to the Massachusetts Behavioral Risk Factor Surveillance System Survey (BRFSS) (n=1014).  The ENS gathered information on the following: (a) health insurance, (b) demographics, (c) employment, (d) unmet needs for prescription medicine, mental health services, physical or occupational therapy, special medical equipment, personal care services, complementary care, care coordination (e) health care costs, and (f) service delivery.

Results: Preliminary results quantify the level of unmet need for services and problems related to health-care costs.  Insured persons with disabilities reported needing but not getting services at the following percentages: prescription medicine, 9%; mental health, 7%; physical, occupational or speech therapy, 6%; special equipment, 5%; personal care 3%; complementary care 11%; and care coordination 5%.  Persons reported problems related to health care costs:  23% needed to cut back on health care spending; 43% needed to cut back on other spending; 23% skipped doses, split pills or did not fill prescriptions due to cost; 21% skipped tests, and  treatment or follow-up due to cost.

Conclusion:  Among insured persons with disabilities, the unmet need for services ranges from 3% for personal care to 11% for complementary care.   The percentage of persons reporting cost-related problems is much higher.