Abstract

The Affordable Care Act (ACA) (2010) provided for the largest reform of Medicaid since its 1965 Centers for Medicare and Medicaid implementation, providing funding for both low-income and disabled citizens. The additional amount of Medicaid beneficiaries increased the complexity and effectiveness of an already struggling, massive and bureaucratic government program. From a beneficiary perspective (emic perspective), Medicaid as a federal agency, is far from "user-friendly." This problematic complexity remains despite ACA-induced Medicaid reform. Thus despite new eligibility for Medicaid services, a client may still face unresolved health concerns due to system-based or client-based obstacles to effective Medicaid utilization. Failure to establish a trusting, durable relationship between Medicaid beneficiary and healthcare provider (HCP) may result in delaying or avoidance of healthcare. Overwhelmed clients' dependence on former unhealthy healthcare seeking behaviors may prevail with a return to episodic emergency department care regardless of symptoms or acuity.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 10808113; ProQuest document ID: 2054017444. The author still retains copyright.

Author Details

Sister Agnes Marie M. Cummings, PhD, IHM, RN, CNE, CHEd

Sigma Membership

Beta Sigma

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Ethnography

Research Approach

Qualitative Research

Keywords:

Health Equity, Chronic Illness, Self-Care Integration, Medicaid

Advisor

Nalini Jairath

Second Advisor

Patricia Connor-Ballard

Third Advisor

Donna Gage

Degree

PhD

Degree Grantor

The Catholic University of America

Degree Year

2018

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

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