This report was produced by the State Health Access Data Assistance Center (SHADAC) at the University of Minnesota as part of our Study of the Impact of the Implementation of the Affordable Care Act (ACA) in Kentucky, funded by the Foundation for a Healthy Kentucky (Foundation). The study evaluates Kentucky's performance in five domains: coverage, access, cost, quality, and health outcomes. This is the Final Report for the study and provides a comprehensive presentation of study findings, including both new study findings based on analysis of recently available data and a review of key findings from prior reports. The study's initial duration was planned to last 34-months (March 2015 through January 2018); however, the duration of the study has been shortened to conclude in February 2017. Due to this, the study did not include previously planned qualitative components--focus groups with Medicaid beneficiaries and interviews with key stakeholders in Kentucky. As part of this project, SHADAC has used semi-annual and annual reports to document the impact of the ACA in Kentucky using a set of indicators selected in consultation with the Foundation and its ACA Impact Study Oversight Committee. These reports have tracked changes in the indicators through the duration of the study, and in certain cases they include comparisons of Kentucky metrics with the U.S. and other states. This report includes data obtained from analysis of a variety of federal and state data resources, including both survey and administrative data. A new section of this report presents an analysis of Medicaid administrative data previously reported in study quarterly snapshots. This section examines trends in enrollment of non-elderly adults in Kentucky's traditional Medicaid program and ACA Medicaid expansion from 2014-2016. This report also presents new findings from the Kentucky Health Reform Survey (K-HRS), which was conducted in spring 2016 by SHADAC and the University of Cincinnati's Institute for Policy Research.
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