The study of psychological and tangible factors on access to care for medicaid population

Access to care is now more affordable for the socioeconomically disadvantaged women after the Affordable Care Act (ACA) and Medicaid Expansion. However, data has shown a decrease in the primary care visit rate in Broome County, NY for Medicaid population since 2013 until now. A system dynamics (SD) model is developed to capture the barriers for access to primary care according to the Health Belief Model (HBM) constructs. HBM is a psychological model that is primarily developed for predicting health services utilization by explaining the health behavior of individuals. The four pillars in the health belief model focus on beliefs and attitudes and include perceived (barriers, susceptibility, severity and benefits). The core structure of HBM is used to support the causal loop diagram (CLD) and assist in capturing the perception and physical barriers in the model. A time series data on primary care utilization is adopted for Broom County from the New York State Delivery System Reform Incentive Payment (DSRIP) dashboard to visualize the problem. As a result, the model will be used to propose policy interventions that are tailored to acknowledge unique perception barriers of access to care, for the purpose of increasing women's access to care.