Critical Health Areas Project (CHAP) Newsletter

Volume 3, Issue 1

February 20, 2008

In This Issue...

Announcements:

Updated CHAP Website
Upcoming Webinar

Chronic Care and Quality:

Utilization of Prescription Drugs for Chronic Condition Treatment on the Rise

Healthcare Access:

Iowa
California

Addiction Prevention and Treatment:

D.C. Inmates Qualify for Reductions in Sentences

Providers and Workforce:

Empire State Turns Attention to Office Surgeries
In other studies/news

Announcements

Check Out the Updated CHAP Website

We are proud to launch our new, improved website—please check it out at http://www.ncsl.org/programs/health/forum/chap/index.htm. It includes updated Frequently Asked Questions that serve as health policy primers on a variety of subjects, as well as resources and information on each of the four critical health areas (chronic care and quality, healthcare access, addiction prevention and treatment, and the health care workforce).

States and Health Information Technology Webinar

Tuesday, February 26, 2008 11am-12:30pm EST/10am-11:30pm CST/9am-10:30am MST/8am-9:30am PST

This webinar on health IT will cover the following:

HIT in Florida

Florida is working to foster the use of health information technology. Florida’s initiatives include start up grants to regional health information exchanges and pilot e-prescribing and electronic medical records programs in Medicaid.

Data Breaches and HIT

Patient fear of data breaches is a major challenge hindering adoption of HIT. How do the majority of these data breaches occur? What role do states have in ensuring the security of patient data?

To register please go to http://www.ncsl.org/public/registration/mtg_reg.htm?mtg=wc022608. This webinar is FREE for all attendees. For more information on program content please contact kory.mertz@ncsl.org.

Chronic Care and Quality

Utilization of Prescription Drugs for Chronic Condition Treatment on the Rise
More adults are using their prescription benefits than in previous years, according to a report released January 2008 by Express Scripts, a large pharmacy benefit management company. This study, which illustrated the changes in patterns of prescription drug use from 2000 to 2006, included 3 million randomly selected benefits subscribers across the country. Potential reasons behind the increase include the swelling in pharmaceutical advertising, better adherence to suggested drug therapies and a greater proportion of physicians relying on medicinal therapy. However, Express Scripts indicates that the main reason for the growth in drug usage is the increasing incidence of chronic conditions. For example, state level prescribing practices for diabetes and hypertension mirror the prevalence of obesity. Overall, use of cholesterol medications doubled from 2000 to 2006. This report indicates that the cost of increased utilization of five of the studied classes of medications contributed to over $12 billion in increased medical spending in 2006 alone.

For more information on this study please visit http://www.express-scripts.com/ourcompany/news/outcomesresearch/onlinepublications/study/geoVariationTrends.pdf

To read more about the California Quality Collaborative which works to improve chronic care treatment, please visit http://www.chcf.org/topics/chronicdisease/index.cfm?itemID=112543&printFormat=true

Healthcare Access

Iowa:

The Iowa Legislative Commission on Affordable Health Plans for Small Businesses and Families released its final report on January 8, recommending that affordable and accessible health insurance be provided to all Iowans. The Commission—consisting of state lawmakers and representatives from small businesses, hospitals, providers and insurance carriers—was established through legislative mandate in 2007 to “review, analyze, and make recommendations on issues relating to the affordability of health care for Iowans”.

According to the Commission’s recommendations to the Legislature, the first step toward universal coverage in Iowa is providing all children in the state with health insurance. It also recommends that a Health Care Exchange be established to oversee and facilitate a movement toward universal coverage and that every Iowan have a “medical home”.

Senator Jack Hatch and Representative Ro Foege, co-chairpersons on the Commission, have drafted legislation to address the health reform issue, taking into account the Commission’s suggestions. The legislation, Senate Study Bill 3140, was introduced in early February.

NCSL served as an advisor of the Commission.

Link to the Commission’s report: http://www.legis.state.ia.us/lsadocs/IntReport/2008/IPPAF000.PDF

California:

January 28, the Senate Health Committee voted down, 10 to 1, Governor Schwarzenegger's and Assembly Speaker Nunez's compromise health care reform legislation (ABX 1). Those who voted against the proposal, which would have created near-universal health care coverage for the state, were primarily concerned with the state's ability to pay for the plan with its sizable budget deficit. Contributing to worries over financing was the state Legislative Analyst's Office analysis of ABX 1, released January 22. The report found that depending on the premium level—$250 versus $300 per month—the plan could either be funded sufficiently or result in a $1.5 billion shortfall after five years.

Link to the report: http://www.lao.ca.gov/2008/hlth/health_reform/health_reform_012208.pdf

Addiction Prevention and Treatment

D.C. Inmates Qualify for Reductions in Sentences

Inmates from the District of Columbia are now eligible for a federal drug treatment program that could reduce their sentences, the Washington Post reports. The Federal Bureau of Prisons currently runs a 500-hour drug treatment program for federal inmates which, if completed successfully, shaves a year off an inmate’s sentence. Previously, D.C. inmates were not eligible for a reduced sentence, since they were not convicted in federal court (although they were incarcerated in federal prisons). The bureau’s decision now allows the sentencing reduction. “They have always been permitted to be enrolled,” Traci Billingsley, a bureau spokeswoman, told the Post. “Now they can get the time off.” The program has been credited with reducing recidivism, the Post reports. Approximately two-thirds of D.C. inmates released from prison have abused drugs.

Link to the article: http://www.washingtonpost.com/wp-dyn/content/article/2008/01/17/AR2008011702816.html

Providers and Workforce

Empire State Turns Attention to Office Surgeries

New York has a new statute that will regulate office surgeries such as face-lifts, tummy tucks and colonoscopies. The law, which went into effect Jan. 14, mandates that doctors and some medical personnel who perform surgical procedures outside the hospital report adverse events to the state. Additionally, in 2009, office-based practices must receive accreditation from a national organization. "In the last 20 years, we've gone from doing virtually nothing in the office other than the most minor skin tag or skin biopsy to now doing significant surgery," said Dr. John Morley, medical director of the Health Department's Office of Health Systems Management. "And we are evolving toward being able to safely do more and more in the office."

To view the article, go to: http://www.timesunion.com/AspStories/story.asp?storyID=658537&category=STATE&newsdate=1/26/2008

Other studies/news

An essay by Ed O’Neil of the Center for the Health Professions at the University of California, San Francisco, on three ideas for addressing the health care workforce shortage without stealing health care professionals away from their home countries who need them.

http://www.futurehealth.ucsf.edu/from_the_director.html

The Wall Street Journal reported on a University of California Los Angeles program aimed at increasing the number of Spanish-speaking physicians in the United States. The program trains medical school students in Latin America for the U.S. board examinations and provides guidance for internships and residencies. The physicians must work three years in the states in either a large city or a rural location. The program has enrolled 14 physicians and costs approximately $48,000 each. It is estimated that 14 percent of the U.S. population is Hispanic, while only 5 percent of physicians are. http://online.wsj.com/public/article/SB119793741946235423.html

According to the Association of American Medical Colleges (AAMC), in 2007 medical schools admitted 8.2 percent more students than in 2006. In November 2007, AAMC released a report documenting, among other things, the percent of physicians in states that are over age 60, the number of doctors who received their training internationally and the proportion of each state’s residents who are medical students. For more information on this report, please visit http://www.aamc.org/workforce/statedatabooknov2007.pdf.

For more information on CHAP and these critical issue areas, visit our website! http://www.ncsl.org/programs/health/forum/chap/index.htm

The Critical Health Areas Project (CHAP) newsletter is published monthly by the Forum for State Health Policy Leadership at NCSL and funded through the generous support of the Robert Wood Johnson Foundation.

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