|
This is the Health Chairs e-Bulletin for April 2005.
Access and Insurance
How are HSA’s doing? NCSL has been tracking legislation http://www.ncsl.org/programs/health/HSA.htm and just issued a legisbrief on them including some suggestions about actions a state may need to take. http://www.ncsl.org/legis/lbriefs/2005/05LBMar_HealthSavings.pdf
AHIP (the mergere of HIAA and HPAA) AHIP maintains a site that features news related to HSAs and links for small businesses, http://www.hsadecisions.org/
Because the program arrived to late for most employers to select in last year’s coverage cycle, most of the early plans have been purchased by individuals. According to an AHIP study of early adopters, “nearly half the covered people [were] over the age of 40. Thirty percent of the individual policies were purchased by people who were previously uninsured.” http://www.ahip.org/content/pressrelease.aspx?docid=7600
How about the uninsured with higher income? A recent analysis from the Employee Benefits Research Institute (EBRI) suggests that 3.9 million of the 11 million in this category are actually adult children or other relatives of the main family unit, who generally have substantially lower incomes themselves. Here’s their summary of findings at http://www.ebri.org/
“The Relationship Between Income and Health Insurance
“• The Census Bureau finds that individuals with family income of $50,000 or more account for 11 million individuals (or 25 percent of the uninsured) and are the fastest-growing segment of the uninsured. This report examines why this apparently high-income population does not have health insurance coverage.
“• Simply looking at family income as a determinant of health insurance coverage masks two important findings: 3.9 million of the 11 million uninsured with family income of $50,000 or more are either adult children who are not full-time students and are continuing to live with their parents, or they are adults related to the main family, and 3.2 million of them earn less than $50,000 per year.
“• The Census Bureau definitions of “family” and “family income” results in too many individuals being classified as having family income at or above $50,000. A more accurate measure indicates about 18 percent of the uninsured have family income of $50,000 or more.” http://www.ebri.org/pdf/notespdf/0205notes.pdf
Source: Employee Benefit Research Institute estimates from the Current Population Survey, March 2004 Supplement.
Children’s Mental Health
The National Institute for Health Care Management (NIHCM) Foundation recently released a report entitled “Children’s Mental Health: An Overview and Key Considerations for Health System Stakeholders.” The report is a wide-ranging survey and introduction to a multi-faceted issue. It includes a good list of additional resources as well, for those ready to explore in greater depth. http://www.nihcm.org/CMHReport-FINAL.pdf At NCSL, Michelle Herman (michelle.herman@ncsl.org) is the expert on this issue.
Costs
The American Hospital Association (AHA) has prepared an analysis of the state of its members’ finances. It’s a clear overview of the issues and concerns from their point of view, including fears that cuts in public programs will hit them hard at the same time they are being asked to make major investments in information technology. If you’ve ever delved into this topic you know that the interpretation of what is a cost, a charge and so forth can be very controversial. But however you define things, the trends and the shares provide a lot of valuable information on what is going on nationally. Your own state may have very different results. http://www.ahapolicyforum.org/ahapolicyforum/resources/content/05fragilehosps.pdf
State Resources
The New Hampshire Endowment for health has just released a report to New Hampshire from the Citizens Roundtable on Health Costs and Coverage, Stepping Up to the Future, A Healthier Health Care System for New Hampshire. The report is available at http://www.endowmentforhealth.org/_docs/59.pdf
You can’t empower consumers without providing real cost data for comparison shopping. New Hampshire’s insurance department offers a site that allows consumers to compare costs of various common procedures. In addition to New Hampshire price data, the site has a “health costs 101” area and many useful cost-related links. Here’s their mission:
“What is the purpose of HealthCost? This site is intended to help consumers with health insurance understand the typical prices of common inpatient and outpatient services. The information displayed on the site comes from New Hampshire's three largest health insurers: Anthem Blue Cross Blue Shield, CIGNA, and Harvard Pilgrim Healthcare. This website can give consumers a better understanding of the cost of health care to insurers and patients and serve as a resource to help consumers make informed decisions about what type of insurance product may best meet their needs.”
Looks like a lot of usable information and a good interface. Check it out at http://www.nhhealthcost.org/index.cfm
Rhode Island’s 1996 Health Care Accessibility and Quality Assurance Act requires health plan performance reporting in the state. This is the sixth report, with “comparative performance information, both over time and to national and regional benchmarks,” according to the press release. The report notes that, given the market in RI, it chiefly serves to serves to foster accountability rather than consumer choice. http://www.health.ri.gov/chic/performance/healthplans2003.pdf
Source: Rhode Island Department of Health 2005
Challenging Conventional Wisdom
Do hospital computers CAUSE medication errors? Sometimes, conclude Ross Koppel and colleagues in a March 9, 2005 JAMA article about the “Role of Computerized Physician Order Entry Systems in Facilitating Medication Errors.” The bottom line seems to be that they do help more than harm, but that doesn’t mean they don’t also create new and unique ways to go wrong. Because of its importance, JAMA is making this article freely available http://jama.ama-assn.org/cgi/content/full/293/10/1197
You might want to get the whole issue to check out related items on computer-assisted decision support systems and an editorial that claims the state of the art is “Still Waiting for Godot.” The crux of the problem, according to authors Wears and Berg, is “there is quite a large mismatch between the implicit theories embedded in these computer systems and the real world of clinical work. Clinical work, especially in hospitals, is fundamentally interpretative, interruptive, multitasking, collaborative, distributed, opportunistic, and reactive. In contrast, CPOE systems and decision support systems are based on a different model of work: one that is objective, rationalized, linear, normative, localized (in the clinician’s mind), solitary, and single-minded.”
Webcasts
Two new webcasts from Kaiser sound very interesting; I’ve copied their descriptions verbatim from the notice. You can subscribe to notices of webcasts by Kaiser at http://www.kaisernetwork.org/email
Disparities in Health Care briefing by Health Affairs and the Robert Wood Johnson Foundation. Business and health leaders assess the progress made since the Institute of Medicine published Unequal Treatment, which focused on ways to eliminate racial and ethnic disparities in health care. Panelists identified gaps in health care that still exist, outlined a way to eliminate disparities, debated the government's role in closing gaps in care and discussed the importance of collecting and reporting data by race and ethnicity. http://cme.kff.org/Key=6478.CwZ.C.D.D7CWN4
America's Health Insurance Plans (AHIP) 2005 National Policy Forum
Key players in health care policy, including Capitol Hill staffers, leaders of federal agencies and educators discuss the 2005 health care agenda, advancing health reform in the 109th Congress, launching the Modernized Medicare Program, and caregivers and health policy. http://cme.kff.org/Key=6478.CwZ.D.D.Dg2gSr
Windows on Worlds
The National Association of Insurance Commissioners (NAIC) has just unveiled an “insurance portal” that lets you automatically search their library and documents in state insurance commissions through a unified portal. I tested it by doing a search for an information request I had just received and was very pleased with what it turned up. Try it for insurance questions. http://www.naic.org/NBP/Basic.jsp
Do you know that NCSL has a similar portal that lets you automatically search state legislation, statute, legislative research and similar documents? http://www.ncsl.org/public/ncsl/nav_LSonlydocuments.htm
The NCSL Healthy Community Design Project has launched a database of state legislative efforts related to healthy community design policies: farm-to-school, pedestrian design, safe routes to school, and supermarket accessibility. To use the database, visit http://www.ncsl.org/programs/environ/envHealth/healthycommunity_bills.cfm.
For more information, contact Leslie Robbins at leslie.robbins@ncsl.org
The Library of Congress also has a very speedy tool for simple searches of current state legislation. InSession is brought to Thomas users by the TrendTRACK Company and is, at least for now, free. http://thomas.trendtrack.com/texis/tt/search/search.html
Tell us about your favorite on-line resources, and what issues you want to see us cover with an e-mail to Kala.ladenheim@ncsl.org
Have any questions you'd like answered? A topic for which you’d like us to gather resources? Do you have a report of your own you'd like to share with your peers? Drop us a line…
Dick Merritt, Group Director
Forum for State Health Policy Leadership
National Conference of State Legislatures
ph: 202-624-8698 fx: 202-737-1069
dick.merritt@ncsl.org
Kala Ladenheim, Ph. D. Program Manager
Forum for State Health Policy Leadership
National Conference of State Legislatures
ph: 202-624-3557 fx: 202-737-1069
kala.ladenheim@ncsl.org
|
