Dear Health Committee Chairs:
These are excerpts from the July, 2007 email update on state health policy resources available on the Internet.
Resources Online
Access
The CDC in June released the latest findings from the National Health Interview Survey (NHIS). They estimate that at a point in 2006, 43.6 million people were uninsured. For non-elderly adults, there was a statistically significant increase in the number of uninsured. The number of adults between 18 and 64 increased by 1.1 million in 2006. http://www.cdc.gov/nchs/about/major/nhis/released200706.htm
Kaiser Family Foundation researchers used the NHIS to track changes in numbers of families offered health insurance via their employer. From 1998 to 2005 the offer rate decreased by 3 percent to 77 percent overall. To view this analysis please visit http://www.kff.org/insurance/upload/7667.pdf.
The Annual Kaiser Family Foundation and Health Research and Educational Trust Employer Health Benefits survey is now available. Some findings: 19 percent of employees who have a choice between consumer-directed health plans and traditional plans select the consumer driven plans. Subscribers to consumer driven plans, such as Health Savings Accounts (HSAs), frequently report dissatisfaction and confusion regarding the plans. One source of dissatisfaction is the elevated deductibles for items like maternity care. The Kaiser Family Foundation and Health Research and Educational Trust survey can be accessed here: http://www.kff.org/insurance/7527/index.cfm.
Another report by the Kaiser Family Foundation and Georgetown University Health Policy Institute compared the deductibles for 12 consumer driven plans with a traditional plan. Combining the three theoretical pregnancy scenarios, traditional plan deductibles cost $12,469, while deductibles for consumer driven plans range from $12,545 to $38,896. The Kaiser Family Foundation and Georgetown University Health Policy Institute report can be found here: http://www.kff.org/womenshealth/7636.cfm.
Using data from the U.S. Census Bureau’s Current Population Surveys (2004-2006), Centers for Medicare & Medicaid Services (2002-2005) and the Centers for Disease Control and Prevention’s National Health Interview Survey (1997 & 2005), the Robert Wood Johnson Foundation (RWJF) and State Health Access Data Assistance Center at the University of Minnesota have compiled a 50 state analysis of children’s access to health insurance. The report can be found at http://www.rwjf.org/files/publications/other/shadacschip07.pdf
Costs
The California HealthCare Foundation released its fourth version of Health Care Costs 101, analyzing U.S. health care spending. For spending distribution by contributors, spending patterns as a share of GDP and associated growth rates please visit http://www.chcf.org/documents/insurance/HealthCareCosts07.pdf.
Hewitt Associates, a human resource outsourcing group, released a study on HMO premium rates across the United States. According to their report, HMO premium rates will increase by an average of 8.4 percent in 2007. http://www.hewittassociates.com/Intl/NA/en-US/AboutHewitt/Newsroom/PressReleaseDetail.aspx?cid=4159
Providers and Workforce
A report released by consumer advocacy group Public Citizen indicates that serious disciplinary actions against physicians by state medical boards decreased by 10 percent to 2,919 in 2006. The Alaskan medical board had the highest rate of serious disciplinary actions while Mississippi had the lowest. The report claims that these findings are evidence that boards are under-disciplining physicians and that additional resources and legislative oversight are needed. Groups like the Federation of State Medical Boards counter that due to the state to state variations in funding and authority these rankings misrepresent the actual situation. To view the report please go to http://www.citizen.org/publications/release.cfm?ID=7525&secID=1158&catID=126.
For more information on the Federation of State Medical Boards visit their web page http://www.fsmb.org/.
Emergency Departments are the subject of two new studies. Press Ganey Associates, a private firm specializing in hospital satisfaction surveys, released a national study on emergency department (ED) wait times by state. The national average wait time was determined to be three hours and forty-two minutes. Iowa scored the shortest waits measuring two hours and eighteen minutes. The longest wait of four hours and fifty seven minutes occurred in Arizona. Although emergency department utilization patterns and wait times reflect differences in hospital size, staffing levels, and rates of underinsurance and uninsured, which vary by state, this survey can be seen as a good starting point for individual state assessments. To see where your state ranks please visit http://www.pressganey.com/products_services/readings_findings/findings/avg_time_spent_er.pdf.
A CDC report released in late June documents the increase in ED visits to 115.3 million in 2005, representing a 31 percent increase since 1995. In contrast to the national ED average wait time determined by Press Ganey Associates of three hours and 42 minutes, the CDC’s report places this figure at 3.3 hours. Please contact your state health department to see how your state compares to these national averages. The CDC report can be viewed at http://www.cdc.gov/nchs/data/ad/ad388.pdf
Quality and Chronic Conditions
The department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) awarded $22 million in grants for HIV/AIDS services to underserved populations. These grants are part of the Ryan White Program which was reauthorized last December. A list of the institutions receiving the grants can be found at http://newsroom.hrsa.gov/releases/2007/PartCgrantsJuly2007.htm.
The CDC has complied multiple sources on aging data at http://www.cdc.gov/Features/Aging/. As our population continues to age and the proportion of elderly increases these statistics and figures will prove to be a valuable resource for all lawmakers. For instructions on accessing individual state aging data please visit http://www.cdc.gov/nchs/about/otheract/aging/statedata.htm.
Public Health
In a Congressionally-requested analysis of abstinence-only sexual education programs, Mathematica concluded that students who were taught the abstinence-only curriculum were as likely to engage in premarital sex as their counterparts who received comprehensive sexual education programs. Many states have rejected federal money for the Title V programs or altered their state laws to require sexual education be “medically accurate.” The Sexuality Information and Education Council of the United States (SIECUS) recently released a review of sexual education and abstinence till marriage programs in each state for fiscal year 2006. The report includes information regarding state laws, proposed legislation, the amount of funding states receive and how it is utilized. To view Mathematica’s report, please go to http://www.mathematica-mpr.com/publications/PDFs/impactabstinence.pdf. The individual state profiles created by SIECUS can be found at http://www.siecus.org/policy/states/index.html.
Health IT
The Center for Information Technology Leadership (CITL) released a study modeling the long-term benefits of using health technology to coordinate and improve diabetes care. The report estimates that over the next 10 years, electronic diabetes registries, which track and store patient-specific information, would save $14.5 billion. To view the report, please go to http://www.citl.org/_pdf/The_Value_of_IT_Enabled_Diabetes_Management.pdf.
Mental Health
A CDC survey of patients medical records from 2005 listed the most frequently mentioned drugs. Topping the list were antidepressants, followed by high blood pressure drugs and then headache and arthritis medications. The figures do not represent the actual number of prescriptions written but the number of times the drug was mentioned in the patients chart. The CDC report can be viewed at www.cdc.gov/nchs/data/ad/ad388.pdf.
Addiction
An article in the Archives of General Psychiatry presented new analyses from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). This report divulges that a “lost decade” between disorder onset and treatment frequently occurs, and that the potential for alcohol abuse is greatest among people ages 30-64. To view the press release please visit http://www.nih.gov/news/pr/jul2007/niaaa-02.htm.
Long Term Care
The National Health Policy Forum released a new issue brief regarding Real Choice Systems Change Grants, which are intended to shift long term care patients from institutions to community based-care. This publication outlines the grant program’s many adjustments since its incarnation in 2000. http://www.nhpf.org/pdfs_ib/IB822_SystemsChange_05-30-07.pdf
Counter Conventional Wisdom
A recent GAO report determined that long term care insurance partnership programs, which were expected to reduce Medicaid costs by helping lower income people purchase private long-term care insurance, may actually increase Medicaid spending slightly. The potential rise would be dampened because few policyholders will exhaust their long term care benefits and spend down their assets to become eligible for Medicaid. The report titled “Long-Term Care Insurance: Partnership Programs Include Benefits That Protect Policyholders and Are Unlikely to Result in Medicaid Savings” can be accessed at http://www.gao.gov/new.items/d07231.pdf.
A Sweet Finish…
A Journal of the American Medical Association study found that dark chocolate is associated with lowered blood pressure. When consumed in small amounts, dark chocolate can lower blood pressure in people with untreated hypertension. To view the study, please visit http://jama.ama-assn.org/cgi/content/short/298/1/49.
Several months worth of past Chairs e-bulletins are archived at: http://www.ncsl.org/programs/health/forum/chairs/ebull/index.htm.
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.
Kala Ladenheim, Ph. D. Program Director
Forum for State Health Policy Leadership
National Conference of State Legislatures
ph: 202-624-3557 fx: 202-737-1069
Kala.Ladenheim@ncsl.org
Donna Folkemer, Group Director
Forum for State Health Policy Leadership
National Conference of State Legislatures
ph: 202-624-8171 fx: 202-737-1069
Donna.Folkemer@ncsl.org
 Health Chairs Project
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