Ohio Health Policy Review

HPIO expects to name new President by end of September

The Chairman of the Board of Directors of the Health Policy Institute of Ohio, Joe San Filippo, has announced that the HPIO Board of Directors Executive Search Committee has begun identifying and interviewing candidates for the permanent President position of the statewide organization. It is anticipated the new President will be announced by the end of September.

Greg Moody, who served as the interim leader since May 3, had contracted with HPIO’s Board of Directors to serve in the position through the end of August before returning, full-time, to his position as a senior consultant with Health Management Associates.

“We appreciate Mr. Moody’s work on behalf of HPIO during this time of transition,” San Filippo said. “It was important for the organization to continue moving forward with research and analysis, particularly in light of national health reform, and I am very pleased that our organization has been able to do that.”

If you have any questions about the leadership change or the work of HPIO, please contact HPIO Vice President and Chief Operating Officer Ted Backus at 614.224.4950, extension 315, or e-mail him at tbackus@hpio.net.

National survey: Employees paying larger share of ESI premiums

A new national study from the Kaiser Family Foundation and the Health Research & Educational Trust found that although annual employer-sponsored insurance premiums increased by just 3 percent this year, employees are being asked to pay 14 percent more of the total cost (Source: “Workers shouldering more of health-care burden,” Akron Beacon Journal, Sept. 2, 2010)

According to the Employer Health Benefits 2010 Annual Survey, the average worker is paying almost $4,000 this year for family coverage, an increase of $482. Total premiums for family coverage increased to $13,770.

The 2010 survey included 3,143 randomly selected public and private firms with three or more employees.

330 Ohioans enroll as high-risk pool opens

Ohio’s new insurance pool for those with pre-existing conditions opened Wednesday and the state announced that 330 Ohioans are currently enrolled (Source: “Ohio health insurance pool covers about 330,” Associated Press via Newark Advocate, Sept. 2, 2010).

As part of national health reform legislation that passed in March, states are required to either set up a special high-risk insurance pool for individuals with pre-existing conditions or enable residents to enroll in a national one. Ohio has contracted with Medical Mutual of Ohio to manage the pool. The state is one of 27  that opted to run its own pool rather than rely on the pool operated by the federal government.

Officials with the Ohio Department of Insurance said the number or enrollees is lower than expected but thousands of applications have been requested and the state still projects that about 5,500 Ohioans will eventually get coverage through the program.

The state's Web site for the high-risk pool is http://www.ohiohighriskpool.com/

Cincinnati’s HealthBridge gets $13.8 million in federal funds

Secretary of Health and Human Services Kathleen Sebelius announced yesterday that Greater Cincinnati HealthBridge will receive $13.8 million over three years to help implement health information technology in the organization’s 16-county service area (Source: “Sebelius announces $13.8M for HealthBridge,” Cincinnati Business Journal, Sept. 2, 2010).

The money comes from the Beacon Community Program, which was created as part of last year’s economic stimulus legislation.

“The Beacon program uses health information technology tools to link health providers and other community-wide resources in new and innovative ways,” Secretary Sebelius said, according to a HealthBridge press release.  “Under the Beacon program, communities first identify leading health problems that are unique to their community, develop innovative, health IT-related strategies, and work together through community collaborations to implement their strategies and track their performance.”

Strickland to reimburse hospitals, mental health with eFMAP funds

Gov. Strickland announced yesterday that he would use nearly $200 million in newly reauthorized enhanced federal Medicaid matching funds to return money to Ohio hospitals, community mental-health services and a prescription assistance program for low-income HIV/AIDS patients (Source: “Hospitals get state funds,” Columbus Dispatch, Sept. 3, 2010).

Strickland said he plans to hold back an additional $243 million in enhanced FMAP funds and consult with legislators on how best to allocate the funds.

The money Strickland plans to spend now will go toward:

• $150 million to Ohio Hospitals as reimbursement for a new tax levied to hospitals last year to balance the budget
• $32.6 million for community mental health service to offset some of the cuts made in last year’s budget
• $12.8million to the Ryan White program for those with HIV/AIDS. Hundreds were dropped from that program this summer because there wasn't enough money to meet increased demand

Study: ER visits by Medicaid enrollees doubled in past decade

A new study by researchers at the University of California San Francisco found that emergency room visits among adult Medicaid enrolless nearly doubled from 1997 to 2007 (Source: “UCSF study finds big jump in ER visits,” San Francisco Chronicle, Aug. 10, 2010).

ER visits nationally jumped from 94.9 million in 1997 to 116.8 million. While rates for the adult  Medicaid population doubled during that time, rates for adults with private insurance or those on Medicare showed now significant change, according to the study, “Trends and Characteristics of US Emergency Department Visits, 1997-2007,” which was published in the Journal of the American Medical Association.

"There are many physicians who refuse to accept new patients with Medicaid," said Dr. Ning Tang,
assistant clinical professor at UCSF and lead author of the study. "This doubling in emergency department visits by adults with Medicaid suggests they might not have adequate access to outpatient care."

And that concern of the lack of primary care capacity is also at the heart of a recent American College of Emergency Physicians survey that found that 71 percent of emergency doctors expect ER visits to increase with the passage of national reform (Source: “Newly insured expected to crowd ERs,” Columbus Dispatch, Aug. 12, 2010).

"The reason is insurance is not equal to access," said Dr. Gary Katz, president of the Ohio chapter of the American College of Emergency Physicians.

Commonwealth article: How states organize for reform will determine if law is a success

Because national health reform legislation was written with an emphasis on state's taking a lead role on implementation, how states begin to organize their efforts will be a critical determinant of whether the new law is successful in improving the U.S. health care system, according to a new article in the Commonwealth Fund’s States in Action report (Source: "Getting Organized—How States Are Preparing to Implement National Health Reform,” Commonwealth Fund States in Action, July/August 2010)
 

Authored by HPIO Interim Director Greg Moody,  the article outlines steps already being taken by a number of states.

“One of the first steps governors are taking to implement national health reform is to identify the state leaders who will guide the process,” according to the article. “Many governors have already formed health reform cabinets or task forces that report directly to them. At least 16 governors have created these implementation teams and outlined their responsibilities through executive orders or press releases.

Ohio to get $513 million after Congress extends enhanced Medicaid matching

Congress approved legislation this week that will send more than $880 million in economic aid to Ohio, included an estimated $513.8 million to extend enhanced federal matching funds for Medicaid that were originally part of last least stimulus package (Source: “Congress gives millions to Ohio, whether it needs it or not,” Cleveland Plain Dealer, Aug. 10, 2010).

The infusion of federal money comes at the same time that the nonpartisan Legislative Service Commission released a memo to the Budget Planning and Management Commission that calculates that, because of expiring one-time funds that were used to balance the current budget, the state will face a deficit of $8.4 billion when the new biennium budget is drafted next year (Source: “$8 billion in funds will disappear from state budget,” Columbus Dispatch, Aug. 12, 2010).

According to LSC projections, the budget shortfall for the 2012-13 budget ranges from $6 billion to $8 billion.

Private ambulance service CEO laments Ohio Medicaid payment change

An executive for a Toledo-based private emergency medical services company warned that changes to the way Medicaid reimburses private EMS companies may threaten the industry (Source: “Ohio’s private EMS industry said to be 'teetering',” Dayton Daily News, Aug. 11, 2010).

Fred Isch, the CEO of MedCorp Inc. said that his company recently was put into receivership and he says rules changes at Medicaid are to blame. Last summer the state began a practice called “bundling,” in which Medicaid reimbursement payments for ambulance services are funneled through nursing homes. However, Isch said rules were not put into place outlining how much or when nursing homes would pass on to private ambulance services.

“There is some real concern that the private EMS system as a whole is teetering,” Isch said. “If the privates fail on a large scale, it will cascade and cause a huge public safety issue.”

Ohio to get $2.8 for healthcare workforce development

Twenty-four Ohio institutions are set to share $2.8 million in federal funds aimed at helping train health care workers (Source: “Ohio will receive $2.8 million to train health-care workers,” Cleveland Plain Dealer, Aug. 6, 2010).

The grants are being awarded through the U.S. Department of Health and Human Services.

"We cannot build a healthier America if our country continues to face a growing health professions shortage," HHS Secretary Kathleen Sebelius said in a written statement.

Nationally, $159.1 million is being distributed to programs that:

• Bolster nursing education and prepare faculty to train future nurses. Those programs will receive $106 million.
• Fund geriatric education and training programs. Those will receive $29.5 million.
• Work to improve recruitment and performance of minority students preparing for careers in health. Those total $23.6 million.

Late last year the Health Policy Institute of Ohio released a report, the Future of the Nursing Workforce in Ohio (pdf, 24 pages), that examined ways in which the state can address an anticipated serious shortage of nurses by 2025.