Ohio Health Policy Review

Website features comparison data on Cincinnati hospitals

"A new Web site allows users to find out how individual Greater Cincinnati hospitals compare on performance measures related to heart attack, congestive heart failure and pneumonia." (Source: "Web site allows Cincinnati hospital comparisons," Business Courier of Cincinnati, Feb. 27, 2008.) The website's data was collected is part through the Hospital Quality Improvement Project initiative of the Greater Cincinnati Health Council and the Ohio Hospital Association. While hospitals were not required to participate in the effort, at least 20 of them did. To access the website, go to www.gchchospitalquality.org.

Business of health care forum in Dayton on March 25

The Dayton Business Journal will be hosting four "Business of Health Care" breakfast forums this year in conjunction with Premier Health Partners. The first forum, on the business view of health care benefits, will take place March 25 from 7:30am to 9:30am at the Crowne Plaza Hotel in Dayton. Registration and more information available here.

GAO: Private Medicare plans can cost beneficiaries more than government-run program

According to a new Government Accountability Office (GAO) report, private Medicare plans often cost beneficiaries more than the traditional government-run Medicare program. (Source: "Private Medicare Plans' Cost Questioned, Feb. 28, 2008, NY Times.) "About one-fifth of the 44 million Medicare beneficiaries--9 million people--are in private plans, known as Medicare Advantage plans. (According to the new report), Medicare spends more per beneficiary in Medicare Advantage than it does for beneficiaries in the original Medicare fee-for-service program, at an estimated additional cost to Medicare of $54 billion from 2009 through 2012." While Bush administration officials and insurance executives say Medicare Advantage plans offer cost savings and added benefits to beneficiaries, the GAO found that "certain costs are not counted toward the out-of-pocket limits established by some insurers. Thus, it said, among Medicare plans with out-of-pocket limits, 29% exclude the cost of some cancer drugs, 23% exclude the cost of some mental health services and 21% exclude home health care expenses." This means beneficiaries who use these excluded services "may pay more in total cost-sharing than is indicated by the plan's out-of-pocket maximum."

Ohio hospitals, emergency rooms see large increase in visits

According to new information from the Ohio Hospital Association (OHA), there were more than 34 million inpatient and outpatient visits to Ohio hospitals in 2006, an increase of nearly 13% in the past five years. (Source: "Different Hospitals, Different Doorways, Constant Care," Health Beat, Feb. 28, 2008, Ohio Hospital Association.) Outpatient visits drove the increase, but 1.5 million visits were serious enough to require hospital admission (with Ohioans receiving inpatient hospital care for a total of 7.7 million days).

Hospital emergency departments are also saw an sharp increase in patients with 5.7 million visits in 2006. This represents a 13.6% increase over 2003. Of these visit to the emergency rooms in 2006, 933,000 were from patients without insurance coverage--even though only 8% of these uninsured patients had a serious enough medical condition to require an observation bed or admittance to the hospital. According to the OHA, this shows that hospital emergency departments are being used as a major source of general health care services for Ohio's uninsured, who have limited access to other sources of health care.

Feds: All kids advised to receive flu shots

A new recommendation from the federal Advisory Committee on Immunization Practices says that all kids between the ages of 6 months and 18 years should receive flu shots. (Source: "All kids advised to get flu shots," Columbus Dispatch, Feb. 28, 2008.) "The change, likely to be made no later than the 2009-2010 flu season, would bring a huge expansion in national guidelines. Both the flu shot--which has been abundant in recent years--and the nasal vaccine may be used in children. At the moment, the Centers for Disease Control and Prevention recommends the vaccination of children 6 months to 5 years old, people 50 or older and those at highest risk of complications from flu." The Dispatch article quoted Dr. William Barson, an infectious-disease specialist at Nationwide Children's Hospital, as saying that vaccinating children helps protect their families and others from getting sick.

Strickland criticizes feds SCHIP rejection

In Washington D.C. on Tuesday to testify before the House Energy and Commerce Committee, Gov. Ted Strickland "criticized the Bush administration for blocking an expansion of a government health insurance program to cover uninsured Ohio children." (Source: "Strickland criticizes federal denial of health insurance expansion," Gannet News Service, Feb. 26, 2008.) Strickland said the Centers for Medicare and Medicaid Services' rejection of an Ohio plan to expand Medicaid eligibility for children in families up to 300% of the federal poverty level was a "clever bureaucratic maneuver" which denied coverage to an estimated 20,000 children. He also criticized several regulatory changes made in the Medicaid program which, while saving the federal government money, will drive up costs in Ohio and decrease the equality of care.

Regional forums on family violence prevention

A series of regional forums on family violence prevention will be held around Ohio starting in early March. The forums, hosted by the Health Policy Institute of Ohio with funding support from the Anthem Foundation of Ohio, aim to present the findings and recommendations in the recently released White Paper on Improving Family Violence Prevention in Ohio and create dialogue around this issue.

For specific dates, locations, and registration information, follow these links:

• March 7th in Canton
• March 14th in Athens
• April 4th in Youngstown
• April 11th in Cleveland
• May 2nd in Toledo
• May 9th in Lima
• May 16th in Cincinnati
• May 23rd in Zanesville

U.S. health care spending projected to double by 2017

According to new federal projections, "By 2017, total health care spending will double to more than $4 trillion a year, accounting for one of every $5 the nation spends." (Source: "Spending on Health to Rise Dramatically," Associated Press, Feb. 26, 2008.) "The 6.7% annual increase in spending--nearly three times the rate of inflation--will be largely driven by higher prices and an increased demand for care, the Centers for Medicare and Medicaid Services said Monday. Other factors in the mix include a growing and aging population."

The projections were published online in Health Affairs, where the abstract adds that slower growth in private health care spending toward 2017 is expected to be offset by stronger growth in public spending. In addition, the health share of the nation's gross domestic product (GDP) is expected to increase to 16.3% in 2007 and then rise throughout the projection period, reaching 19.5% of GDP by 2017. (Source: "Health Spending Projections Through 2017: The Baby-Boom Generation Is Coming To Medicare," Health Affairs.)

CMS proposes new rules on Medicaid coverage, cost-sharing

Last Thursday the Centers for Medicare and Medicaid Services (CMS) announced two proposed rule changes that the agency said would grant states "unprecedented flexibility" in designing Medicaid programs even as the rules required more cost sharing for beneficiaries. (Source: CQ HealthBeat via American Health Line.) According to CMS, the proposed rules are part of efforts to implement the Bush administration's "goals of aligning Medicaid more closely with private market insurance and giving states more control over their Medicaid benefits packages."

As reported in American Health Line, "The rule changes would allow states to offer alternative benefit packages called benchmark plans, which would provide Medicaid beneficiaries with health coverage that has the same value as plans offered to other individuals in the same state. Benchmarks would include the standard PPO plan offered to federal government employees, state employee coverage offered by the largest HMO or coverage approved by (United States Department of Health and Human Services). States would have the choice of offering additional benefits such as dental coverage. States also would be able to contribute to a beneficiary's employer-sponsored health plan premiums so that the individual could remain insured through the private sector." As part of these rules, states could also increase cost sharing for beneficiaries with incomes between 100% and 150% of the federal poverty level, while beneficiaries with incomes greater than 150% of the poverty level could be required to contribute copayments.

National Health Council meeting on Feb. 28 in Columbus

The National Health Council, in partnership with the Alzheimer's Association, will sponsor a town hall meeting and news conference on Thursday, February 28, 2008 in Columbus. The event starts at 10:00 am and ends at 11:30 am and will take place in the Clinton Room of the Fawcett Center at The Ohio State University, 2400 Olentangy River Road. For more information, please contact Joseph LaMountain at joseph.lamountain@gmail.com or 202-288-5124.