Ohio Health Policy Review

ODH, HPIO release dental Care data brief

Researchers at the Ohio Department of Health and the Health Policy Institute of Ohio have released a data brief, titled “Oral Health Findings from the Ohio Family Health Survey, 2008,” (pdf, 2 pages) examining dental care in Ohio, using data from the most recent Ohio Family Health Survey.

The report found that regardless of family income status, dental care was the most pressing unmet health care need for both adults and children.

Some of the findings include:

• 479,000 Ohio children (or 18.3 percent) were without dental insurance, compared to 111,000 children (4 percent) who were uninsured for medical care
• Even though low-income children (those in families earning less than 200 percent of the federal poverty level, or $41,300 for a family of four) had higher rates of dental coverage, they were less likely to have a dental visit in the past 12 months (68 percent of low-income children, compared to 81.5 percent of higher-income children)
• 3,433,000 (or 39.4 percent) of Ohio adults 18 and older reported having no dental coverage, compared to 1,232,000 (or 14.1 percent) of adults who reported being uninsured for medical care
• For adults, family income and job status are associated with a lack of dental coverage

Ohio Medicaid Director: Expansion this year unlikely

Although federal reform legislation enables states to expand Medicaid coverage as early as this year, Ohio Medicaid Director Tracy Plouck said the state’s tight budget makes that unlikely here (Source: “Ohio Medicaid chief says early expansion unlikely,” Associated Press, via Business Week, May 20, 2010).

Plouck said Ohio, like many other states, is concerned about paying its share of the federal-state insurance program, even though the federal government currently pays about 74 percent of Ohio's Medicaid costs, an increased match rate written into the stimulus bill that was signed by President Obama last year. The state’s standard federal match is 63 percent.  That increased aid runs out at the end of 2010, however, and it's unclear if Congress will extend it.

States will be required to extend Medicaid eligibility in 2014, covering people with incomes up to 133 percent of the federal poverty level, or about $29,327 a year for a family of four. Also, childless adults will be covered for the first time. The federal government will pick up 100 percent of the cost for newly eligible enrollees for three years. After that, federal support gradually declines through 2020.

The state had planned on implementing an expansion of Medicaid for children from 200 percent of the federal poverty limit to 300 percent of the FPL as part of the bienium budget that was passed last July. The State's fiscal year 2010-2011 budget called for funding the expansion, and other non-health related measures, with a portion of the State's tobacco settlement dollars; however, questions as to whether the State can use this funding source remain unclear and that expansion also remains on hold.

Central Ohio hospital systems create ‘Columbus Fetal Medicine Collaborative’

The four major hospital systems in the Columbus area have formed one of the nation’s first fetal medicine collaboratives aimed at improving outcomes for high-risk expectant mothers, according to a news release from the hospitals.

Officials from Mount Carmel Health System, OhioHealth, The Ohio State University Medical Center and Nationwide Children’s Hospital announced this week that they have created the Columbus Fetal Medicine Collaborative.

Dr. Richard O’Shaughnessy, director of the fetal treatment program at Ohio State University Medical Center and professor of maternal fetal medicine, and Dr. Donna A. Caniano, surgeon-in-chief and chief of pediatric surgery at Nationwide Children's Hospital, co-chair the collaborative.

The collaborative has created a Web site at www.columbusfetalmedicine.org.

Ohio first state to join national push to eliminate unenrolled eligible children

Ohio announced this week plans to become the first state to join an Obama Administration challenge to eliminate within five years the ranks of unisured children who are eligible for government assistance (Source: “Ohio joining push to insure kids,” Columbus Dispatch, March 12, 2010).

Two of three uninsured kids in Ohio , or 77,000 children,  are eligible for public programs but are not enrolled.

To meet the goal eliminated uninsured eligibles, Ohio will adopt three initiatives to make it easier for families to enroll in the State Children's Health Insurance Program (SCHIP) and keep them covered longer. The initiatives are:

• Give children 12 months of continuous eligibility.
• Allow entities such as hospitals and community clinics to grant "presumptive eligibility" to children who appear to qualify, allowing them immediate access to care. Providers would be guaranteed payment should the application later be denied.
• Establish "express-lane eligibility" to eliminate much of the paperwork for families already determined to be eligible for food stamps and other government programs.

OSU study: Three simple steps could reduce childhood obesity

A study authored by an Ohio State researchers has found that preschoolers who eat dinner with their families, got adequate sleep and limited television viewer were significantly less likely to be obese (Source: “Study: Family routines cut the risk of childhood obesity,” Columbus Dispatch, Feb. 8, 2010).

The study, “Household Routines and Obesity in US Preschool-Aged Children,” was published on the Web site for the journal Pediatrics.

The research found that, independent of diet and exercise, 4-year-olds were 40 percent less likely to be obese if their parents limited TV viewing to no more than two hours a day, if the family ate dinner together at least six nights a week, and if the preschooler slept at least 10 1/2 hours on weekdays. And even if families were able to do one or two of those things, they would still help, according to Sarah Anderson, the study's lead author and an assistant professor of epidemiology at Ohio State University's College of Public Health.

The findings are particularly noteworthy because such routines are free and relatively easy to accomplish.

The research looked at 8,550 children whose parents were asked about various behaviors in 2005 for the national Early Childhood Longitudinal Study.

 

Ohio bill aims to reduce obesity through school reforms

On Tuesday lawmakers in both the Ohio House and Senate introduced a bill aimed at reducing childhood obesity by requiring schools to provide more nutritious food, making physical activity mandatory and tracking students’ body-mass index rate (Source: “Ohio bill targets obesity in schools,” Cincinnati Enquirer, Nov. 17, 2009).

"Kids spend six, seven hours a day at school. It's the No. 1 place they are outside their homes," said state Sen. Eric Kearney (D-North Avondale), a co-sponsor of the "Healthy Choices for Healthy Children" bill. "The easiest way to build good behaviors is by starting in schools."

The bill is being backed by the Health Choices for Health Children coalition, a newly formed group of businesses, providers and health-care advocates led by the Ohio Business Roundtable. The Health Policy Institute of Ohio met with the coalition as it worked to develop recommendations for reducing childhood obesity.

March of Dimes: Ohio gets ‘F’ for preterm birthrate

The March of Dimes released its latest Premature Birth Report Card this week and Ohio was given an F, ranking 33rd among the 50 states plus the District of Columbia and Puerto Rico (Source: “March of Dimes report card gives Ohio a grade of 'F' for its preterm birthrate,” Cleveland Plain Dealer, Nov. 17, 2009).

In the organization’s second annual Report Card, Ohio was one of just two states to see their preterm birthrate drop, from 13 percent last year to 13.3 percent on this year's report card. The nation, as a whole, was given a grade of D.

The Report Card is based on data from the National Center for Health Statistics, which lags a couple of years behind. One reason for optimism for Ohio is that that means the birth rate does not reflect the work of the Ohio Perinatal Quality Collaborative, which formed in 2007 and includes the state’s 20 largest birthing hospitals. One of the primary goals of the OPQC is to reduce medically unnecessary preterm births at 36, 37 and 38 weeks gestation.

Cincinnati researchers tout benefits of physician ‘bulletin board’

Researchers at Cincinnati Children’s Hospital Medical Center say that doctors who used a Web-based “global bulletin board” to share information on treatments saw dramatic increases in patient outcomes (Source: “Health 'bulletin board' shows promise,” Cincinnati Enquirer, Nov. 13, 2009).

The study focuses on a program called “ImproveCareNow,” which involved a group of pediatric gastroenterologists sharing information on new treatments and their effectiveness on patients with Crohn’s disease and ulcerative colitis. Over a 27-month period, participating doctors saw the percentage of patients in remission increase by 20 percent.

The program's success earned Cincinnati Children's a five-year, $8.3 million grant from the National Institutes of Health that will expand on the original concept and bring patients and their families into the network.

Ohio infant mortality collaborative sees early success

A collaboration of state agencies, hospitals and other entities in Ohio has found early success in reducing the number of some scheduled deliveries, which have been increasing nationally for more than a decade (Source: “Collaboration of Ohio agencies, hospitals, other groups reduces scheduled preterm births,” Cleveland Plain Dealer, Sept. 15, 2009).

The Ohio Perinatal Quality Collaborative was formed in 2007 to reduce the number of preterm births at 36, 37 and 38 weeks' gestation that aren't medically necessary and reduce the number of hospital infections in babies weighing less than 3 pounds, 5 ounces.

Since March 2007, the average number of scheduled deliveries (babies born in member hospitals between 36 weeks' and just under 39 weeks' gestation) that were not medically necessary has dropped from about 13 percent to 6.8 percent.

According to OPQC, preterm birth is the leading cause of infant mortality in Ohio.

Akron Children's Hospital gets $800k in stimulus funds to treat abuse victims

Akron Children’s Hospital has been given $882,550 in federal stimulus funds to expand services that evaluate children who are victims of sexual, physical or emotional abuse (Source: “Akron Children's Hospital to expand services for young abuse victims using federal stimulus money,” Cleveland Plain Dealer, Sept. 3, 2009).

The hospital’s Children at Risk Evaluation Center currently evaluates children who are referred by private doctors, law enforcement and other agencies, but will now be able to offer longer-term treatment.

"Children who are victims of abuse carry the psychological and sociological trauma throughout their lives," Dr. Daryl Steiner, director of CARE, said in a prepared statement. "Early intervention minimizes the long-term effects of the child's victimization."

The hospital was one of 14 organizations to be given the two-year stimulus grant through the U.S. Department of Justice.