Ohio Health Policy Review

HPIO interim director: Medicaid could cost state extra $1 billion in 2012

Testifying at Tuesday’s hearing of the state Budget Planning and Management Commission, Health Policy Institute of Ohio Interim Director Greg Moody told the bipartisan legislative panel that unless the federal government provides more funds or the state takes action, the Medicaid program is going to cost Ohio an additional $1 billion from 2011 to 2012 (Source: “Medicaid to add $1 billion to state budget quandary,” Columbus Dispatch, July 20,2010).

And this comes at a time when the state is already expected to face a budget shortfall estimated at between $5 billion and $8 billion.

Moody said his projection is based on the assumption that federal matching funds, which were increased as part of the federal stimulus package last year, return to normal levels and the state experiences a 6.1 percent increase in spending, as projected by the Congressional Budget Office. Moody's presentation is available here (pdf, 10 pages).

While unlikely to remedy short-term budget challenges for the Medicaid program, Moody outlined a series of cost containment strategies that could reduce long-term costs for the program:

• Focus on prevention and primary care
• Care coordination and disease management
• Price and quality transparency
• Payment reforms that reward value
• Behavioral/physical health integration
• Rebalance Medicaid long-term care

Another speaker at the hearing, John Begala, executive director of the Cleveland-based Center for Community Solutions, said among the short-term options that the state may consider are capping hospital payments and reducing the 12.5 percent administrative allowance for HMOs. Those recommendations were included in Community Solution’s recently published report on the state budget, “Thinking the Unthinkable: Finding Common Ground for Resolving Ohio’s Fiscal Crisis.” (pdf, 50 pages)

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

2010 Ohio Family Health Survey interviews set to begin

The 2010 Ohio Family Health Survey, managed by the Ohio Colleges of Medicine’s Government Resource Center and the Health Policy Institute of Ohio, is expected to begin collecting interviews in the middle of July, with interviews to be concluded in August.

The stratified random digital dial survey of approximately 5,200 Ohio households (using both land-line and cellular phones) is a follow-up to the 2008 Ohio Family Health Survey, which was one of the largest and most comprehensive state-level health and insurance surveys conducted in the nation.

The emphasis for the 2010 survey is gauging the level of economic stress on Ohio families and how that is impacting Ohio's health system and indicators of health, according to Tim Sahr, HPIO Director of Research and co-principal investigator on the OFHS. The OFHS team also is planning another major survey of 50,000-plus households in 2012 that will track results from the 2008 survey and will include county-level information.

Initial data results from the 2010 OFHS are expected later this year.

HPIO releases fact sheet on impact of national reform on Ohio's uninsured

As Ohio policymakers continue to implement national health reform, the Health Policy Institute of Ohio is planning to publish a series of Health Reform Fact Sheets. Over the next six months, HPIO will be releasing the short papers designed to describe the Ohio-specific impact of national reform on coverage, provider capacity, delivery system reform, information transparency, and State resources. The latest of these, finished this week, addresses Ohio’s uninsured and how they will be impacted by reform.

HPIO also has released its National Health Reform Framework — a one-page summary of implementation priorities that can be used by HPIO and others as a starting point for more detailed discussions about the challenges and opportunities related to reform.

In addition, HPIO also has created a presentation,"What Reform Means for Ohio," that describes national reform, implementation challenges, and opportunities for Ohio to improve health system performance (this presentation is ideal for strategic planning — please contact Jill Huntley at 614-224-4950 or jhuntley@healthpolicyohio.org if you are interested in scheduling Greg Moody, HPIO Interim Director, to present at your organization and/or facilitate a discussion on the impact of reform).

HPIO releases "A Snapshot of Ohio's Health Safety Net"

The Health Policy Institute of Ohio, through support from the HealthPath Foundation of Ohio, has released A Snapshot of Ohio's Safety Net (pdf, 71 pages, 13MB), a report on the economic downturn’s impact on safety net services in Ohio and other states’ strategies to monitor safety net change. HPIO, with support from the HealthPath Foundation of Ohio, collaborated with researchers at Wright State University to undertake the Safety Net Snapshot Project, which surveyed Ohio-based safety net providers, conducted community-level interviews and investigated other states' monitoring efforts. A fact sheet (pdf, 2 pages) of the general findings in the report is also available.

In addition, HPIO and the Ohio Association of Second Harvest Foodbanks are hosting five regional forums to discuss the status of the health care safety net in Ohio (see details below, in the left-hand column). Each forum will include a presentation of the findings of the Ohio Safety Net Snapshot Report as well as a panel of local providers to address the impact of the economic downturn and federal health reform on the safety net.

Click here for the regional forums presentation (pdf, 65 pages)

HPIO, partners release family violence profiles of all 88 Ohio counties

The Health Policy Institute of Ohio and its partners in the Ohio Family Violence Prevention Project, under the leadership of Kenneth Steinman of The Ohio State University College of Public Health, have released profiles of family violence in all 88 counties in Ohio.

Links to all 88 profiles can be found at: http://www.hpio.net/OFVPP_CountyProfiles.html

To coincide with the release, HPIO is hosting five regional forums throughout the state. Each forum will present data on child abuse/neglect, intimate partner violence and elder abuse/neglect and provide training to those interested in using the information to build support for prevention. The events are scheduled from 9:30 a.m. to 12:30 p.m.  on April 9 in West Chester, April 12 in Columbus, April 16 in Nelsonville, April 19 in Toledo and April 23 in Akron (the forum are free, but registration is required; see www.hpio.net for more details about the forums and specific locations).

“Family violence is a compelling issue because it is common, consequential, and yet preventable,” said Steinman, noting that the most striking findings from the county profiles are that family violence is much more common than many believe, it has a tremendous negative impact on families affected by it and there are proven prevention methods that can be adopted at the local level.

HPIO creates fact sheet on federal reform

To help Ohioans better understand the federal health reform legislation signed into law by President Obama on Tuesday, the Health Policy Institute of Ohio has created a fact sheet outlining the major provisions in the bill and the accompanying reconciliation legislation.

Over the coming months, HPIO will be leading an effort to provide more in-depth analysis of federal reform and its potential impact on Ohio.

Below is a list of other resources that might be helpful in understanding the legislation:

The Washington Post has posted on its Web site several resources for understanding the legislation:

• A timeline of how the health care overhaul has come to fruition; from President Obama’s inauguration to the passage of the bill on March 23
• A calculator for consumers to assess the impact of reform by entering their Put in your income, insurance status, family size and marital status

• A graphic that breaks down the ways in which people would be insured in 2019, after all provisions go into effect

The Wall Street Journal has posted on its site an explanation of how health care reform will affect consumers, based on insurance status.

The New York Times has posted an interactive graphic that explains how different types of people will be affected by the health care overhaul.

Kaiser Health News has published an FAQ about how citizens – uninsured or insured – may be affected by health care reform.

The Health Foundation of Greater Cincinnati continues to update federal reform site devoted to explaining the legislation

The reconciliation bill text and related material can be found here

 

HPIO to host regional forums on family violence prevention

The Health Policy Institute of Ohio invites you to attend one of five free, half-day regional forums to discuss county-level findings on family violence in Ohio. The forums, titled "Using Family Violence Data to Build Support for Prevention in Ohio," will present data on child abuse/neglect, intimate partner violence and elder abuse/neglect and provide training to those interested in using the information to build support for prevention.

At the end of this forum, participants will be able to:

• describe at least four sources of family violence data in Ohio;
• demonstrate the ability to access online sources of family violence data in Ohio;
• prepare an accurate, compelling graph that conveys at least one of the following themes: (1) family violence in your county is as common as other widely recognized threats to health and well-being, (2) many cases in your county never come to the attention of authorities, (3)both prevention and intervention are key to curtailing family violence. 

All sessions will be held from 9:30 am to 12:30 pm.

Cincinnati (West Chester)/Butler County - April 9, 2010
Columbus (Grove City)/Franklin County - April 12, 2010
Nelsonville/Athens County - April 16, 2010
Toledo (Maumee)/Lucas County - April 19, 2010
Akron/Summit County - April 23, 2010

To register, visit this page

Editor’s note

Because of staff illness, we were unable to post new material last week. We apologize and expect our production to be back to normal this week.

--- Nicholas Wiselogel, Senior Health Communications Coordinator, Health Policy Institute of Ohio

Ohio ranks 27th in new Commonwealth State Scorecard

The Commonwealth Fund released its latest state score card on health care access and quality and Ohio slipped one spot from 26th overall in 2007 to 27th overall this year (Source: “Report: Ohio stuck in middle on health cost, quality,” Business Courier of Cincinnati, Oct. 5, 2009).

The 2009 Scorecard on State Health System Performance, which is published by Commonwealth Fund Commission on a High Performance Health System, ranks states based on population health and quality of the health care system. According to the report card, Ohio slipped from 17th in 2007 to 19th in 2009 for access,fell from 11th to 21st on the report card’s equity ranking and dropped from 39th to 42 on the healthy lives ranking. On the bright side, Ohio improved from 29th to 24th on the prevention and treatment ranking and from 37th to 34th on the avoidable hospital use and costs ranking.

The Commonwealth Fund also has released a new companion report to it’s State Scorecard that profiles seven health systems: six that rank in the top quarter of all states—Vermont, Hawaii, Iowa, Minnesota, Massachusetts, and Wisconsin—plus Delaware, which was among the most-improved states from 2007 to 2009.

On November 10 the Health Policy Institute of Ohio will be hosting a forum on the Commonwealth Fund scorecard, as well as The 2009 U.S. Index of Health Ownership created by the Pacific Research Institute, which ranks states according to how their health laws and regulations reflect free-market principles. Ohio is ranked 40th overall in the PRI report.