Ohio Health Policy Review

Lagging provider reporting leaves ODH unclear of H1N1 vaccination rate

A lag in H1N1 vaccine providers reporting data has meant that the state has an inaccurate, low count of how many Ohioans have been vaccinated for the virus (Source: “H1N1 vaccination rates don't show full picture,” Columbus Dispatch, Feb. 10, 2010).

Although providers are required to report data within 24 hours to the Ohio Department of Health, there are no penalties spelled our for delayed reporting.

According to ODH, 17 percent of Ohioans in all priority groups for the vaccine had been vaccinated and about 33 percent of children younger than 10 who received a first dose have received a second dose.
The state has ordered nearly 5 million doses of vaccine, and fewer than 1.4 million doses had been administered, according to the data from last week.

"I'm not really drawing any conclusions based on the data," said Amy Bashforth, the state's immunization program chief, adding that national polls, including one from Harvard University, have found much higher rates.

ODI: Liability closed claims down 40 percent since tort reform passed

A new report from the Ohio Department of Insurance has found that the number of medical liability closed claims has dropped 40 percent since tort reform was enacted in 2005 (Source: “Tort reforms cited in Ohio’s medical claims decline,” Dayton Daily News, Feb. 3, 2010).

The annual Ohio Medical Liability Closed Claim Report is mandated as part of the tort reform legislation. Among the provision in the tort reform law is capping noneconomic damages at $350,000 and limitations on claims. According to the Ohio State Medical Association, which was a strong supporter of the legislation, premiums have decreased by an average of 22 percent since the bill was passed.

Ohio’s Hospital Compare site goes live

The Ohio Department of Health this month launched a new Web site that lets users look up outcomes, patient satisfaction and other performance measures for hospitals across the state (Source: “State launches new Web site to compare hospitals,” Akron Beacon-Journal, Jan. 4, 2010).

The free Ohio Hospital Compare tool includes more than 100 measures in a dozen categories: heart attack care, heart failure care, heart surgery, stroke care, pneumonia care, surgical care, hospital-acquired infections, infection prevention measures, patient safety, patient satisfaction, children's asthma care and pregnancy/delivery.

The majority of the data available online is based on patient care delivered in 2008. Although about 65 percent of the information is obtainable from other sources, primarily from the online hospital compare tool run by the U.S. Centers for Medicare & Medicaid Services, information about stroke care, heart surgery, patient safety, infection prevention measures and pregnancy care at hospitals previously wasn't easily accessible for Ohio patients, according to ODH officials.

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.

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.

Ohio Medicaid enrollment growing at record clip

With its rolls swelling by 154,000 in the past 12 months, Medicaid enrollment and spending are now at record levels in Ohio (Source: “Medicaid keeps stretching,” Columbus Dispatch, Oct. 11, 2009).

The 12-month increase in enrollment is the largest caseload growth in nearly seven years and means the program now covers nearly 2 million Ohioans (1 out of every 3 children and nearly 1 out of every 5 adults).

Interim Ohio Medicaid Director Maureen Corcoran, attributes the dramatic increase in Medicaid enrollment almost entirely to rising unemployment in Ohio.

"The dramatic increase is not occurring in the disabled category -- it's in the children and families category," she said.

The counter-cyclical nature of Medicaid means its costs typically increase at times in which state revenues are down. But despite the state budget crisis, Medicaid has avoided cuts in eligibility levels or services because of $1.1 billion in federal stimulus funds. However, there is increasing concern that the state may have to take drastic steps when stimulus money is exhausted at the end of 2010.

Through support from the HealthPath Foundation of Ohio, the Health Policy Institute of Ohio is undertaking an analysis of Ohio’s safety net services in light of the severe economic recession. A white paper on the topic is expected to be released in December.

State data: 100k Ohio workers are Medicaid beneficiaries

According to data from the Ohio Department of Job and Family Services, more than 100,000 low-wage employees in Ohio receive Medicaid benefits (Source: “100,000 Ohio workers getting Medicaid,” Columbus Dispatch, Sept. 30, 2009).

Wal-Mart has the most employees on Medicaid, with more than 15,000, followed by McDonald’s, with nearly 13,000 employees covered by Medicaid.

The release of the information coincides with new legislation that would require the state to annually publish the names of companies with the most employees on Medicaid. Supporters of the legislation say they hope such a report would put pressure on employers to provide coverage for their employees.

"The state of Ohio cannot afford to pick up the cost of corporate irresponsibility," said Rep. Dan Stewart, D-Columbus.

For its part, Wal-Mart, which has topped similar lists in more than 20 states, says it offers some of the best health-care coverage in the retail sector.

"We have 94.5 percent of our associates (with) health-care coverage from either the company or through a spouse or parent," said Greg Rossiter, a spokesman for Bentonville, Ark.-based Wal-Mart. "We've made significant strides in getting our associates covered."

HPIO brief examines gender disparities in Ohio

In its latest in a series of policy brief titled Unhealthy Differences (pdf, 8 pages), the Health Policy Institute of Ohio examines health disparities between men and women ages 18 to 64 in Ohio.

Authored by HPIO Research Specialist Lisa Frazier, MPH, the paper uses data from the 2008 Ohio Family Health Survey and highlights key differences (or disparities) found in health behaviors, risk factors, family income, experiences with the health care system, and other key indicators based on gender. Policymakers and other decision makers may look to these findings as they shape strategies to build health equity and improve the physical, mental, and social well-being of all populations in Ohio’s communities.

The brief on gender disparities is the second of three briefs on health disparities in Ohio that are being produced by HPIO. The first brief, released in August, focused on racial and ethnic health disparities and the third policy brief will examine geographic health disparities.

Census: Uninsured rate level in Ohio, up nationally

New U.S. Census Bureau data from 2008 showed that the number of uninsured Ohioans increased from 1.2 million in 2007 to 1.3 million in 2008, an increase that is considered statistically insignificant (Source: “New census numbers show more uninsured,” Cleveland Plain Dealer, Sept. 11, 2009).

Nationally, the number of the uninsured increased to 46.3 million, or 15.4 percent, up from 45.7 million in 2007. 

Some contend that the estimated number of uninsured is too high because the Census counts noncitizens as well as those who qualify for government programs and are not enrolled. Others, however, say the number is too low because the Census counted anyone who reported having health care coverage at any time during the year as being insured.

"A lot of people who lost their insurance weren't counted," admitted David Johnson, chief of the Census Bureau's housing and household economic statistics division, when asked about it during a media call.

Survey finds Ohio doctors feeling impact of economy

A survey released Tuesday by the Ohio State Medical Association found that 70 percent of medical professionals in the state report either a decrease in business or an increase in cancellations from October 2008 through June (Source: “Survey: Ohio medical practices feeling economy’s sting,” Dayton Business Journal, Aug. 11, 2009).

The statewide survey of 559 medical professionals was conducted in June and July. The results were released in a report (pdf, 13 pages) available on the OSMA’s Web site. The survey also found that 92 percent of respondents have seen an increase in the number of patients who have lost their health coverage and 86 percent said that have seen in an increase in patients who have had trouble paying their bills.

“No sector of the economy is immune to the effects of this recession,” OSMA President Roy Thomas said in a statement. “However, we are trying to work with our patients to ensure continuity of care in this harsh economic climate.”