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Access to health care for the poor varies widely among states

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WASHINGTON - Access to affordable, quality health care for poor Americans varies dramatically among the states, according to a new study that found a wide disparity in measures of health between states with the best health care systems and those with the worst.

In the highest-performing states, low-income, less educated residents are more likely to be covered by health insurance, to have a regular source of medical care and to get recommended preventive care, such as cancer screenings.

These Americans were also less likely to die prematurely or end up in the hospital for conditions such as diabetes and asthma, the report from the nonprofit Commonwealth Fund found.

"There are often two Americas when it comes to health care, divided by geography and income," the study's authors concluded.

The disparities highlighted by the report - titled "Healthcare in the Two Americas" - were supposed to shrink under President Barack Obama's healthcare law, which was designed to guarantee health care access for all Americans no matter where they live.

Starting next year, the Affordable Care Act will require insurers to provide coverage to consumers with pre-existing medical conditions and offer a basic set of benefits.

But many states with Republican leaders are fighting the law, and nearly half have declined federal aid to expand insurance coverage to their poorest residents through the government Medicaid program. GOP officials in these states say the law is too costly and imposes too many federal regulations.

Cathy Schoen, the study's lead author and the fund's senior vice president, said the results suggest the new health law could make a difference if states ranked at the bottom were to take advantage of new tools and resources in the law to bring their systems up to the standards of the highest-ranking states.

"We ought to be able to close the geographic divide," she said. "There is potential for a real leap forward."

The report, a scorecard based on 30 indicators, does not analyze the potential effect of the 2010 health care law, but it shows that states resisting the law already have among the weakest health safety nets.

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Access to health care for the poor varies widely among states

First glimpses of a new health care world

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By Elizabeth G. Olson

FORTUNE -- As health insurance is reshaped, some major corporations are switching the way they offer coverage to current employees and retirees, in a move that is likely to pave the way for major change to the American health care system.

IBM (IBM) -- which has about 110,000 retirees -- is planning to shift its traditional company-administered plan to private Medicare health insurance exchanges for people who are 65 and older. Retirees can use company subsidies to buy Medicare Advantage plans or other coverage to supplement the services they receive under the federal program.

On the heels of IBM's retiree changeover, drug-store giant Walgreen Co. (WAG) announced this week that it would move its 160,000 current employees to Aon Hewitt's Corporate Health Exchange starting next year. Two major companies, Sears Holdings Corp. (SHLD) and Darden Restaurants (DRI), have already signed their current employees with Aon Hewitt, which says that it is now providing services to some 330,000 active employees.

IBM's move could be a win all around -- savings for companies trying to keep a lid on contributions to retired employee medical costs, lowered costs because of more insurance carrier competition, and a wider range of coverage options. Or, as the health care overhaul kicks into gear, it could usher in an era of confusion as people struggle to navigate online insurance marketplaces.

MORE:Google's stealthy anti-aging startup

One point of confusion is the word "exchange." A private exchange, like Extend Health, where IBM's retired workers are being directed, or Aon Hewitt, is different from public health insurance exchanges, called for under the Affordable Care Act in every state, where government-subsidized premiums help those with lower incomes.

With private exchanges, companies pay a set amount annually to cover the company's obligation for health care, and workers use that sum to buy coverage of their choice.

"A private exchange is a fancy word for more choice," says Paul Fronstin, head of health research for the Employment Retirement Benefits Institute.

Although the institute conducts research independently, one of its founders was IBM, which was fairly blunt about its reasons it opted to switch how it provides health care insurance to its retirees.

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First glimpses of a new health care world

Better pay coming for home health care workers

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Economy

Allison Linn CNBC

Sep. 20, 2013 at 9:08 AM ET

Home health care workers, who for years have been exempt from minimum wage and overtime laws because of a stipulation that classified them as similar to casual babysitters, will soon be eligible for fatter paychecks.

The Labor Department announced this week that the nearly two million workers who provide in-home care for people who are elderly, sick or disabled will be subject to the Fair Labor Standard Acts minimum wage and overtime protections start in January of 2015.

The move is a major victory for advocates of in-home health care workers. They have long argued that the fast-growing profession has evolved beyond its origins providing informal companionship to elderly people and into a much more complex job providing medical and other care.

Now you have millions of home care workers doing this as a means to support themselves and their families, said Steve Edelstein, national policy director for the Paraprofessional Healthcare Institute, which has been advocating for the change.

But opponents say the new protections will make in-home care more expensive for families and government programs such as Medicaid that pay for such services, and that it could result in a reduction in covered services.

What this means for patients is less care. What it means for aides and caregivers is less work and reduced compensation, Andrea Devoti, chair of the National Association for Home Care & Hospice, a trade group for home care agencies, said in an e-mail to NBCNews.com.

Fifteen states already provide minimum wage and overtime protections under states laws, according to the Paraprofessional Healthcare Institute.

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Better pay coming for home health care workers

Health care volunteers target outreach to Seattle's most uninsured

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by ELISA HAHN / KING 5 News

KING5.com

Posted on September 20, 2013 at 6:19 PM

Updated yesterday at 9:44 PM

Health care volunteers spread out across King County Friday to spread the word about getting health insurance under the Affordable Care Act. They targeted the most uninsured neighborhoods.

One of the first stops was the Salvadorean Bakery in Seattles White Center, where only two of the dozen restaurant employees have health insurance.

"Sometimes, I feel embarrassed, said Aminta Elgion, one of the bakerys co-owners. "About four years I've been without insurance and it's been very, very, hard.

The volunteers talked briefly with the restaurant staff, giving them the flier and the website to get more information to enroll.

At least 20 percent of the residents in the White Center area have no health insurance.

"A big barrier that I see this is the first time that many people will have health insurance, said Penny Lara, project manager with the countys access and outreach team. I dont know about you, but it is confusing to me to navigate the system.

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Health care volunteers target outreach to Seattle's most uninsured

Your Senior Moment with Leigh St John: Funding Your Senior Health Care Costs – Michael Chamberlain – Video

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Your Senior Moment with Leigh St John: Funding Your Senior Health Care Costs - Michael Chamberlain
Senior Guide USA is a comprehensive resource directory for seniors. The various state Senior guides provide information about homes, health, services and lei...

By: SeniorGuideUSA

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Your Senior Moment with Leigh St John: Funding Your Senior Health Care Costs - Michael Chamberlain - Video

Linette Scott, MD, CIO, Dept. of Health Care Services, EHR Adoption in CA – Video

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Linette Scott, MD, CIO, Dept. of Health Care Services, EHR Adoption in CA
Dr. Scott describes progress in 2013 under the Medicare and Medicaid EHR Incentive Program, coordinated in California through her office. Over $1 billion has...

By: CALeHealthInitiative

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Linette Scott, MD, CIO, Dept. of Health Care Services, EHR Adoption in CA - Video

Professor Marc Spindelman testifies during the Clyde Hearings on women’s health care. – Video

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Professor Marc Spindelman testifies during the Clyde Hearings on women #39;s health care.
Today at the Ohio Statehouse, six witnesses provided testimony on the anti-women budget. Rep. Kathleen Clyde convened the hearing: "Ohioans are still reeling...

By: Gabriel Mann

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Professor Marc Spindelman testifies during the Clyde Hearings on women's health care. - Video

Vorys Health Care Advisors and Truven Health Analytics Co-Author SAMHSA’s “Medicaid Handbook: Interface with …

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COLUMBUS, Ohio & ANN ARBOR, Mich.--(BUSINESS WIRE)--

Maureen Corcoran, president of Vorys Health Care Advisors (VHCA), and Daphne Saneholtz, senior advisor with VHCA, partnered with John Easterday, Ph.D. and Truven Health Analytics to author a Medicaid handbook for the federal Substance Abuse and Mental Health Services Administration (SAMHSA). The handbook, titled Medicaid Handbook: Interface with Behavioral Health Services, provides readers with an understanding of the Medicaid program and how it relates to services and programs for individuals with behavioral health needs.

The handbook is a great resource for policy makers, consumers and behavioral health services providers trying to better understand the Medicaid program, which is the single largest funder of behavioral health services in the United States, said Corcoran. While the Handbook is written with a behavioral health focus, it will also prove to be an invaluable resource to anyone interested in the fundamentals of Medicaid.

In addition to basic information about Medicaid and behavioral health services, the handbook covers a variety of topics, including care coordination initiatives, structure and reimbursement methodologies, and the relationship between Medicaid and Medicare.

With the Affordable Care Act set to enact the largest expansion of Medicaid in history, the shared understanding between State Medicaid and behavioral health authorities is fundamental to designing efficiently coordinated care, said John Easterday, Ph.D., Senior Project Manager/Center for Financing Reform and Innovations at Truven Health Analytics and co-author of the handbook. We believe this handbook will prove invaluable in helping a wide range of parties involved with behavioral healthcare coordination to better understand the new landscape in which they will be navigating.

The handbook is available electronically on the SAMHSA website.

About Vorys Health Care Advisors:

Vorys Health Care Advisors (VHCA) provides health care consulting services designed to help providers, consumer organizations, associations and other stakeholders meet the challenges of a complex, rapidly changing state and federal health care environment. VHCA has expertise in Medicaid policy, health care service delivery and payment systems in the context of states unique considerations, services for children, behavioral health care, developmental disabilities, aging and community-based services. With a unique combination of Medicaid, public policy, financial and clinical experience, we are able to deliver smart, effective solutions in a number of areas: the Affordable Care Act, including Medicaid policy and reimbursement implications; managed care and other care coordination strategies, including integration models involving mental health and substance use disorder services; EPSDT (early and periodic screening, diagnosis, and treatment) requirements and issues associated with services and benefit design for children and youth with special needs; and evaluating organizational options, partnerships or other changes in service delivery. VHCA is a wholly owned subsidiary of the law firm Vorys, Sater, Seymour and Pease LLP. For more information, visit voryshcadvisors.com.

About Truven Health Analytics:

Truven Health Analytics delivers unbiased information, analytic tools, benchmarks and services to the healthcare industry. Hospitals, government agencies, employers, health plans, clinicians, and pharmaceutical companies have relied on its solutions for over 30 years. Truven Health Analytics combines deep clinical, financial and healthcare management expertise with innovative technology platforms and information assets to make healthcare better, collaborating with customers to uncover and realize opportunities for improving quality, efficiency, and outcomes. Truven Health Analytics employs approximately 2,000 people worldwide and has its principal offices in Ann Arbor, MI; Chicago; and Denver. For more information, visit http://www.truvenhealth.com.

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Vorys Health Care Advisors and Truven Health Analytics Co-Author SAMHSA’s “Medicaid Handbook: Interface with ...

Health Care Exchanges Go Online October 1

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The next phase of the Affordable Care Act kicks in this fall, bringing big changes to the nation's health care system. Beginning on October 1, 2013 new, federally-mandated health insurance exchange. Covered California here in this state go online, offering one-stop shopping for individuals and small businesses looking for coverage. If you're not covered by your company's insurance plan, and you don't have adequate private insurance, you need to sign up in 2014. If you don't, you might have to pay a fine when you file your 2014 federal tax forms.

There's a lot to know about the health insurance law change. Many local cities and organizations are offering workshops to help make sense of the plan and the insurance marketplaces. Call your local politicians and Congressmen to see what is set up in your area. In the meantime, here are some key points and resources to help get you started.

Affordable Care Act

Covered California

Resources:

Department of Health and Human Services: https://www.healthcare.gov

Covered California: http://www.coveredca.com

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Health Care Exchanges Go Online October 1

GuideSpark Brings Clarity on Health Care Reform to Employees

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MENLO PARK, Calif.--(BUSINESS WIRE)--

GuideSpark, a digital employee communications company, has launched a solution for explaining benefits and the complex implications of health care reform (HCR). This Health Care Reform Video Series gives customers on-demand, customized communication tools to engage and educate employees on HCR. The video series can help busy human resource executives reach employees with vital information and empower them to become smarter consumers of their benefits.

As the first of October approaches, employers have an opportunity to help employees understand how HCR will impact their individual benefits plans. At the same time, employees are becoming increasingly accustomed to accessing information especially short-form videos on their smartphones, laptops and tablets both at home and at work. GuideSparks solution delivers clear and concise information in a straightforward and engaging way through video technology giving HR professionals an alternative approach to traditional paper-based communication that have limited impact.

GuideSpark offers a Health Care Reform Video Series that is broken down into easy-to-digest pieces, including videos that focus on:

Additional videos are available that cover related topics, such as how to be a better consumer of benefits in a post-HCR world and overall health and wellness information.

The web has changed the way people consume information, and employees are no exception. Our customers see demand increasing for new ways to take complex content like HCR and deliver it in a way that is rich in nature but easy to digest, said GuideSpark CEO Keith Kitani. Engaging employees through on-demand, customized video not only can save money and reduce HR support calls, but it also can increase enrollment in important benefit programs and improve the employer/employee relationship.

We faced a significant challenge in communicating health care reform as it created confusion for our managers and employees, said Paige Claus, Sr. Director, Benefits with 7-Eleven, Inc. Implementing customized, simple content from GuideSparks Health Care Reform Video Series has given our organization a way to effectively communicate to our dispersed population and an easy way to encourage employees to understand their options and get more involved in their care.

About GuideSpark

GuideSpark provides a customized and engaging digital employee communications solution for educating employees on complex topics such as benefits, health care reform and compensation programs .Our videos simplify complex HR topics, and transform employees into informed, engaged, and intelligent consumers of company benefits. As a result, GuideSparks clients are able to improve overall employee satisfaction and retention and save HR time and money. For more information, visit http://www.guidespark.com.

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GuideSpark Brings Clarity on Health Care Reform to Employees

Geography, Income Determine Health Care in U.S., Report Says

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WEDNESDAY, Sept. 18 (HealthDay News) -- Low-income Americans' access to health care and the quality of care they receive vary widely based on where they live, according to a new report.

Compared to wealthier people, low-income Americans lose more teeth, have more asthma flare-ups and miss out on vaccinations and cancer screenings. They also are less likely to have health insurance, finds the report, which was released Wednesday by the Commonwealth Fund, a health policy think tank.

The report provides a state-by-state comparison of health care for the 39 percent of people with incomes less than 200 percent of the federal poverty level, or $47,000 for a family of four and $23,000 for an individual.

"We found repeated evidence that we are often two Americas, divided by income and geography when it comes to opportunities to lead long and healthy lives," report lead author Cathy Schoen, Commonwealth Fund senior vice president, said in an organization news release. "These are more than numbers."

Low-income people account for at least one-quarter of total state populations, and almost half in some states, including Arkansas, Louisiana, Mississippi and New Mexico, according to the report.

The report authors also compared the quality of health care received by people with low incomes and higher incomes -- more than 400 percent of the poverty level, or $94,000 for a family of four -- and found major disparities by income in each state.

Higher-income people in states with low health care scores are often worse off than low-income people in states with high health care ratings, the report says. For example, low-income elderly Medicare beneficiaries in Connecticut and Wisconsin are less likely to receive high-risk medications than high-income elderly people in Mississippi, Louisiana and Alabama.

The report ranks states on 30 indicators, including access to affordable health care, preventive care and quality, potentially avoidable hospital use, and health outcomes.

Hawaii and states in the upper Midwest and Northeast had the best scores, while Southern and South Central states often lagged. Among low-income people, there were two- to five-fold differences in their health care and health outcomes scores, depending on where they lived.

Among the other findings:

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Geography, Income Determine Health Care in U.S., Report Says


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