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Where Innovation Is Tradition
Where Innovation Is Tradition
Overview
- ACA Dashboard
- Regional Coverage Trends
- Implications for Health Centers
- Implications for our future
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Health Reform: How are WE Doing? Len M. Nichols, Ph.D. Center for - - PowerPoint PPT Presentation
Health Reform: How are WE Doing? Len M. Nichols, Ph.D. Center for - - PowerPoint PPT Presentation
Health Reform: How are WE Doing? Len M. Nichols, Ph.D. Center for Health Policy Research and Ethics Grantmakers In Health Washington, DC November 6, 2014 Where Innovation Is Tradition Overview ACA Dashboard Regional Coverage Trends
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Where Innovation Is Tradition
What Metrics for ACA?
- Coverage expansion/uninsured reduction
- Cost growth
- NHE
- Federal spending
- Household spending
- Quality
- Health
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Newly Covered by Source, US
millions
2 4 6 8 10 Marketplace Medicaid 8.019 7.964
2014
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Source: Kaiser Family Foundation, based on ASPE data.
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Percentage of Uninsured Americans Now Lowest on Record The percentage of Americans without health insurance takes another significant decline.
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Where Innovation Is Tradition
What Metrics for ACA?
- Coverage expansion/uninsured reduction
- Cost growth
- NHE
- Federal spending
- Household spending
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Cost growth is coming down
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Where Innovation Is Tradition
What Metrics for ACA?
- Coverage expansion/uninsured reduction
- Cost growth
- NHE
- Federal spending
- Household spending
- Quality
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AHRQ Quality and Disparities Report, 2013
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Where Innovation Is Tradition
Quality is Improving . . . slowly
19 18.4 18 17.4 17.6 17.8 18 18.2 18.4 18.6 18.8 19 19.2 2007-11 2012 2013
Medicare Readmission rates
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Quality Getting Better due to ACA?
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Medicare Fines 2,610 Hospitals In Third Round Of Readmission Penalties Armed With Bigger Fines, Medicare To Punish 2,225 Hospitals For Excess Readmissions 2014 2013
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Where Innovation Is Tradition
What Metrics for ACA?
- Coverage expansion/uninsured reduction
- Cost growth
- NHE
- Federal spending
- Household spending
- Quality
- Health
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Worse? Suicide
- Adol. Depress.
Visits to dentist NO CHANGE? Obesity Vegetable eating A1c control Binge drinking
- Adol. Smoking
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Where Innovation Is Tradition
Overall Grade So Far ?
Category Grade as of 10/14 What to watch COVERAGE B+ Expansion in 2015 COST B OOP and premiums in 2015 QUALITY C+ PQI Admissions HEALTH C Obesity, chronic incidence
OVERALL B-
Spread and depth
- f reform
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Where Innovation Is Tradition
Lots of stuff has been called “socialism”
- “The crown jewel of the socialist welfare
state in America is Social Security.”
- “The American Medical Association said
today that it was placing an advertisement in 100 newspapers to make its position clear on its opposition to Medicare. The advertisement calls Medicare ‘the beginning of socialized medicine.'"
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From Poolesville, MD 1954
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We’ve been having this debate a very long time…
Ron Chernow Jon Meachem
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Implications for Philanthropy
- Uninsured are still (and will always be) a large
population
- Enrollment assistance more important now than in 2014
- If ACA wildly successful, uninsured in 2020 will not be
US citizens
- Pay reform not going away and must “work”
- VBP is coming to Medicaid
- Integrating behavioral health VERY important
- Data/documentation VERY important
- Non-partisan conversations essential
- You Don’t have be to neutral to be objective
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