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Health Care Finance Access to Needed Quality Care Health Policy & System Integration Health Promotion & Disease Prevention
ACHI Scope
- f WorkACHI’s Scope of Work
of Work ACHIs Scope of Work Health Policy & System Integration - - PowerPoint PPT Presentation
of Work ACHIs Scope of Work Health Policy & System Integration - - PowerPoint PPT Presentation
ACHI Scope of Work ACHIs Scope of Work Health Policy & System Integration Health Health Access to Promotion & Care Needed Disease Finance Quality Care Prevention Health System Financing in Transition 1910 Flexner Report
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Health System Financing in Transition
- 1910 Flexner Report – Medical education
- 1928 Penicillin discovered
- 1944 first patient treated
- 1941 WWII Wage controls / Employers’ response
- 1957 Hill Burton Act stimulates hospitals
- 1965 Medicare / Medicaid established
- 1973 Federal HMO Act
- 1990s Employer / Medicaid HMO expansions
- 1997 State Children’s Health Insurance Program
- 2003 Medicare Modernization Act
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Healthcare’s Iron Triangle
Access Cost Quality
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Income
Age
Medicaid w/ Disability Private Insurance 100% FPL 200% FPL
10 20 30 40 50 60 70
300% FPL ARKids First B Medicaid for Pregnant Women/Family Planning Currently Uninsured: ~520,000 Medicare ARKids First A (Medicaid) Income
Age
Medicaid w/ Disability Private Insurance 100% FPL 200% FPL
10 20 30 40 50 60 70
300% FPL ARKids First B Medicaid for Pregnant Women/Family Planning Currently Uninsured: Medicare ARKids First A (Medicaid)
Current patchwork quilt of Arkansas health insurance coverage
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Changing Cost Allocations for Arkansas Families’ Annual Insurance Premiums
Source: AHRQ. Medical Expenditure Panel Survey (2000, 2001 & 2005). Tables of private-sector data by firm size and state (Tables II.D.1 and II.D.2). Available at www.meps.ahrq.gov/mepsweb/data_stats/ quick_tables_search.jsp?component=2&subcomponent=2. Accessed 05/01/08.
$4,582 $5,430 $5,650 $5,969 $6,667 $1,773 $1,858 $2,347 $2,414 $2,523
$0 $2,000 $4,000 $6,000 $8,000 $10,000 2000 2001 2003 2004 2005
Employee Company
$6,355 $7,288 $7,997 $8,383 $9,190
28% 72% 25% 75% 29% 71% 29% 71% 27% 73%
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Views of health care: A right or benefit?
Medicaid Benefit:
Governmental
- bligation
Employer Benefit:
Private sector responsibility Unable to afford Unwilling to support
Increasing health care costs
TURMOIL
Cost sharing Limited benefits Defined contributions Dropped coverage
Drivers of heath care costs: Changing demographics Illness burden Medical research Technological advancements Consumer expectations
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Source: CDC Behavioral Risk Factor Surveillance System.
1 9 9 8 2 0 0 7
Obesity Trends* Am ong U.S. Adults BRFSS, 1 9 9 0 , 1 9 9 8 , 2 0 0 7
( * BMI ≥3 0 , or about 3 0 lbs. overw eight for 5 ’4 ” person) 1 9 9 0 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
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Source: CDC Behavioral Risk Factor Surveillance System.
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Source: CDC Behavioral Risk Factor Surveillance System.
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Source: CDC Behavioral Risk Factor Surveillance System.
Source: Mokdad et al., Diabetes Care 2000;23:1278-83; J Am Med Assoc 2001;286:10.
Diabetes Trends* Among Adults in the U.S.,
(Includes Gestational Diabetes) BRFSS, 1990,1995 and 2001
1990 1995 2001