of Work ACHIs Scope of Work Health Policy & System Integration - PowerPoint PPT Presentation

ACHI Scope of Work ACHI’s 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 – 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

Healthcare’s Iron Triangle Quality Cost Access

Current patchwork quilt of Arkansas health insurance coverage Income Income Private Insurance Private Insurance 300% 300% FPL FPL Currently Uninsured: Currently Uninsured: Medicare Medicare 200% 200% ~520,000 FPL FPL ARKids ARKids First B First B Medicaid for Medicaid for Pregnant Pregnant 100% 100% Women/Family Women/Family FPL FPL ARKids ARKids Planning Planning First A First A (Medicaid) (Medicaid) Medicaid w/ Disability Medicaid w/ Disability 0 0 10 10 20 20 30 30 40 40 50 50 60 60 70 70 Age Age

Changing Cost Allocations for Arkansas Families’ Annual Insurance Premiums $10,000 $9,190 $8,383 $7,997 $8,000 27% $7,288 $2,523 29% $2,414 $6,355 29% $2,347 $1,858 25% $6,000 28% $1,773 $4,000 $6,667 73% 71% $5,969 71% $5,650 75% $5,430 72% $4,582 $2,000 $0 Employee 2000 2001 2003 2004 2005 Company 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.

Views of health care: A right or benefit? Drivers of heath care costs: Medicaid Changing demographics Employer Illness burden Benefit: Benefit: Medical research Governmental Private sector Technological advancements obligation responsibility Consumer expectations Increasing Unable health care costs Unwilling to afford to support TURMOIL Limited Defined Dropped Cost sharing benefits contributions coverage

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 8 1 9 9 0 2 0 0 7 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥ 30% Source: CDC Behavioral Risk Factor Surveillance System.

Source: CDC Behavioral Risk Factor Surveillance System.

Source: CDC Behavioral Risk Factor Surveillance System.

Diabetes Trends* Among Adults in the U.S., (Includes Gestational Diabetes) BRFSS, 1990,1995 and 2001 1990 1995 2001 Source: Mokdad et al., Diabetes Care 2000;23:1278-83; J Am Med Assoc 2001;286:10. Source: CDC Behavioral Risk Factor Surveillance System.