Category Archives: Health Care

CMS Reports U.S. Health Care Spending Growth Accelerated Only Slightly in 2006, but Still Faster Than Economic Growth and General Inflation

Source: Centers for Medicare & Medicaid Services (HHS)

Health care spending growth in the United States accelerated slightly in 2006, increasing 6.7 percent compared to 6.5 percent in 2005, which was the slowest rate of growth since 1999. Health care spending, however, continues to outpace overall economic growth and general inflation, which grew 6.1 percent and 3.2 percent, respectively, in 2006.

In 2006, health care spending reached a total of $2.1 trillion, or $7,026 per person, up from $6,649 per person in 2005, according to a report by the Centers for Medicare & Medicaid Services (CMS). The health spending share of the nation’s Gross Domestic Product (GDP) remained relatively stable in 2006 at 16.0 percent, up by only 0.1 percentage point from 2005.

Health care spending data

Financial Burden of Health Care, 2001-2004

Source: Health Affairs (Commonwealth Fund)

Rising health care costs, combined with slowed economic growth, have created greater financial burdens for U.S. families in recent years–and raised the likelihood that they will face problems paying bills, accumulate medical debt, and even forgo needed medical care. In a Commonwealth Fund-supported study examining families’ financial burdens and out-of-pocket spending between 2001 and 2004, researchers found that by 2004, more than 45 million Americans lived in families with high financial burdens–spending more than 10 percent of their after-tax income on health care. That represents an increase of nearly 6 million people over 2001.

Full Report

Insurers Maintain Record Profits in 2007 by Overpricing Policies and Underpaying Claims

Source: Consumer Federation of America

From press release:
State and national consumer organizations joined the Consumer Federation of America (CFA) today to release a new study concluding that the property/casualty insurance industry continued in 2007 to systematically overcharge consumers and reduce the value of home and automobile insurance policies, leading to profits, reserves, and surplus that are at or near record levels. The study estimates that insurer overcharges over the last four years amount to an average of $870 per household.

The report provides extensive data demonstrating that property/casualty insurance companies are paying out lower claims in relationship to the premiums they charge consumers than at any time in decades. The pure loss ratio, the actual amount of each premium dollar insurers pay back to policyholders in benefits, was only 54.6 cents in 2007. Over the past 20 years, the amount paid back as benefits has dramatically declined from over 70 cents per premium dollar, indicating a huge loss in the value of insurance to consumers.

Full Report (PDF; 316 KB)

State Children’s Health Insurance Program: Program Structure, Enrollment and Expenditure Experiences, and Outreach Approaches for States That Cover Adults

Source: U.S. Governmental Accounting Office

In 2006 about 4.5 million individuals were enrolled in the State Children’s Health Insurance Program (SCHIP). Congress created SCHIP with the goal of significantly reducing the number of low-income uninsured children. Under certain circumstances, states may also cover adults, and in June 2006 about 349,000 adults were enrolled. Each state receives an annual allotment of federal funds, available as a federal match based on the state’s expenditures. Generally, states have 3 years to use each fiscal year’s allotment, after which unspent federal funds may be redistributed. Congress initially authorized SCHIP for 10 years, from 1998 through 2007, and provided approximately $40 billion for that period.

GAO examined (1) how 10 states that cover adults–parents, childless adults, or both–in SCHIP structured their programs; (2) these states’ enrollment and expenditure experiences for adults, which GAO considered in the context of those for all other SCHIP populations (children and pregnant women); and (3) the approaches these states adopted to attract all eligible individuals. To accomplish this, GAO reviewed 10 states that covered adults in SCHIP as of 2007. GAO interviewed officials in the 10 states; reviewed states’ 2006 annual reports and information available on states’ Web sites; and analyzed enrollment and expenditure data obtained primarily from the 10 states, as well as from the Centers for Medicare & Medicaid Services (CMS) and published sources.

Full-text

New Medicaid Rules Would Limit Care for Children in Foster Care and People With Disabilities in Ways Congress Did Not Intend

Source: Center on Budget and Policy Priorities

On December 4, the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services published interim final rules governing case management services provided by state Medicaid programs. CMS claims the new rules are necessary to implement changes Congress made in the Deficit Reduction Act of 2005 (DRA). In fact, the rules go well beyond what Congress intended in the DRA and would have a detrimental impact on beneficiaries, particularly poor children in foster care and poor individuals with physical or mental disabilities or other chronic health conditions.

Report

State Tobacco Settlement Report

Source: Campaign for Tobacco-Free Kids, American Heart Association, American Lung Association and American Cancer Society Cancer Action Network

Since the November 1998 multi-state tobacco settlement, we have issued regular reports assessing whether the states are keeping their promise to use a significant portion of their settlement funds – expected to total $246 billion over the first 25 years–to attack the enormous public health problem posed by tobacco use in the United States.

This year, we find that the states have made important progress by increasing funding for tobacco prevention and cessation programs by 20 percent to a total of $717.2 million in fiscal year 2008, which is the highest level in six years. However, most states still fail to fund tobacco prevention programs at minimum levels recommended by the U.S. Centers for Disease Control and Prevention (CDC), and altogether, the states are providing less than half what the CDC has recommended.

Complete Report (PDF; 5.7MB)
Individual state reports and supporting materials also available.

Achieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other Countries

Source: Annals of Internal Medicine

From press release (American College of Physicians):
In a new evidence-based paper, the American College of Physicians (ACP) analyzes health care in the United States and 12 other industrialized countries and identifies lessons that could be applied to the particular political and social culture of the United States to achieve a high performing health care system, including achieving universal health insurance coverage for all Americans.

In the paper, “Achieving a High Performance Health Care System with Universal Access: What the USA Can Learn from Other Countries,” published on the Web site of ACP’s flagship journal, Annals of Internal Medicine, ACP notes that spending on health care in the United States is the highest in the world and has been rising at a faster pace than spending in the rest of the economy. Yet an estimated 47 million Americans – nearly 16 percent of the population – lack health insurance protection. Even among those with health insurance coverage, wide variations exist in terms of cost, utilization, quality, and access to health care services.

Statistics: Nearly One in Five Americans Say They Can’t Afford Needed Health Care

Source: Health, United States, 2007 Edition

From the summary/news release:
Nearly one in five U.S. adults – more than 40 million people – report they do not have adequate access to the health care they need, according to the annual report on the nation’s health released today by the Centers for Disease Control and Prevention (CDC).

The report, “Health, United States, 2007,” is a compilation of more than 150 health tables prepared by CDC’s National Center for Health Statistics. The report also contains a special section focusing on access to care, which shows that nearly 20 percent of adults reported that they needed and did not receive one or more of these services in the past year – medical care, prescription medicines, mental health care, dental care, or eyeglasses – because they could not afford them.

CMS Publishes a National List of Poor-Performing Nursing Homes, Key Tool for Families Seeking Quality Care

Source: Centers for Medicare & Medicaid Services (HHS)

From press release:
The Centers for Medicare & Medicaid Services (CMS) today released the first ranking of the nation’s poor-performing nursing homes. Release of the national list of facilities, identified as special focus facilities (SFFs), is expected to offer individuals, seeking long-term health care services, and their families powerful new information when choosing nursing homes.

The creation of the list was prompted by the number of facilities that were consistently providing poor quality of care, yet were periodically instituting enough improvement that they would pass one survey only to fail the next (for many of the same problems as before). Such facilities with a ‘yo-yo’ compliance history rarely addressed underlying systemic problems that were giving rise to repeated cycles of serious deficiencies.

Once a facility is selected as an SFF, the state survey agency conducts twice the number of standard surveys and will apply progressive enforcement until the nursing home either (a) significantly improves and is no longer identified as an SFF, (b) is granted additional time due to promising developments, or (c) is terminated from Medicare and/or Medicaid. CMS and the state can more quickly terminate a facility that is placing residents in immediate jeopardy.

The CMS policy of progressive enforcement means that any nursing home, not just those identified as an SFF, that reveals a pattern of persistent poor quality is subject to increasingly stringent enforcement action. If problems continue, the severity of penalties will increase over time, ranging from civil monetary penalties, denial of payment for new admissions and, ultimately, removal from Medicare and/or Medicaid.

As of October 2007, there were 128 SFFs, out of about 16,000 active nursing homes. The number of SFFs in each state varies according to the number of nursing homes in the state. These nursing homes, at the time of their selection as an SFF, had survey results that were among the poorest five or 10 percent in each state.

Today’s list includes 54 facilities that are at the top of the poorest performers in those states and among those facilities that have failed to improve significantly.

Special Focus Facility Background Information (PDF; 15KB)

Special Focus Facility Public List (PDF; 16 KB)

2007 Nursing Home Action Plan (PDF; 993 KB)

Making the Grade on Women’s Health: A National and State-by-State Report Card

Source: National Woman’s Law Center (NWLC) and Oregon Health & Science University Center for Women’s Health (OHSU)

From press release:
While some states made some small gains in critical indicators for improving women’s health, the nation as a whole and most states are falling behind in their quest to meet national goals for women’s health, a comprehensive analysis of state policies and women’s health status finds.

Released today, Making the Grade on Women’s Health: A National and State-by-State Report Card is the fourth in a series of triennial reports to grade and rank each state based on 27 health status benchmarks developed largely using goals set by the U.S. Department of Health and Human Services’ Healthy People 2010 initiative. The report is a project of the National Women’s Law Center and Oregon Health & Science University. With major support from the Bristol-Myers Squibb Foundation as well as a number of other funders, this report reflects the importance of improving women’s health and the substantial commitment required to do so.

Making the Grade gives the nation an overall grade of “unsatisfactory” for meeting only three of 27 benchmarks – the percent of women 40 and over who receive regular mammograms, the percent of women who annually see a dentist, and the percent of women 50 and over who receive screenings for colorectal cancer.

No state receives an overall “satisfactory” grade for women’s health status, although three states receive a “satisfactory minus.” This is down from eight states that received a “satisfactory minus” in 2004. Vermont receives a “satisfactory minus” and ranks No. 1, followed by Minnesota and Massachusetts. Twelve states receive failing grades, up from six states that failed in 2004. Mississippi ranks last. The other 11 failing states are Louisiana, Arkansas, Indiana, Oklahoma, West Virginia, Kentucky, Tennessee, the District of Columbia, South Carolina, Texas and Alabama. The remaining states receive “unsatisfactory” marks.

National Report Card
Key Findings
State by state reports are also available.