Managed Healthcare Executive - February 2009 - (Page 29) State Report Alaska COMMONWEALTH FUND STATE PERFORMANCE RANKING (2007): 26 AMERICAN INDIAN LEADERS are looking to the Obama administration for support in passing the Health Care Improvement Act reauthorization bill. The bill, approved by the Senate, would allocate $35 billion over the next 10 years for American Indian healthcare programs, including screening services and mental health programs, and would improve access to healthcare. The bill also would increase tribal access to Medicare and Medicaid, prompt new construction and modernization of reservation health clinics, and seek to recruit more American Indians into healthcare professions. President Obama campaigned heavily in Indian Country. During the campaign he said he supports more funding for the Indian Health Service (IHS) and better services at IHS clinics. He also promised to create the rst White House position to oversee American Indian a airs. ALCOHOL AS A CAUSE OF DEATH ALASKA Number of Residents: 652,846 Uninsured: 18% Healthcare Expenditures (2004): $4.2 billion Average Annual Percent Growth in Expenditures Per Capita (1991-2004): 7% Healthcare Expenditures per Capita: $6,450 cancer rates in the nation while American Indians in the Northern Plains have the highest rate of lung cancer among native communities. The report called for implementing prevention and education programs and basing treatment on cultural di erences within the tribal subgroups. In a separate study published last spring in Ethnicity & Disease, researchers surveyed 112 elders to assess their willingness to participate in a hypothetical cancer clinical trial. Factors most in uencing participation included having a lead researcher of native descent, a study physician with experience in treating the groups, family support for participation and hope that the study would result in new treatments. Results indicate a “need to establish partnerships with native communities and include American Indian/Alaska Native and culturally competent professionals in research e orts.” NONPROFIT SECTOR program designed to promote a healthier nonpro t sector in Alaska. The program o ers two options that will help expand coverage to underinsured individuals and families or those who currently have no insurance. Alaska’s 18% uninsured rate exceeds the national average. Under the Foraker insurance initiative, a high-deductible ($1,500) plan with a health savings account or a catastrophic indemnity plan with a $2,500 deductible are available. Both plans o er options for preventive care and prescription bene ts. The high deductible/HSA plan requires the employer to contribute at least half the annual deductible level into an individual’s HSA. Both options also incorporate an individual and family wellness program that is intended to reduce the need for medical care and keep down the cost of claims. The program is available through Premera Blue Cross Blue Shield of Alaska. NURSING HOME VIOLATIONS Nearly 12% of American Indian and Alaska Native deaths over a four-year period from 2001 to 2005 were alcohol related, according to a Centers for Disease Control and Prevention report. That compares with a national average of 3.3%. Researchers examined the death certi cates of American Indian and Alaska Natives during the time period and found that more than 1,500 deaths were alcohol-related. The report found tra c accidents and liver disease are the two leading causes of alcohol-related deaths among the groups. CANCER RATE HIGH The Foraker Group and the Rasmuson Foundation are o ering a health insurance SOURCES OF COVERAGE, 2006-2007 54% Employer Uninsured 18% 12% 7% 6% 4% Medicaid Medicare Other Public Individual Every nursing home in Alaska, Idaho, Wyoming and Washington, D.C., was cited for federal health and safety violations in 2007, according to a report by the Health and Human Services O ce of the Inspector General last fall. Nationwide, 90% of U.S. nursing homes were cited for violations. Nursing homes in Alaska had an average of 6.5 de ciencies in 2007, down from 9.5 in 2006. According to the report, the most common de ciencies nationwide centered on quality-of-care measures, including treatment and prevention of bedsores and urinary tract infections. MHE The incidence of cancer among American Indians and Native Alaskans varies tremendously based on geography, according to research published in Cancer. Native Alaskans had some of the highest MHE Sources: Centers for Medicare & Medicaid Services; Urban Institute; Kaiser Family Foundation; U.S. Census Bureau; The Commonwealth Fund. FEBRUARY 2009 29
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