Managed Healthcare Executive - March 2009 - (Page 29) State Report Washington COMMONWEALTH FUND STATE PERFORMANCE RANKING (2007): 17 WASHINGTON Number of residents: 6.3 million Uninsured: 12% Healthcare expenditures (2004): $31.6 billion Average annual percent growth in expenditures per capita (1991-2004): 6% Healthcare expenditures per capita: $5,092 Projected state budget shortfall (FY2009): $509 million treatment patients received at 46 medical groups and all 170 clinics in the region with six or more doctors. Federal data were also used to measure performance at 30 area hospitals. Collectively, the survey covers about 70% of primary-care doctors in ve counties. The yardsticks used for comparison are common standards of care, and results for each facility or group are compared with regional averages in an e ort to inspire quality improvement. Most of the data collected are available online, allowing consumers to see how medical groups, REPORT SHOWS ROOM TO IMPROVE clinics and hospitals stack up. The quality of medical care varies The report found: widely at clinics and hospitals across the Nearly half of clinics surveyed were Puget Sound region, according to the below average at ensuring regular eye exPuget Sound Health Alliance’s “Com- ams for diabetics; munity Checkup” report, released in The percentage of heart surgery November. patients receiving standard treatment to The report used huge volumes of prevent blood clots ranged from 59% to health-insurance-billing data from 1.6 96%; and million area residents to compare the At some clinics, fewer than one in four sexually active young women were screened for chlamydia. SOURCES OF However, about 94% of children seen COVERAGE, for the cold virus were not given antibiotics, which is considered the proper course of 2006-2007 action. Also, nearly 90% of patients with asthma were prescribed long-term medications to control their condition. The Alliance is made up of more than Employer 57% PROMOTING MEDICAL HOMES 160 organizations, including major emA Washington healthcare team is working ployers, such as Boeing and Starbucks, to improve care by promoting patienthealth insurers, city and county governcentered medical homes. The team’s acments and medical providers. Alliance Medicaid 13% tion plan seeks to create an operational members said the hope is that the report de nition of medical home in order to will spur improvements. MHE Uninsured 12% measure and improve medical home capacity; develop reimbursement strategies MHE Sources: Centers for Medicare & MedMedicare 11% to support providers in adopting a mediicaid Services; Urban Institute; Kaiser FamIndividual 5% Other Public 2% cal home model; and engage consumers ily Foundation; U.S. Census Bureau; The and providers in participating in patientCommonwealth Fund. MARCH 2009 WASHINGTON STATE WILL now offer steeply discounted health insurance for children in families earning up to three times the poverty level. State leaders applauded reauthorization of the State Children’s Health Insurance Program (SCHIP), which covers children in families that make too much for Medicaid, but struggle to buy private insurance. The legislation, which President Obama signed in February, will help Washington move closer to its aim of providing universal coverage for kids by 2010. Passage of the SCHIP bill aims to increase federal spending on children’s insurance by $32.8 billion between now and September 2013, to be funded by a 61-cent hike in the federal cigarette tax. The bill will boost the state’s annual share of federal money for kids’ insurance from $80 million to $94 million. But the bill’s biggest impact comes from a change eliminating a quirky penalty that has forced the state since 1997 to forgo tens of millions of dollars in federal help to pay for health coverage for lower-income children: Washington was one of just four states that was already providing free insurance to children in families making up to twice the federal poverty level when the federal government raised its matching rates. The change will allow the state to claim its full federal allotment, bringing in an extra $50 million a year. centered medical homes. By the end of the summer, the team expects to have an operational de nition of a medical home as well as performance measures and patient outcomes that can be demonstrated and rewarded. Over the coming years, the state plans to evaluate data sources, performance indicators, reimbursement models, and ways to engage practitioners and consumers. As part of a broader health reform package, it plans to pilot a payment system that rewards providers who incorporate evidence-based practices and elements of patient-centered care by 2011. 29
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