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In this Issue:
1.
SCI Releases Issue Brief on State Reinsurance Efforts
2. Premium Assistance Toolbox Available Online
3. SCI/HCFO Cyber Seminar on Consumer-Driven Care Available
Online
4. Rhode Island's RIte Care Celebrates 10-years
5. HRSA Awards Next Round of State Planning Grants
6. Pennsylvania Program's Waiting List Hits All-Time
High
7. Kaiser Releases Employer Health Benefits Survey
8. Coming Soon
9. Reports of Interest
1.
SCI
Releases Issue Brief on State Reinsurance Efforts
A new
SCI issue
brief examines the role of reinsurance in states’ efforts
to expand health insurance coverage. Written by SCI Senior Consultant
Deborah Chollet, Ph.D., the brief describes the lessons and experiences
of several states that have recently implemented reinsurance programs.
States
had generally abandoned reinsurance in the early 1990s, when discussions
about national health insurance began. Now, however, many states
have revisited the concept. Arizona, Connecticut, Idaho, Massachusetts,
New Mexico, and New York use reinsurance to support small-group
coverage, improve individual access to coverage, or subsidize health
insurance for small groups or low-income workers.
2.
Premium Assistance Toolbox Available Online
SCI,
in coordination with the National
Academy for State Health Policy (NASHP) and the Centers
for Medicare and Medicaid Services (CMS), has recently released
the Premium Assistance Toolbox.
The toolbox is intended to assist states in improving their existing
premium assistance programs, planning and implementing new programs,
and evaluating whether the model would work in their state.
The
toolbox highlights strategies and processes used by states with
experience operating premium assistance programs. As of February
2004, 14 states are operating these programs, and at least 10 others
are at various points in the planning process. Toolbox resources
include state examples, links to articles, reports, data sources
or sources of expertise, and other tools created to answer key questions
that a state may want to consider when designing a premium assistance
program.
3.
SCI/HCFO
Cyber Seminar on Consumer-Driven Care Available Online
In
September, The Robert Wood Johnson Foundation's State
Coverage Initiatives (SCI) and Changes
in Health Care Financing and Organization (HCFO) programs hosted
an interactive Cyber seminar to share updated research on consumer-driven
health plans (CDHPs) and explore the policy implications of such
plans. The complete archived seminar can be accessed online.
The
seminar also featured the release of two important resources: an
SCI Issue Brief, Health
Savings Accounts: Issues and Implementation Decisions for States
and the August 2004 Health Services Research special issue, "Consumer-Driven
Health Care- Beyond Rhetoric with Research and Experience."
4.
Rhode Island’s RIte Care Celebrates 10 Years
RIte
Care—Rhode Island’s Medicaid managed care program—turns
10 this year, and the program’s administrators don’t want
to miss the opportunity to celebrate. Since October 2001, the Rhode
Island Department of Human Services has been working to expand health
insurance coverage through an SCI demonstration grant.
RIte
Care has contributed to the decline in uninsured children and adults
in Rhode Island, which continues to have one of the lowest rates
of uncovered individuals in the nation. In addition, children enrolled
in RIte Care have immunization rates that are comparable to those
of other children in the state. A recent study also indicated that
lead screening rates for RIte Care children were 88 percent, compared
to national Medicaid screening rates of 15 to 20 percent.
RIte
Care’s success is based on partnerships among health plans,
community advocates, and the state’s governor and legislature.
RIte Care has partnered with researchers at Brown University and
Rhode Island’s Department of Health to measure and analyze
Medicaid data for program management and also to look at trends
in health outcomes. A new resource that lists all of Rhode Island’s
reports and publications can be found at ritecareresearch.org.
5.
HRSA
Awards Next Round of State Planning Grants
The
Health Resources and Services Administration’s (HRSA) State
Planning Grant (SPG) Program has awarded 35 new grants for Fiscal
Year 2004. The program supports states in their efforts to develop
plans for providing affordable health insurance coverage to their
citizens.
Of
the 35 grants, nine were given to states and territories that had
not previously received SPG funds, including American Samoa, Guam,
Kentucky, Louisiana, Michigan, North Carolina, Pennsylvania, Puerto
Rico, and Tennessee. In addition, nine grants are supporting the
design and planning for a pilot project to expand coverage; and
17 were awarded as continuation grants to states that needed additional
resources to expand on the activities they had initiated with previous
grant funds. The full list of grantees will be available shortly
on the HRSA SPG Web site.
AcademyHealth—the national program office for the SCI program—is
under contract with HRSA to provide technical assistance to awardees
as they move forward with their research. The Robert Wood Johnson
Foundation's State Health Access and Data Assistance Center (SHADAC)
at the University of Minnesota is also giving data assistance to
grantee states.
6.
Pennsylvania Program’s Waiting List Hits All-Time High
The
number of people on the waiting list for Pennsylvania's adultBasic
coverage program for low-income adults reached 100,000 in July,
and is currently at 97,000. Financed with the state's portion of
the national tobacco settlement fund, adultBasic is available to
residents between the ages of 19 and 64 who have not had health
care coverage, including Medicaid, for more than 90 days and who
have incomes at or below 100 percent of the federal poverty level.
By
paying a $30 monthly premium, beneficiaries have access to a benefit
package that covers hospital care, doctor visits, and lab work;
however, it does not cover prescription drugs. The future of adultBasic
may be in jeopardy because the tobacco settlement fund will be reduced
by $12 million next year. To learn more about adultBasic and other
public programs with streamlined benefit packages, please read the
July 2004 SCI Issue Brief Limited
Benefit Policies: Public and Private-Sector Experiences. To
further explore how states are being affected by limited benefit
packages, see slides from
SCI's summer workshop.
7.
Kaiser Releases Employer Health Benefits Survey
The
Kaiser Family Foundation and the
Health Research and Educational Trust
recently released their 2004
Annual Employer Health Benefits Survey, an in-depth look at
trends in health insurance costs and coverage in the workplace.
The
survey showed that private health insurance premiums rose 11.2 percent
in 2004. Although this rate of increase is less than last year’s
(13.9 percent), 2004 marks the fourth consecutive year of double-digit
growth in premiums. The 2004 rise is about five times the rate of
inflation (2.3 percent) and workers’ earnings (2.2 percent).
The
survey, which was conducted between January and May, included 3,017
randomly selected public and private firms with three or more employees.
In addition to documenting premium changes, the survey describes
employer cost-sharing mechanisms, including those related to prescription
drugs and hospital care, workers’ contribution to the cost
of coverage, the types of insurance that employers are offering,
and the prevalence of consumer-directed health plans.
8.
Coming
Soon
Upcoming
SCI Products
Check
in with statecoverage.net
for updates on SCI's latest publications. We have several in the
pipeline, including:
-
A “Profile in Coverage” with Healthy New York (Q &
A with Governor Pataki and Commissioner Serio);
-
An issue brief on lessons learned from the Communities in Charge
program (SCI collaboration with Terry Stoller, project director,
Communities in Charge);
-
State of the States 2005, SCI’s annual report summarizing
state coverage expansion efforts during the previous year.
Coming
Soon from AcademyHealth
“Paying
for Performance,” a free Web Conference conducted by AHRQ’s
Knowledge Transfer team housed at AcademyHealth, will be held on
Thursday, October 21, 2004, at 3:00-4:30 p.m. Eastern Time. This
event will explore the emerging evidence base for quality-based
purchasing and the utility of this knowledge for implementing quality-based
purchasing programs. This is the first in a series titled "Buy-Right
for Healthcare Quality: the Evidence Base and Practical Tools."
For more information, visit academyhealth.org/ahrq/valuepurchasing.
9.
Reports of Interest
The
following are the most recently released reports on coverage, most
of which are additions to SCI's
database of state reports.
Beneath
the surface: Barriers Threaten to Slow Progress on Expanding Health
Coverage of Children and Families
The Henry J. Kaiser Family Foundation
October 2004
The
Continuing Medicaid Budget Challenge: State Medicaid Spending Growth
and Cost Containment in Fiscal Years 2004 and 2005
The Henry J. Kaiser Family Foundation
October 2004
Wages,
Health Benefits, and Workers’ Benefits
The Commonwealth Fund
October 2004
A
Brief Update on State Fiscal Conditions and the Effects of Federal
Policies on State Budgets
Center on Budget and Policy Priorities
September 2004
The
Chronic Problem of Declining Health Coverage
Economic Policy Institute
September 2004
Medicaid
and Other Public Programs for Low-Income Childless Adults: An Overview
of Coverage in Eight States
The Henry J. Kaiser Family Foundation
August 2004
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