Payers & Providers Midwest Edition – Issue of July 17, 2012

7/31/2019 Payers & Providers Midwest Edition Issue of July 17, 2012

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In Brief

Childhood ObesityCreeps Upward In

Minnesota

A new study by the ChilidrensHospitals and Clinics of Minnesota

has concluded that unhealthyeating habits are contributing to theobesity of the states children.

Altogether, about 11% o fMinnesotas children are obese,while 23% have some weightproblems. Although both are belowthe national average, the rates havecontinued to climb in recent years,according to the report, which isentitled Starting Early to PreventChildhood Obesity.

We've seen a disturbinggrowth in obesity-related diseasesamong our kids," said Alan L.Goldbloom, M.D., CEO ofChildren's of Minnesota. This

increase includes conditions likeType 2 diabetes, heart disease, liverdisease, asthma, and joint problems some of which were previouslyuncommon in children. This is anepidemic communities must jointogether to fight at our kitchentables, in our schools and acrossour healthcare system.

The report links the growingobesity rate to unhealthy eatinghabits only 20% of the stateschildrens eat the recommendedportions of fruits and vegetables,and 34.4% do not meals with theirfamilies. Minority children are alsomore likely to be obese because

they live in places with few parksand places to buy groceries.

The report recommended thatpublic and private healthorganizations develop researchprojects and collaborations toaddress the obesity epidemic.

"When it comes to preventingobesity, the earlier we get startedwith children, the better the chance

Continued on Page 3

NEWS

University of Kansas (Continued from Page One)

for treatment to the Mayo Clinic inMinnesota or the MD Anderson CancerCenter in Texas, both NCI designated centers.

Those are fantastic institutions, but it isincredibly disruptive, to say the least, to leavehome when they are given a diagnosis, hesaid. It is a pretty traumatic experience.

As part of the centers efforts, it increasedthe percentage of patients who are involvedin clinical trials. Jensen said the center takescare of about 8,000 cancer patients a year. In2004, only about 4% of patients were inclinical trials; this past year, that numbergrew to about 14%.

The center grew these numbers by hiringresearch nurses and other employees whocould screen for trials. It created disease

working groups that would focus on differentorgans to make sure the trialspatients tookpart in related to their needs.

We made sure it became part of theculture to evaluate every single patient thatwalked through the door for potentialenrollment in a trial, Jensen said.

And the NCI credentialing will increaseeven further the cancer centers participationin trials. Jensen said the designation willmake them more competitive when recruitingscientists and clinicians in the future.

They (NCI-designated centers) are thecrucibles from which nearly every

therapeutic advance over the last 40 yearshas emanated, he said. They want to bepart of that realm; be at one that is making adifference in this ght.

Being an NCI-designated institutionalso helps attract funds from organizationsIt sets up for successfully applying for NIH

or other dollars, said Mary Sumpmann,associate director for administration of theMasonic Cancer Center at the University oMinnesota in Minneapolis. Largeorganizations are supportive of us andindividuals have supported initiatives forendowed chairs.

The Masonic Cancer Center received idesignation in 1998. Sumpmann said its

integrated cancer research model hasattracted funding from various kinds oforganizations including philanthropies. In2008, the masons made a gift of $65million over 15 years. Their total

contributions equal more than $100million.

Jensen said the organization isgratied and humbled by the support ithas received and sees the designation as away to continue its journey and not as adestination.

The need for increased cancer researcis demonstrated in the fact that 67% ofpeople diagnosed with cancer have morethan a ve-year survival rate. He said thatmeans there is no answer for one-third ofthe patients that walk through their doors.

Our ultimate goal is to become a

nationally signicant cancer center that istaking on the responsibility of moving theneedle in a positive direction for bothcancer incidence and mortality in ourspecic area, he said.

Minn. Awards Exchange ContractsMaximus, Connecture Win Construction Pacts

While many other states are on the fence on

constructing health insurance exchanges,Minnesota announced two contracts this weekto build and support its own. Maximus, a Reston, Va.-based rm thatspecializes in Medicare and Medicaidprogram administration, won a $41 million,21-month contract to build the exchange anddesign and launch its website. Connecture, a Wisconsin-based rm thatspecializes in systems automation for thehealth insurance industry, won a bid tobecome the primary subcontractor. Maximus

will deploy StateAdvantage, Connecture-

designed software, to operate the primarycomponents of the exchange, includingenrollment and plan administration. Thatcontracts value was not immediatelydisclosed. IBM and EngagePoint were also namsubcontractors.

Continued on Next Page


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NEWS

In Brief

of success. Investing in earlyintervention is critical," said JulieBoman,M.D., a Childrenspediatrician and hospitalist.

Take Care Opens SiteOn Notre Dame

Campus

Walgreens affiliate Take CareHealth Systems has opened awellness center on the campus ofNotre Dame University in SouthBend, Ind.

The 7,000-square-foot facilityprovides services to universityfaculty and employees, theirspouses and dependents, as well asgraduate students and their

families. It offers primary care,urgent care, lab testing andpharmacy services.

Officials say the clinic willserve about 12,000 individualsoverall.

We are increasingly seeingeducational institutionsrecognizing what many innovativecompanies have found namelythat by investing in broad worksitehealth programs they can expect tosee improved patient outcomes,overall savings and happier andmore productive employees, saidPeter Hotz, a group vice presidentfor Walgreens health and wellness

division.The financial arrangementsbetween Take Care and NotreDame were not disclosed.

According to a report releasedlast year by Towers Watson andNational Business Group onHealth, 23% of companiessurveyed said they currently offeronsite health services, and thatanother 12% plan to offer suchservices this year.

Healthcare Price Spikes Remain LowRecession Has Helped to Dampen Big Increases

New data from a Michigan think tank hasconcluded price spikes in the healthcaresector have slowed to a rate not seen in morethan a decade.

According to Ann Arbor-based AltarumHealth, prices were up just 2% between May2011 and May 2012, the slowest growth sinceJanuary 1999. Healthcare spending was alsotaking a slow growth approach, increasing

3.8% between May 2011 and May 2012, andon pace for about $2.8 trillion this year.

Spending has experienced an averageannual increase of about 3.9% since themiddle of 2011, according to Altarum.

Our analysis continues to show stablehealth spending growth hovering around the4% mark, and this three-and-a-half year trendis entirely unprecedented, said CharlesRoehrig, director of the Altarum Center forSustainable Health Spending. As a result,health spending as a share of GDP has held

steady at about 18% over this same periodand, were it not for disappointing GDPgrowth, could actually be falling.

Spending has increased about 11% sincthe Great Recession began in late 2007,compared to a 7.3% increase in non-healthcare prices.

Altarum could not give a specic reasonfor the slowing in healthcare prices, whichroutinely outstripped ination by two or thretimes in years prior to the Great Recession.

Prior to the economic turmoil, the annuprice growth was about 10.6% per year,according to Altarum.

Hospitals represented the biggest chunkof healthcare spending in May, about $890billion on an annualized rate, or 32% of allexpenditures. Physician and clinical servicesrepresented about 19% of total spending, or$536 billion. Prescription drugs representedabout 10% of spending, while other healthspending was about 16% of all expenditures

Minnesota (Continued from Page One)

This contract is a signicant milestone inthe design and development of a Minnesotahealth insurance exchange, said state

Commerce Commissioner Mike Rothman.We can now move forward on developingthe technology backbone of the exchange.

State ofcials have projected as many as1.2 million Minnesotans will use the exchangeto purchase their insurance coverage, many ofwhom will have premiums subsidized byfederal tax breaks starting in January 2014. It isexpected to launch in November 2013.

About 463,000 Minnesotans currentlylack health insurance, according to the Kaiser

Family Foundation 9% of the statesresidents, one of the lowest rates in the natio

A statement issued by Maximus suggests

the company will be bidding on exchangecontracts in other states.The awarding of this contract represent

a signicant opportunity for MAXIMUS as wbegin to gain traction and establish ourleadership role in this emerging market, saidMaximus Chief Executive Ofcer Richard A.Montoni. This award speaks to ourcapabilities to translate policy into effectivesolutions for our clients, and further positionMaximus to capitalize on new growthprospects.

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The single biggest mistake in all of healthpolicy is the belief that the best way to makehealthcare accessible is to make it free at thepoint of delivery. This mistake underlies ourentire approach to providing healthcare tolow-income families in thiscountry; it is the basis for theorganization of the entirehealth system in most otherdeveloped countries; and itis deeply embedded in theObama administrationsapproach to health reform.

The major barrier to care

for low-income families isthe same in the United Statesas it is throughout thedeveloped world: the timeprice of care and other non-price rationing mechanismsare far more important than themoney price of care.

The burdens of non-pricerationing rise as income falls, withthe lowest-income families facingthe longest waiting times and the largestbureaucratic obstacles to care.

The Patient Protection and Affordable

Care Act, by lowering the money price of carefor almost everybody while doing nothing tochange supply, will intensify non-pricerationing and may actually make access tocare more difcult for our most vulnerablepopulations.

Interestingly, a natural experiment forms atest of my critique: the recent recession. Asexplained in a report from the Center forStudying Health System Change, middle-classfamilies are responding to bad economictimes by cutting back on their consumption ofhealthcare. They are postponing electivesurgery, forgoing care of marginal value, and

making more cost-conscious choices whenthey do get care. This reduction in demand isfreeing up resources, which are apparentlybeing redirected to meet the needs of peoplewho face price and non-price barriers to care.

From 2007 to 2010: The percentage of thepopulation experiencing an unmet health careneed actually fell from 7.8 % to 6.5%. Thepercent of people who say they have delayedcare fell from 12.1% to 10.7% over the sameperiod.

And this is in the middle of one of our

worst recessions!During the recession the money price

barrier to care actually rose among theuninsured, although the increase was notstatistically signicant. The number of

uninsured people reporting accessproblems because they wereworried about cost rose from91.5% to 95.3%. (Translation:virtually everybody who isuninsured worries about cost.) Yetover the same period, the numberof people experiencing accessproblems because of waiting and

other non-price barriers wasalmost cut in half.

Suppose that in an attemptto increase access to care, we addone more doctor, one more nurseor one more clinic. Who is likely

to benet? The study implies that thehigher your income, the greater thelikelihood you will gain.

During the recession, for example,the percent of people experiencing an

unmet need with income at 400% of thepoverty level or above was more than cut inhalf. Yet, among those with income below

200% of poverty, the percent of those withunmet needs actually rose.

Think (metaphorically) of a waiting linefor care. The lowest-income families are at theend of that line. The longer the line, the longethey will have to wait. If you do something toshorten the line, you will be mainly benettinhigher-income people who are at the front.Why is that? I believe that many of the skillsthat allow people to do well in the market arethe same skills that allow them to do well innon-market settings. High-income, highlyeducated people, for example, will nd a wayto get to the head of the waiting line, whether

the thing being rationed is quality education,healthcare or any other good or service. Low-income, poorly educated individuals willgenerally be at the rear of those lines.

OPINION

How Income Really Dictates AccessWe May Be Examining The Wrong Waiting Time Drive

John C. Goodman is founder, president and

CEO of the National Center for Policy

Analysis.

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By

John C.

Goodman

Op-ed submissions of up to 600 words are

welcomed. Please e-mail proposals to

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Payers & Providers Midwest Edition – Issue of July 17, 2012

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