Health Care and Texas May 2011

7/31/2019 Health Care and Texas May 2011

1/34

Health Care and Texas:Where Weve Been & Where Were Going

President and CEO

May 4, 2011


2/34

Overview Introduction

Determinants of Health

The Health Care Dilemma

Chronic Disease

Texas Legislative Session

Health Care Reform

Health Care and Bioscience Industry


3/34

About Methodist Healthcare Ministries

Our Mission:

Serving Humanity to Honor God by improving the physical,

mental and spiritual health of those least served in the SouthwestTexas Conference area of The United Methodist Church.

Who We Are:

Dedicated to providing medical and health-related services Low income families and the uninsured

242 authorized sites throughout South Texas

Largest private funding source for health services in South Texas

Half owner of Methodist Healthcare System


4/34

About Methodist Healthcare Ministries

What We Do:

Budgeted expenditure of $60,000,000 in 2011, to provide over 500,000

client encounters. This is achieved through programs owned and operated

by MHM and through contracts with partners who have similar missions.

MHM Programs/Services:

Wesle Nurse Health Ministries Grants mana ement

Church Based Counseling Parenting Programs

Health Education

School Based Health Centers

Clinical Services (Primary and Medical)

Advocacy and Public Policy Family Wellness Programs

Behavioral Health Services

Charity Care


5/34


6/34

Determinants of HealthHealth Care

10%

Environment

19%

Lifestyle

(Smoking, Obesity, Str

ess, Nutrition, Blood

Pressure, Alcohol, and

Human Biology

20%

Drug Abuse)

51%


7/34

Determinants of Health

19%

14%

12%

fDeath

What's Really Killing Us?Half of all deaths can be attributed to these factors

Heart Disease

Cancers Heart Disease

Heart Disease

5%

Tobacco Use Diet/Activity Alcohol Use Other*

Causeso

Respiratory

Disease

Infant Deaths

Cancers

Diabetes

Infant DeathsHeart Disease

Cancers

Injuries

Infant Deaths

Cancers

Diabetes

All Injuries

Respiratory

Disease

HIV/AIDS

Infant Deaths


8/34

High Cost of Care


9/34

HCR: High Cost of Care & Access

It is ALL Connected!


10/34

U.S. Average: 15.1%

Mass. 4.1%

Access to CarePercent Uninsured

Texas 24.1%


11/34

Texas Demographics: The UninsuredCurrently in Texas:

4.5 million uninsured adults

1.2 million uninsured children

5,745,286 people

Bexar County: 352,944 (22.3%)

Webb County: 85,696 (36.2%)

Hidalgo County: 273,887 (38.0%)

Cameron County: 139,388 (35.7%)


12/34

Percent Persons with No Health Insurance Coverage (2008)

Why Health Care Reform is Critical: Access

29.4% - 38.0 %


13/34

Texas Businesses Offering Coverage by Size

60%

80%

100%

120%

ering

coverage

Why Health Care Reform is Critical: Access

0%

20%

40%

Percento

f

Number of employees

Less than 10 10 - 24 25 - 99 100 - 999 1,000 or more


14/34

Texas Uninsured by Income Today88% of 6.4 million uninsured


15/34

Obesity in Children Texas ranks 7th highest in the nation for obesity in 10-17 year olds

42% of 4th graders in Texas are obese or overweight

Obesity associated annual hospital costs among children (x3) in

the past three years due to a (x2) of diabetes cases, a (x3) of

.

The US Surgeon Generals Office reports that overweight children

have a 70% change of becoming overweight or obese adults

34.1% low-income children (2-5) are overweight or obese in Texas.

Sources:Texas Health Institute, Obesity in Texas: Reaching Epidemic Proportions and Responding to theEpidemic: Strategies for Improving Diabetes Care in Texas,Center for Diseased Control and Prevention, National Hospital Discharge SurveyNational Initiative for Childrens Healthcare Quality, 2008 Pediatric Nutrition Surveillance System


16/34

Diabetes in Texas Diabetes is the 6th leading cause of death in Texas

4th leading cause among Hispanics and African Americans

Diabetes is the leading cause of kidney failure, non-traumatic limbamputations and blindness

A roximatel one in ever 400 to 600 Texas children and

adolescents has Type I diabetes.

In 2009, Childrens Health Insurance Plan (CHIP) payments for

diabetes related services were estimated at $3.8 million

Sources:Texas Diabetes Council, Diabetes: A Comprehensive Approach, 2010Texas Health Institute, Responding to the Epidemic: Strategies for Improving DiabetesCare in Texas, 2010.


17/34

Projected Diabetes Percentages in Bexar County

2010 2020 2030 2040

Bexar County 13.5 % 19.0 % 22.6 % 25.7 %

State of Texas 11.9 % 17.1 % 20.8 % 23.8 %

County Projections of Diabetes in Texas

Source: Texas Health Institute, Responding to the Epidemic: Strategies for Improving Diabetes Care in Texas


18/34

Ratio of Providers per 100,000 Population 2008, by geographic location

Occupation TexasUrban Rural

Border Non-Border Border Non-Border

Primary Care Physicians 68.4 52.8 72.7 35.4 55.0

Physician Assistants 17.3 13.5 18.5 16.0 12.8

Dentists 37.2 16.5 41.8 11.9 25.3

Dental Hygienists 38.8 18.4 42.9 8.8 30.3

Registered Nurses 671.3 483.1 730.9 230.6 470.1

Licensed Vocational Nurses 277.5 202.9 257.2 298.8 473.9

Pharmacists 77.0 42.7 84.9 31.5 56.4

Psychologists 25.9 8.7 30.3 6.2 11.7

Social Workers 67.1 45.0 73.4 20.4 46.9


19/34

$27 Billion Shortfall in Texas State Budget2012-13 Forecast

General Revenue $77 billion

Fiscal 2011 Ending Deficit - 4 billionSet aside for Rainy Day Fund - 1 billion

TOTAL GR AVAILABLE $72 billion

Minimum needed for current services,

considering population growth &

health cost inflation

$99 billion

GAP: $27 billion

Source: Center for Public Policy Priorities


20/34

GR Shortfall in HB 1 as Introduced

Requested GR Recommended

GR

General Revenue

Shortfall

HHS $ 31.0 b $ 20.0 b - $11.0 b

Education 56.4 b 41.7 b - 14.7 b

r m n a

Justice 9.2 b 7.5 b - 1.7 b

The rest 6.2 b 4.1 b - 2.1 b

Total $ 102.8 billion * $ 73.3 billion - $29.5 billion

Source: Legislative Budget Estimates, HB 1: * excludes $4billion requested by TXDoT


21/34

IN THECOMPANY OFPOORSTATES

Worst States for

Children

State Median Household

Income in 2009

% of Children in Poverty

in 2009

Arkansas $38,815 26%

South Carolina $43,625 21%

Texas $50,043 23%

Oklahoma $42,822 22%

http://everychildmatters.org/resources/reports

New Mexico $43,508 25%

Mississippi $37,790 29%

Louisiana $43,733 27%


22/34

Health Care ReformThe Patient Protection and Affordable Care Act (HR-3590)

Expands health coverage to 32 million previously uninsured citizens.

Includes Medicaid Expansion to 133% FPL. Creates a State-Based Insurance Exchange System

Employer and Individual Mandate

u s n p ace nsurance e orms:

No lifetime limits on coverage

No exclusion based on pre-existing conditions

No penalty based on health status

No rescission of coverage


23/34

Health Care Reform Improves Prevention and Wellness Programs

Medicare beneficiaries will be provided annual physicals

Created the Prevention and Public Health Fund Provide grants to small employers for wellness programs

Invests in Health Care Workforce

Establishes a multi-stakeholder Workforce Advisory Commission Increase the number of Graduate Medical Education positions

Provides additional scholarships & loans to increase workforce

Supports the development of training programs.


24/34


To date:

Increased funding for Community Health Centers ($11 Billion)

Increased dependent age to 26 years old. Created medical home pilot programs.

Provided grants for employer wellness programs.

Created reinsurance for early retirees.

Medical loss ratio limitation (85%)

Cobra extension until the Exchange is fully functional (2014)

Ban on Lifetime Limits

Prevent Health Insurance Rescission

Pre-Existing Condition Exclusion for children

Initiated the closing Medicare Part D, doughnut hole Provided a small business tax credit (35%)


25/34


IN 2011

Eliminates barriers in Medicare Low-Income Subsidy.

Increases reimbursement for primary care (10%) Establishes a free annual wellness test for Medicare beneficiaries

Additional funds to states with high unemployment costs.

IN 2012

Improves low-income protections in Medicare

Directs CMS to track hospital readmission rates

Extends months of coverage of immunosuppressive drugs for

kidney transplant patients.


26/34


IN 2013

Begin paying physician based on value not volume.

Comprehensive health insurance reforms initiates. Creation of health insurance exchange.

Subsidy (tax credits) made available.

Individual and employer mandate effective.

IN 2014

Health insurance exchange expands.

Medicaid expansion to 133% FPL.

Open exchange to individuals with employer based coverage.

Reduces overpayments in Medicare advantage.


27/34


What results?

Significantly reduces the federal deficit:o $138 Billion (2010 2019)

o 1.3 Trillion over the next decade (2019 2029)

e uces cos s an p oves ou co es o consu e s

Extends solvency of Medicare, which protects senior citizens.

Establishes a competitive marketplace for consumers to shop

for insurance coverage. (Health Insurance Exchange)

Establishes pilot programs for continued innovation.


28/34

Source: The Greater San Antonio Chamber of Commerce,

San Antonios Health Care and Bioscience Industry


29/34

Source: The Greater San Antonio Chamber of

Commerce, San Antonios Health Care and BioscienceIndustry


30/34

Source: The Greater San Antonio Chamber of Commerce,

San Antonios Health Care and Bioscience Industry


31/34




32/34




33/34

DO ALL THE GOOD YOU CAN, BY ALL THE MEANS YOU CAN,

IN ALL THE WAYS YOU CAN, IN ALL THE PLACES YOU CAN,

AT ALL THE TIMES YOU CAN, TO ALL THE PEOPLE YOU CAN,AS LONG AS EVER YOU CAN.

~ John Wesley

Founder of Methodism


34/34

For More Information Contact:

Methodist Healthcare Ministries

page

www.mhm.org(210) 692-0234

Documents

Health Care and Texas May 2011