Health Reform in Kansas Murphy Society

University of Kansas School of MedicineOctober 25, 2012

Health Reform in Kansas Murphy Society

University of Kansas School of MedicineOctober 25, 2012

Suzanne Schrandt, J.D.

Kansas Health Institute

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Kansas Health InstituteKansas Health Institute

The Kansas Health Institute is an independent, nonprofit health policy and research organization that informs policymakers about important issues affecting the health of Kansans.

Our mission is to inform policymakers by identifying, producing, analyzing and communicating information that is timely, relevant and objective.

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Health in KansasHealth in Kansas

Health Outcomes Ranking, by County

Source: County Health Rankings and Roadmaps Project, Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute, 2012 3

Kansas Compared to U.S.Kansas Compared to U.S.

Source: Kaiser Family Foundation, State Health Facts, retrieved October 2012 4

Health Insurance CoverageHealth Insurance Coverage

Primary Sources of Health Insurance, All Kansans (2010-2011)

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Distribution of Kansas HospitalsDistribution of Kansas Hospitals

Source: Kansas Hospital Association, 2011 STAT Report 6

Kansas Health InstituteKansas Health Institute

7Source: Kansas Association for the Medically Underserved

Primary Care HPSAsJanuary 2012

Primary Care HPSAsJanuary 2012

Source: KDHE Bureau of Community Health Systems, 2012 8

Why Health Reform?Why Health Reform?

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Three Primary Components of the ACA

Three Primary Components of the ACA

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Public HealthPublic Health

ACA Public Health Funding March 2010 – September 2012

Source: Kaiser Family Foundation ACA Funds Tracker, September 2012 11

Cost Containment, Payment and Delivery Reform

Cost Containment, Payment and Delivery Reform

Quality ImprovementPayment AdjustmentsDelivery Reform Transparency/Financial Relationships

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What’s happening in Kansas?What’s happening in Kansas?

Kansas 55 hospitalsAverage penalty of .20%

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What’s happening in Kansas?What’s happening in Kansas?

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What’s happening in Kansas?What’s happening in Kansas?

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Coverage and AccessCoverage and Access

Primary Sources of Health Insurance, All Kansans (2010-2011)

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ACA Coverage ProvisionsACA Coverage Provisions

Access rules Guaranteed Issue Pre-existing condition exclusions

Cost impacts Rating rules Federal assistance

Navigation Health insurance exchanges

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Employment-Based Coverage in Kansas

Employment-Based Coverage in Kansas

Source: KHI Analysis of 2011 Medical Expenditure Panel Survey Data

Private Kansas Employers by Number of Employees

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Uninsured Kansans by ACA Eligibility Category

Uninsured Kansans by ACA Eligibility Category

Source: KHI Analysis of 2010-2011 Current Population Survey Data19

Medicaid Expansion?Medicaid Expansion?Uninsured Kansas Adults, age 19-64, by ACA Eligibility Category

Source: KHI Analysis of 2010-2011 Current Population Survey Data20

Medicaid Expansion?Medicaid Expansion?

Cost concernsDSH payment reductionsEmployer liability?

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Coverage Changes Already in Place

Coverage Changes Already in Place

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Provision Impact in Kansas

Dependent coverage to age 26

As of June 2011, 22,000 young adult Kansans were covered through this provision—and that number has likely grown

Preventive services at no cost

529,000 Kansans in private plans and 313,000 Kansans in Medicare have received free preventive care

through this provision

Early Retiree Reinsurance Program

62 Kansas employers including Koch Industries, Sprint, City of Topeka, and Wolf Creek

Federal fundingAround $90 million has been awarded to public and private

Kansas recipients

Lifetime limit prohibition

1.02 million Kansans no longer have lifetime maximum limits on their health insurance plans

Workforce Funding Opportunities

Workforce Funding Opportunities

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Primary care loan repayment/forgiveness programs

Pediatric specialty/underserved area Public health workforce loan repayment Allied health workforce loan repayment National Health Service Corps Community Health Workforce grants Rural physician/underserved area

Loan Repayment ChangesLoan Repayment Changes

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Income-Based Repayment (IBR) Reduction from 15 to 10 percent of adjusted

gross income—begins in 2014 for new borrowers

Maximum loan forgiveness period from 25 to 20 years

Looking ForwardLooking Forward

November elections Sequestration Health insurance exchange

preparation Medicaid expansion decision Ongoing legal challenges

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Questions?Questions?

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Information for policy makers. Health for Kansans.Information for policy makers. Health for Kansans.

Kansas Health InstituteKansas Health Institute

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