Sources of Coverage, 2006-2007
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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. PROMOTING MEDICAL HOMES
A Washington healthcare team is working to improve care by promoting patient-centered medical homes. The team's action plan
seeks to create an operational definition of medical home in order to measure and improve medical home capacity; develop reimbursement
strategies to support providers in adopting a medical home model; and engage consumers and providers in participating in patient-centered
medical homes.
By the end of the summer, the team expects to have an operational definition 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.
REPORT SHOWS ROOM TO IMPROVE
Washington
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The quality of medical care varies widely at clinics and hospitals across the Puget Sound region, according to the Puget Sound
Health Alliance's "Community Checkup" report, released in November.
The report used huge volumes of health-insurance-billing data from 1.6 million area residents to compare the 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 five 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 effort to inspire quality improvement. Most of the data collected are available online, allowing consumers
to see how medical groups, clinics and hospitals stack up.
The report found:
- Nearly half of clinics surveyed were below average at ensuring regular eye exams for diabetics;
- The percentage of heart surgery patients receiving standard treatment to prevent blood clots ranged from 59% to 96%; and
- At some clinics, fewer than one in four sexually active young women were screened for chlamydia.
However, about 94% of children seen for the cold virus were not given antibiotics, which is considered the proper course of
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 160 organizations, including major employers, such as Boeing and Starbucks, health insurers,
city and county governments and medical providers. Alliance members said the hope is that the report will spur improvements.
MHE Sources: Centers for Medicare & Medicaid Services; Urban Institute; Kaiser Family Foundation; U.S. Census Bureau; The
Commonwealth Fund.
