Improving the Mind, Body, and Spirit of Texans. Kevin C. Moriarty, President & CEO Methodist Healthcare Ministries April 2010

Transcription

1 Improving the Mind, Body, and Spirit of Texans Kevin C. Moriarty, President & CEO Methodist Healthcare Ministries April 2010

2 Methodist Healthcare Ministries Programs and Partnerships

3 Part 1: Strategic Management Obesity and diabetes drive up costs A large uninsured population drives up costs We can t count on the government to cover health care costs

4 POTENTIAL Total % Obesity in Texas by County 2010 Percent of adults with BMI >=30; Office of the State Demographer, Projection

5 POTENTIAL Total % Obesity in Texas by County 2020 Percent of adults with BMI >=30; Office of the State Demographer, Projection

6 POTENTIAL Total % Obesity in Texas by County 2030 Percent of adults with BMI >=30; Office of the State Demographer, Projection

7 POTENTIAL Total % Obesity in Texas by County 2040 Percent of adults with BMI >=30; Office of the State Demographer, Projection

8 Obesity Poverty Poverty Rates (%) 0-11% 12-15% 16-20% 21-29% 30-50% Source: Texas State Demographer

9 Changes in Food Prices

10 Select Health Indicators, San Antonio Source: The Behavioral Risk Factor Surveillance System (BRFSS), San Antonio Metropolitan Statistical Area 2008

11 Texans Without Health Insurance in Source: US Census Bureau, Current Population Survey, Annual Social & Economic Supplement 2008 & 2009, working age is defined as years old; Texas Health Care Primer, Nov 2009, Center for Public Policy Priorities.

12 Percent of Persons with No Health Insurance Coverage (2008) 29.4% %

13 Spending Per-Capita 2007 (Comparing Texas with National Average) CDC: Centers for Disease Control HRSA: Health Resources & Services Administration April, Short-Changing America s Health 2008: A State by State Look at How Federal Public Health Do Trust for America s Health.

14 Part 2: Workforce Planning and Employment What about Health Care Reform? Who benefits in Texas?

15 Health Care Reform 2010 The Patient Protection and Affordable Care Act (HR-3590) & The Health Care & Education Reconciliation Act of 2010 (HR-4872) Expands health care coverage to 32 million previously uninsured citizens Includes Medicaid Expansion to 133% FPL Creates a State-Based Insurance Exchange System Employer and Individual Mandates

16 Health Care Reform 2010 Insurance Reforms: No lifetime limits on coverage No exclusion based on pre-existing conditions No penalty based on health status No rescission of coverage (you can t lose your coverage for using it)

17 Health Care Reform 2010 Improves Prevention and Wellness Programs Medicare beneficiaries will receive annual physicals Prevention and Public Health Fund Grants to small employers for wellness programs

18 Health Care Reform 2010 Invests in Health Care Workforce Establishes a multi-stakeholder Workforce Advisory Commission Increase the number of Graduate Medical Education positions Provides additional scholarships and loans to increase workforce supply Supports the development of training programs

19 Health Care Reform 2010 Timeline: 2010 Medical loss ratio limitation (85%) Cobra extension until the Exchange is fully functional (in 2014) Ban on Lifetime Limits Prevent Health Insurance Rescission Pre-Existing Condition Exclusion for children Initiates closing of Medicare Part D doughnut hole Provides a small business cost sharing tax credit With 25 employees or less, up to 35% tax credit With 10 employees or less, up to 50% tax credit

20 Health Care Reform 2010 Timeline: 2010 Small Business (50 or less employees) are exempt from financial penalties. Those eligible small businesses who choose to provide coverage will receive a cost sharing tax credit based on the number of employees: For example: With 25 employees or less, up to 35% tax credit With 10 employees or less, up to 50% tax credit

21 Health Care Reform 2010 Timeline: 2010 (Continued) Increase funding for Community Health Centers ($11 Billion) Increase dependent age to 26 years old Create medical home pilot programs Provide grants for employer wellness programs Create reinsurance for early retirees

22 Health Care Reform 2010 Timeline: 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. Timeline: 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.

23 Health Care Reform 2010 Timeline: 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 Timeline: 2014 Health insurance exchange expands Medicaid expansion to 133% FPL Open exchange to individuals with employer based coverage Reduce overpayments in Medicare advantage

24 Health Care Reform 2010 What results? Significantly reduces the federal deficit (per Congressional Budget Office): o $138 Billion ( ) o $1.3 Trillion over the next decade ( ) - Per the Congressional Budget Office (CBO) Reduces costs and improves outcomes for consumers Extends solvency of Medicare, which protects senior citizens. Establishes a competitive marketplace for consumers to shop for insurance coverage. Establishes pilot programs for continued innovation.

25 What is Texas Share? Year Federal Funding State Contribution % % 5% % 6% % 7% % 10% Beyond % 10% Source: Kaiser Family Foundation

26 Spending on Health & Public Assistance per Person Below Poverty Level

27 Part 3: HR Development The missing element in Health Care Reform: Cost control of Health care Services The cost of health care will continue to rise until the cost of services are standardized and controlled.

28 Average National Annual Premiums for Single and Family Coverage, $2,196 $5,791 Single Coverage 2000 $2,471* $6,438* Family Coverage $2,689* $3,083* $3,383* $3,695* $4,024* $7,061* $8,003* $9,068* $9,950* $10,880* $4,242* $4,479* $4,704* $4,824 $11,480* $12,106* $12,680* $13,375* $0 $2,000 $4,000 $6,000 $8,000 $10,000 $12,000 $14,000 $16,000 * Estimate is statistically different from estimate for the previous year shown (p<.05). Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits,

29 Average Health Insurance Premiums and Worker Contributions for Family Coverage, $9,860 $4,247 $1,543 $3, Employer Contribution Worker Contribution Note: The average worker contribution and the average employer contribution may not add to the average total premium due to rounding. Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits,

30 Links Between Business and the Uninsured

31 Part 4: Total Rewards Outcomes if Further Corrective Action is Not Taken Possible growth of health care costs to employers and individuals Health care takes over the GDP unsupportable economically

32 Average Annual Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, $4,000 $3,500 $3,000 $2,500 $2,412* $2,137* $2,661* $2,713 $2,973* $3,281* $3,354 $3,515 $2,000 $1,500 $1,543 $1,619 $1,787* $1,000 $500 $318 $334 $355 $466* $508 $558 $610 $627 $694* $721 $779 $ Single Coverage *Estimate is statistically different from estimate for the previous year shown (p<.05). Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, Family Coverage

33 Projected Spending on Health Care as a Percentage of Gross Domestic Product 25% 20% 15% 10% Total National Health Spending 19.3% 7.6% Medicare Spending 5% Medicaid Spending 0% Total NHE: (in billions) $2,472 $2,570 $2,703 $2,850 $3,025 $3,225 $3,442 $3,684 $3,936 $4,204 $4, % Source: Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group, at (see Projected; NHE Historical and projections, , file nhe65-19.zip).

34 Part 5: Employee and Labor Relations Benefits important for hiring and retaining quality staff On-site health promotion increasingly important for cost control Take advantage of the wellness program grants when they appear

35 Part 6: Risk Management (Important Strategic Considerations) Cost is the greatest risk to businesses Lost productivity is a risk; keep your people healthy Aging workforce will bring additional health care costs

36 Resources Web sites for more information and analysis of health care reform: Kaiser Family Foundation: Commonwealth Fund: Community Catalyst: Methodist Healthcare Ministries:

37 Serving Humanity to Honor God 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 every you can. John Wesley Founder, Methodism