Download - Health Care and Texas May 2011
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Health Care and Texas:Where Weve Been & Where Were Going
President and CEO
May 4, 2011
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Overview Introduction
Determinants of Health
The Health Care Dilemma
Chronic Disease
Texas Legislative Session
Health Care Reform
Health Care and Bioscience Industry
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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
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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
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Determinants of HealthHealth Care
10%
Environment
19%
Lifestyle
(Smoking, Obesity, Str
ess, Nutrition, Blood
Pressure, Alcohol, and
Human Biology
20%
Drug Abuse)
51%
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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
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High Cost of Care
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HCR: High Cost of Care & Access
It is ALL Connected!
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U.S. Average: 15.1%
Mass. 4.1%
Access to CarePercent Uninsured
Texas 24.1%
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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%)
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Percent Persons with No Health Insurance Coverage (2008)
Why Health Care Reform is Critical: Access
29.4% - 38.0 %
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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
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Texas Uninsured by Income Today88% of 6.4 million uninsured
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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
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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.
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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
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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
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$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
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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
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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%
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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
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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.
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Health Care ReformThe Patient Protection and Affordable Care Act (HR-3590)
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%)
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Health Care ReformThe Patient Protection and Affordable Care Act (HR-3590)
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.
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Health Care ReformThe Patient Protection and Affordable Care Act (HR-3590)
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.
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Health Care ReformThe Patient Protection and Affordable Care Act (HR-3590)
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.
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Source: The Greater San Antonio Chamber of Commerce,
San Antonios Health Care and Bioscience Industry
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Source: The Greater San Antonio Chamber of
Commerce, San Antonios Health Care and BioscienceIndustry
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Source: The Greater San Antonio Chamber of Commerce,
San Antonios Health Care and Bioscience Industry
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Source: The Greater San Antonio Chamber of
Commerce, San Antonios Health Care and BioscienceIndustry
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Source: The Greater San Antonio Chamber of
Commerce, San Antonios Health Care and BioscienceIndustry
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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
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For More Information Contact:
Methodist Healthcare Ministries
page
www.mhm.org(210) 692-0234