Wednesday, March 2, 2011

Need For Health Reform Greater Than Ever

Two new reports from the Agency for Healthcare Research and Quality, the National Healthcare Quality Report and the National Healthcare Disparities Report, seem to bolster the need for provisions of the Patient Protection and Affordable Care Act. These reports found that health care quality and access are lower than is desirable, that access to and disparities in care are not improving and some are worsening.

In the report summary, the AHRQ wrote that “our analyses indicate that health care quality in America is suboptimal. The gap between best possible care and that which is routinely delivered remains substantial across the Nation.”

Access to health care services and disparities in care are especially connected to socioeconomic status, race, and ethnicity. For example, low income individuals overwhelmingly experienced worse quality of care (in 82% of measures) and access to care for all care measures than did high income; followed by Hispanics (in three-fifths of measures for quality of care and four-fifths of measures for access to care) compared with nonHispanic whites; and blacks (in two-fifths of measures for quality of care) compared with whites.

But it isn’t just the disadvantaged uninsured that experienced lower than desired quality and access to care—on average, individuals received recommended preventive services two-thirds of the time and appropriate acute care services and recommended chronic disease management services three-quarters of the time. Also, individuals reported barriers to care 20% of the time with 60% of individuals indicating that their “usual” medical provider hhad no office hours on evenings or weekends.

The AHRQ reports also found that individuals with private non-group health insurance are nearly three times as likely as those with private, employer-sponsored health insurance to pay high premiums and out-of-pocket medical expenses.

Adults age 18 through 44 and Hispanics are least likely among all age and ethnic groups to have health insurance. Of particular note is that the percentage of people with health insurance worsened for middle-income individuals. In the current, depressed economic climate, middle-income individuals are increasingly vulnerable to loss of health insurance.

“We need to improve access to care, reduce disparities, and accelerate the pace of quality improvement, especially in the areas of preventive care, chronic disease management, and safety,” the AHRQ concluded. The ACA is attempting to do just that, if only we will work with it.

For a comprehensive analysis of the Patient Protection and Affordable Care Act, including the full text of the law and additional information on health reform implementation and other recent developments in employee benefits, just click here.


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