President Donald Trump's new health secretary took office Friday after a close Senate vote (Source: “Trump's Pick for Health and Human Secretary Takes Office,” Associated Press via New York Times, Feb. 10, 2017).
Vice President Mike Pence administered the oath of office to Tom Price, of Georgia, at the White House hours after the Senate confirmed him 52-47 in a party-line vote.
As head of the Health and Human Services Department, Price, an orthopedic surgeon, will take center stage as the administration and congressional Republicans try delivering on their pledge to scrap the ACA and substitute their own programs.
The number of opioid pills dispensed in Ohio dropped 20 percent from 2012 to 2016, a recently released report found (Source: “Opioid prescriptions, number of pills dispensed declining in Ohio,” (Lorain) Morning Journal, Feb. 5, 2017).
According to the report from the Ohio Automated Rx Reporting System, a prescription monitoring program operated by the Ohio Pharmacy Board, the number of pills dispensed has declined for the past four years after peaking in 2012 at 793 million pills. The number dispensed dipped to 631 million in 2016. Opioid prescriptions written in the state also peaked in 2012 at 12.6 million and have decreased each of the following four years. The number of prescriptions dropped to 10.1 million in 2016, a 20.4 percent decrease since 2012. The total number of “doctor shoppers” in Ohio has decreased over the past several years as well. Doctor shopping is defined as “an individual receiving a prescription for a controlled substance from five or more prescribers in one calendar month.”
Ohio passed legislation in 2011 cracking down on pill mills — doctor’s offices, clinics and pharmacies prescribing and dispensing pills inappropriately or for nonmedical reasons. Despite the crackdown, Ohio’s opioid overdose deaths increased since the bill was put into place, with heroin (and increasingly fentanyl) becoming the leading contributors.
The year Ohio legislators passed that bill was the last year natural and semisynthetic opioids (oxycodone, hydrocodone) were the state’s leading cause of opioid overdose deaths. Natural/semisynthetic overdose deaths decreased from 582 in 2011 to 499 in 2012. In 2012, heroin surpassed natural and semisynthetic opioids for the leading cause of overdose deaths. Heroin accounted for 438 overdose deaths in 2011, rocketing to 1,208 in 2014.
As part of his biennial budget plan, Gov. John Kasich wants to move the last group of Medicaid beneficiaries into private managed care plans (Source: “Kasich administration makes final push to Medicaid managed care,” Feb. 1, 2017).
Nearly 90 percent of the 3 million poor and disabled Ohioans enrolled in Medicaid are already in managed care. The rest, with some exceptions, would transition from fee-for-service beginning in July 2018, under Kasich’s two-year budget plan. The more than 150,000 remaining fee-for-service Medicaid enrollees are mostly elderly and disabled Ohioans receiving long-term care services at home or in nursing facilities.
Until recently, most states have excluded the elderly and disabled from managed care because of their complex needs, but that's changing as states seek to reign in rising health care costs. However, Greg Moody, director of the Governor's Office of Health Transformation, said "Our motivation is not savings driven (but) we believe better care coordination has produced savings." Rather, the administration wants to create incentives for health care providers to keep patients healthy and eliminate gaps in services. These last, and most complex, beneficiaries to move into managed care probably need care coordination the most, he added.
But the proposal is creating angst for some who worry that the care won't be as high quality. "Managed care companies have struggled because they don't have the expertise in long-term care," said Pete Van Runkle, executive director of the Ohio Health Care Association which represents the nursing home industry.
As Republican lawmakers work to dismantle the Affordable Care Act, officials at community health centers across Ohio say they are concerned that changes could halt progress they've made over the past several years in treating more people, expanding services and boosting economies in struggling areas (Source: “Obamacare repeal worries community health centers,” Columbus Dispatch, Feb. 9, 2017).
Such centers, set up to care for underserved populations, have benefited not only from an increase in funding authorized by the Affordable Care Act, but also from a provision of the law that allowed states to expand Medicaid to more low-income people.
Before the law took effect, 34 percent of health center clients were uninsured; in 2015, that dropped to 16 percent. Among homeless clients, the uninsured rate dropped from nearly 80 percent to less than 25 percent.
Overall, community health centers have expanded from about 200 to 275, adding services in about two dozen counties statewide. The centers served 623,000 patients in 2015, about 50,000 more than the year before.
In conjunction with the release of the policy brief “Connections between education and health,” HPIO has created an online resource page to provide more information on the topic.
The resource page, Intersections between education and health, will be updated on a continuous basis throughout 2017.
Health and education are areas of significant focus for Ohio policymakers, representing the largest shares of Ohio's biennial budget for state fiscal years (SFY) 2016-2017. Among the 971 bills introduced in the 131st General Assembly between Jan. 1, 2015 and Nov. 4, 2016, 42 percent were related to health and/or education. This brief provides an overview of the relationship between education and health.
"There is widespread agreement that factors outside of the healthcare system influence health," according to the brief. "Research consistently shows a strong relationship between educational attainment and health, even after accounting for factors such as income, race, ethnicity and access to health care."
Later this year, HPIO plans to release a series of fact sheets discussing specific policy recommendations to improve health and educational outcomes in Ohio.