U.S. Continues to Receive Bad Marks in Healthcare
December 12th 2024
The healthcare system in the U.S. is regularly getting bad marks: In Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System, the Commonwealth Fund noted that the U.S. ranks last among 10 developed countries in terms of healthcare system performance, but first when it comes to healthcare expenditures. Similar data from Kaiser Family Foundation show that the US spends twice as much per person on healthcare than other similarly situated countries, but has much lower life expectancy To be fair, according to the Mirror, Mirror 2024 report, the U.S. does well in the category of care delivery process (including preventive services such as vaccination and routine imaging), but it ranks near the bottom in every other category, including access to care, administrative efficiency, health equity, and health outcomes. These data points lead to an unavoidable observation: we appear to be overpaying for underperformance.
One of the dominant issues in healthcare currently is adequate workforce. Even the Mayo Clinic, which is consistently ranked the best hospital in the world, is feeling the effects. An October article reported that the Mayo Clinic facility in Fairmont, MN, a rural area 120 miles from the flagship Mayo Clinic facility in Rochester, MN, and 130 miles from the metropolitan Minneapolis area, is closing its surgical and labor and delivery units due to a shortage of providers in the area. New Hampshire has seen the closure of more than 10 labor and delivery units in the last several years. The issue is not unique.
What is a healthcare system to do? Try some creative approaches to staffing? A very recent Bloomberg article highlighted some quality problems at a hospital owned by HCA, implying that HCA’s practice of using more nurse practitioners (NPs) - an attempt to address critical healthcare workforce shortages - was the root cause of the quality problems. However, the article was notably silent about the fact HCA may have been exploiting this practical workforce shortage solution to maximize profits by operating the facility under very lean staff ratios or acknowledge what role very lean staff ratios have in contributing to poor outcomes.
Viable solutions to healthcare workforce shortages and maintaining fidelity to best practices are both requirements for ensuring meaningful access to care, a key component of which is ensuring healthcare is affordable. At this time when the expense of accessing healthcare is increasingly a barrier to care for Granite Staters, New Hampshire policy makers need to be more focused than ever in finding practical solutions for providing affordable, quality care in New Hampshire.
- Deb Fournier & Alison Mehlman
US Continues to Receive Bad Marks in Healthcare
December 12th 2024
See an analysis of this years Mirror, Mirror report from the Commonwealth Fund and continued reports of healthcare facilities struggling with inadequate staffing.
Four New Hampshire Hospitals Earn “A” on the Fall 2024 Leapfrog Hospital Safety Grade
November 15th 2024
On November 15th, The Leapfrog Group, a national nonprofit representing hundreds of the nation’s most influential employers and purchasers of health care, announced today the Fall 2024 Leapfrog Hospital Safety Grades.
How Hospitals Use a Low-Cost Drug Program to Profit on Patient Care
November 2024
Have you ever heard of 340B? No? Well, it’s coming. Policy pundits across the country predict that 340B will be a prime topic of conversation for employers in the coming year because it is costing them a lot of money and contributing to the unsustainable growth in healthcare expenditures.
Continuing the quest for affordable and equitable healthcare
October 17th 2024
On October 17, IHPP held its annual symposium, this year entitled, “Continuing the quest for affordable and equitable healthcare.” Attendees discussed the wicked problem of healthcare costs and affordability in New Hampshire. The day’s dialogue included the current trends in healthcare prices and the affordability crisis in healthcare, affordability as a component of access and equity, primary care’s role in improving costs and outcomes, equity beyond affordability, and available state policy solutions to address cost and affordability, such as cost growth benchmarks with Rachel Block of Milbank Memorial Fund and prohibiting anti-competitive contracting with Maureen Hensley-Quinn at NASHP.
On October 25, the New Hampshire Insurance Department held its annual hearing on its report on NH healthcare premium rates and claims. Public comment is being accepted on the report through November 15, 2024. NHID also held a robust discussion of using a total healthcare expenditure model to learn more about New Hampshire’s drivers of healthcare costs – neatly echoing the cost growth benchmark discussion that was held the week prior at the symposium. Panelists included Rhode Island’s Health Insurance Commissioner, Cory King and President of the Milbank Memorial Funds, Chris Koller.
Meanwhile, the Attorney General’s office held a public hearing about the proposal for HCA to purchase Catholic Medical Center on October 23, 2024. Public comments are being accepted through November 1, 2024.
Last in this post, but certainly not least, Medicare Open Enrollment began on October 15 and Marketplace Open Enrollment begins November 1.
