Chronic Disease Under Control: Diabetes and Hypertension

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Closing the Quality Chasm: Opportunities and Strategies for Moving Toward a High Performance Health System Karen Davis President The Commonwealth Fund.

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Exhibit 1. Continuously insured adults with private coverage or Medicaid rated the quality of their health care as excellent or very good at higher rates.

Exhibit 1. Two of Five Insured Adults with Incomes Below the Federal Poverty Level Spent 5 Percent or More of Their Income on Medical Out-of-Pocket Costs.

Exhibit 1. Adults with Marketplace Coverage with Incomes Under 250 Percent of Poverty Paid Monthly Premiums Comparable to Those with Employer Coverage.

Insured Women Are More Likely to Receive Cancer Screenings Than Uninsured Women, 2016 Percent of women Notes: “Continuously insured” refers to adults.

Insured Women Are More Likely to Have a Regular Source of Care and Receive Preventive Services Percent of women ages 19–64 Notes: “Continuously insured”

Has a regular source of care

Exhibit 1 Adults with High Needs Have Higher Health Care Spending and Out-of-Pocket Costs Average annual out-of-pocket spending Average annual health.

More Than One-Quarter of Insured Adults Were Underinsured in 2016

Nearly a Quarter of Underinsured Adults with Health Problems Skimped on Medications or Got Care in a Hospital or Emergency Department Percent adults ages.

Of Adults with High Costs, Most Have Multiple Chronic Diseases, With or Without Functional Limitations Percent with high needs: Three or more chronic diseases,

More Than One-Quarter of Insured Adults Were Underinsured in 2016

Most Adults with Marketplace or Medicaid Coverage Continue to Rate It Highly Now thinking about your health insurance coverage, how would you rate it?

Uninsured Adults and Those with Coverage Gaps Reported Cost-Related Access Problems at Higher Rates Than Did Those Continuously Insured Percent of adults.

Fair/poor health status or any chronic condition**

Adults with High Needs Have Unique Demographic Characteristics

Adults ages 19– Uninsured now 15%

Adults ages 19–64 who are uninsured or have individual coverage

Receipt of Recommended Screening and Preventive Care for Adults

Fewer Women Say They Are Not Getting Needed Care Because of Costs

Across Income Groups, Increasing Numbers of U. S

Women in the U.S. Report Highest Rates of Not Getting Needed Care Because of Cost Percent of women ages 19–64 who experienced any access problem because.

Percent adults ages 19–64 insured all year who were underinsured*

Adults in California and New York Reported Lower Rates of Cost-Related Access Problems Than Those in Florida and Texas Percent of adults ages 19–64 U.S.

Percent of adults ages 19–64

Health Care Spending Was Higher at Every Level for Adults with High Needs Than for Adults with Multiple Chronic Diseases Only Total adult population Three.

Receipt of Recommended Screening and Preventive Care for Adults, by Family Income and Insurance Status, 2002 Percent of adults (ages 18+) who received.

Current national average Impact on number of people

Percent adults ages 19–64 with a health problem or condition^

Health Status by Income

Average annual out-of-pocket spending

Percent of adults ages 19– In the past 12 months:

More Than One-Third of Young Adults Experienced a Medical Bill Problem or Were Paying Off Medical Debt Percent of adults ages 19–29 who experienced the.

Average number of medical office visits per year

Women in Switzerland and the U.S. Report Very High Out-of-Pocket Costs

One-Quarter of Women in the U. S

Percent of women ages 19–64 Total <133% FPL 133%–249% FPL

Adults with Major Depressive Episode Who Received Treatment, 2009

High Chronic Disease Burden Among U.S. Women

High-Need Adults Are More Likely to Be Socially Isolated

Uninsured and Underinsured Adults with Chronic Conditions Are More Likely to Visit the ER for Their Conditions Percent of adults ages 19–64 with at least.

Two of Five Insured Adults with Incomes Below the Federal Poverty Level Spent 5 Percent or More of Their Income on Medical Out-of-Pocket Costs Percent.

Percent of adults ages 19– In the past 12 months:

Percent of adults ages 19–64* Total <133% FPL 133%–249% FPL

2008 Survey Profile of Sicker Adults with Any Chronic Condition

Medical Bill Problems and Accrued Medical Debt, 2005–2007

16 Million Adults Under Age 65 Were Underinsured in 2005

Percent of adults ages 19–64 with at least one chronic condition*

Adults with Health Problems Who Have an Excellent Patient Experience Report Greater Support to Help Manage Their Health Condition Percent of adults 18–64.

Uninsured Adults with Low and Moderate Incomes Are Less Likely to Be Up to Date with Recommended Preventive Tests Percent of adults ages 19–64, income.

Medical Bill Problems or Medical Debt

Adults ages 19–64 with individual coverage

Two of Five Adults Uninsured or Underinsured 25 Million Underinsured 60 Percent Increase in Underinsured from 2003 to 2007 Percent of adults (ages 19–64)

EFFICIENCY Managed Care Health Plans: Potentially Inappropriate Imaging Studies for Low Back Pain, by Plan Type Percent of health plan members with a primary.

Adults Ages 19–64 Who Are Uninsured and Underinsured, by Poverty Status, 2003 *Underinsured defined as insured all year but experienced one of the following:

Percent of privately insured adults 21–64

QUALITY: EFFECTIVE CARE

Problems with Medical Bills or Accrued Medical Debt Increased, 2005–2007 Percent of adults ages 19–64 with medical bill problems or accrued medical debt.

Figure 4. Profile of Medicare Elderly Beneficiaries and Employer Coverage Nonelderly, by Poverty and Health Status, 2003 Health problems, lower income.

Uninsured during the year

Uninsured and Underinsured Adults with Chronic Conditions Are More Likely to Visit the ER for Their Conditions Percent of adults ages 19–64 with at least.

Adults with Health Problems Who Have an Excellent Patient Experience Are Most Likely to Be Well-Informed About Their Prescription Medications Percent of.

Patient Engagement in Care Management for Chronic Condition, by Medical Home Percent reporting positive patient engagement in managing chronic condition*

Chronic Disease Under Control: Managed Care Plan Distribution, 2006

Adults with Major Depressive Episode Who Received Treatment

More Than Three of Five Adults Who Selected a Private Plan or Enrolled in Medicaid Were Uninsured Prior to Gaining Coverage What type of health insurance.

Percent of adults ages 19–64

EQUITY: EFFECTIVE CARE

Percent adults insured all year ages 19–64 who were underinsured*

The Number of Adults Reporting Not Getting Needed Care Because of Cost Declined in 2014 for the First Time Since 2003 Percent of adults ages 19–

Presentation transcript:

Chronic Disease Under Control: Diabetes and Hypertension QUALITY: EFFECTIVE CARE Chronic Disease Under Control: Diabetes and Hypertension U.S. Average By Insurance, 2005–2008 Percent of adults age 18+ Percent of nonelderly adults ages 18–64 REPORT EXHIBIT *Refers to diabetic adults whose hemoglobin A1c is <9.0% **Refers to hypertensive adults whose blood pressure is <140/90 mmHg. Data: J. M. McWilliams, Harvard Medical School analysis of National Health and Nutrition Examination Survey. Source: Commonwealth Fund National Scorecard on U.S. Health System Performance, 2011.