A Celebration of Children s Health
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1 A Celebration of Children s Health November 4, 2013
2 Rhode Island s Achievements In Children s Health We lead the nation in health outcomes for children and families. Lowest child & teen deaths (1 st ) Vaccination coverage 1+ MMR (1 st ) 3+ Hib (1 st ) 3+ Polio, 3+ HepB (3 rd ) 4+ PCV, Rotavirus (3 rd )
3 Rhode Island s Achievements In Children s Health Preventive dental care (7 th ) Teen births (7 th ) Repeat teen births (7 th ) Parents health coverage (8 th ) Children s health coverage (10 th ) Teen obesity (13 th ) Preterm births (13 th )
4 Our Shared Goal: 100% of children living in Rhode Island are covered by affordable, high quality health insurance.
5 Uninsured Children in Rhode Island, % 10.9% 10% 8% 6% 6.0% 4% 2% 0% 4.3% Source: US Census Bureau, Current Population Survey, , three-year averages, labeled by the midpoint year. Data are for children under 18 years of age. Prepared by Rhode Island KIDS COUNT, 2013.
6 How are Children Covered? 160, , , , ,000 80,000 77,000 60,000 40,000 20,000 10,000 10,000 13,000 0 Employer Sponsored Medicaid (with RIte Care) Individual/Direct Purchase Other Govt. (Non-Medicaid) Uninsured Source: Rhode Island KIDS COUNT analysis of the U.S. Census Bureau, Current Population Survey, , RI, three-year average
7 Who are the Uninsured Children? Children Under Age 19 Without Health Insurance, by Poverty Level, Rhode Island 29% Not Income- Eligible for RIte Care (4,328) 71% Income-Eligible for RIte Care (10,791) They live in families who are not offered or cannot afford ESI. 28% 29% 71% They live in families that do not know about RIte Care, face administrative barriers, or are ineligible due to immigration status. n= 15,119 Population Reference Bureau analysis of the U.S. Census Bureau, Current Population Survey, , RI, three-year average
8 RIte Care: Cost-Effective and High Quality National Ranking of RIte Care Health Plans Among Medicaid Health Plans in the U.S. 4 th Neighborhood Health Plan of RI (85.7%) 8 th UnitedHealthcare Community Plan of RI (85.2%) Source: 2013 U.S. News & World Report, National Committee on Quality Assurance rankings 260 Medicaid Health Plans were evaluated and 131 were ranked based on clinical performance, member satisfaction, and NCQA Accreditation.
9 RIte Care Works for Families Emergency hospital admissions for children and adults with RIte Care/Medicaid and those privately insured are much lower than the uninsured.
10 RIte Care Works for Families Children who have either RIte Care or private health insurance have fewer preventable hospitalizations than uninsured children.
11 RIte Care Works for Families While adults with private health coverage have the lowest preventable hospitalization rates, those with RIte Care/Medicaid are also much lower than adults without insurance.
12 RIte Care Works for Pregnant Women Fewer women with RIte Care coverage smoke during pregnancy.
13 RIte Care Works for Pregnant Women In 2011, the percentage of women with short term births (less than 18 months in between) was lower for women with RIte Care than those with private insurance.
14 RIte Care Works for Babies Low birthweight rates have remained fairly steady among babies with RIte Care coverage, while increasing among babies with private coverage. Infant mortality rates have fallen over the past two decades. RI s most recent infant mortality rate for all births was above the national average.
15 RIte Care Works for Children High Primary Health Care Provider Visit Rates 98% of infants and toddlers have a primary health care provider. 95% of preschool and early elementary school children have a primary health care provider. 85% of children have been screened for lead poisoning (national Medicaid average is 68%). Source: Results of 2012 HEDIS and CAHPS Measures in RIte Care's Performance Goal Program as reported in Monitoring Quality and Access in RIte Care and Rhody Health Partners, EOHHS, October 2013.
16 RIte Care Works for Parents 93% pregnant women received timely prenatal care. 91% of parents with RIte Care coverage had an ambulatory or preventive care visit. Children have better access to care when their parents also have health coverage. Source: Results of 2012 HEDIS and CAHPS Measures in RIte Care's Performance Goal Program as reported in Monitoring Quality and Access in RIte Care & Rhody Health Partners, EOHHS, October 2013
17 Children s Coverage - Now Household Income by Federal Poverty Level 0-138% % % % > 400% Children (under 19) Pregnant Women Parents & Caretakers Children with Special Health Care Needs Former Foster Youth RIte Care Plans RIte Care Plans RIte Care / Katie Beckett Medicaid Ages only
18 Children s Coverage - Now Household Income by Federal Poverty Level 0-138% % % % > 400% Children (under 19) Pregnant Women Parents & Caretakers RIte Care Plans RIte Care Plans Potential Coverage Gap Children with Special Health Care Needs Former Foster Youth RIte Care / Katie Beckett Medicaid Ages only
19 Children s Coverage Household Income by Federal Poverty Level 0-138% % % % > 400% Children (under 19) Pregnant Women Parents & Caretakers Children with Special Health Care Needs Former Foster Youth RIte Care Plans RIte Care Plans RIte Care / Katie Beckett Medicaid Ages only
20 Children s Coverage Household Income by Federal Poverty Level 0-138% % % % > 400% Children (under 19) Pregnant Women Parents & Caretakers RIte Care Plans RIte Care Plans HealthSource RI Children with Special Health Care Needs Former Foster Youth RIte Care / Katie Beckett Medicaid Ages only
21 Children s Coverage Household Income by Federal Poverty Level 0-138% % % % > 400% Children (under 19) Pregnant Women Parents & Caretakers RIte Care Plans RIte Care Plans HealthSource RI Children with Special Health Care Needs Former Foster Youth RIte Care / Katie Beckett RIte Care Plans Ages only
22 What s Next for Children s Health? Good News ACA maintains RIte Care eligibility levels for children General Assembly eliminated monthly RIte Care premiums for kids ACA extends RIte Care coverage for youth aging out of foster care until age 26 ACA requires Essential Health Benefits for commercial coverage, including dental and vision
23 What s Next for Children s Health? Challenges Connect parents to affordable coverage Monitor and improve affordability for families Promote help with applying make every door the right door
24 What s Next for Children s Health? Opportunities Build on what s worked in Rhode Island for 2 decades RIte Care. Ensure comprehensive coverage for kids. Put out the welcome mat!
25 Let s Cross the Finish Line for Kids! Text
26 A Celebration of Children s Health
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1 Pennsylvania s Medicaid program (Medical Assistance) has dozens of eligibility groups and programs, each with its own qualifying criteria. Non Financial Factors include: Age; Disability (temporary, permanent