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					   Texas Key Health Indicators

Texas Indigent Health Care Association
          Annual Conference
        November 19-21, 2008
   Renaissance Hotel, Austin, Texas

            Camille D. Miller
          Texas Health Institute
            President / CEO
       The Report Card on Texas
• Texas ranks:

   The Commonwealth Fund Commission on High Performance Health System, 2007
 The Commonwealth Fund: Texas 49th
            High Performing State Health Systems

Overall and Dimension Ranking Criteria:
• Overall : 49
• Access: 51
• Quality: 46
• Avoidable Hospital Use & Costs: 48
• Equity: 49
• Healthy Lives: 24
Total number of Indicators: 32
             Shared Vision:
           RAISE the health of Texas

Five Elements Guide THI’s Work:
          Regional Solutions
          Access for All
          Incentives for Personal Responsibilities
          Sound Use of Resources
          Education About Consequences
        Raising the Bar Report

•   Uninsured
•   Obesity / Diabetes
•   Mental Health
•   Healthcare Workforce

• Long Term Care
Where We Are:
• 15.2 million Texans uninsured by 2040
                                                   Of Texans Who
• Over half of Texas counties will see             Work Full-Time
                                                  Have No Employer
  uninsured increases of up to 37% by 2040        Sponsored Health
• One-fourth of Texans do not have health
• 3/4 uninsured Texas children are eligible for
  Medicaid or CHIP but are not enrolled
• 72 percent of uninsured Texans live in
  households where one or more family
  members work full-time

• Texas: highest uninsured rate in
  the nation
Uninsured Projections

       • 1.4 million
       • 23%

       • 3 million
       • 27%
                       State Data Center, 2008
√   1.Provide Technical Assistance and Seed Funding for 3-Share/Multi-
  Share Programs.
√ 2. Expand Use of Medicaid Health Insurance Premium Program (HIPP).
• 3. Enact Employer Tax Credits.
• 4. Replace State’s Existing Reinsurance Program.
√ 5. Expand Eligibility for Texas’ Insurance Health Risk Pool (TIHRP).
• 6. Increase Access to Pre-Paid Medical Plans.
• 7. Require All Texas Higher Education Students to Have Health Coverage.
• 8. Allow CHIP Buy-In at Full Premium Cost.
√ 9. Fully Restore the Children’s Health Insurance Program (CHIP).
• 10. Align Medicaid and CHIP Renewal Policies.
• 11. Expand Access to Medicaid for Poor Parents.
• 12. Encourage Expansion of Federally Qualified Health Centers.
                                                 √ Legislative Progress In 2007
            Obesity / Diabetes
Where We Are:                         $3.3 billion
                                      Texas business
                                       price tag for
• More than one in three Texas        obesity in 2005

 children are overweight or at risk
• 10.1 million Texans were
 overweight or obese in 2006
• One in five Texans are obese
         Obesity / Diabetes
• Obesity effects: high blood pressure, high
  cholesterol levels and cancer risks.
• Chronic diseases are leading causes of death
  and disability
• Chronic diseases are among the most common
  and costly health problems; and among the
  most preventable.
• Obesity could cost the state
  $36-40 billion in 2040.
         Obesity / Diabetes
• Coordinate state programs to better use
  resources and achieve common goals.
• Invest in school- and community-based
  programs to promote healthy habits among
  children and their families.
• Implement population-targeted awareness
  programs about chronic disease risk factors and
• Increase incentives for employers to promote
  wellness in the workplace.
                Mental Health       20%
Where We Are:                   of all Texas children
                                need active mental
• 2003: Cost of mental                  health
  illness in Texas: $16.6
• 3.1 million Texas adults
  and 1.2 million children
  have a diagnosable
  mental illness
               Mental Health
Where We Are:
• Mental illnesses / addictive disorders can be
  prevented or managed with proper care

• Only 57% of Texas children who need mental
  health services receive them

• Texas ranks 48th on mental health spending
                     Mental Health
1.   Provide adequate funding for mental health services
2.   Support housing programs for persons with mental health illnesses
3.   Expand school based mental health programs
4.   Enhance the mental health workforce
5.   Support, through incentives, the integration of mental & physical health
6.   Provide incentives for creation and expansion of information technology
7.   Develop and support return to work and reintegration programs targeting
     individuals with mental health illness
8.   Consumer driven services
   Healthcare Workforce
                                   nursing students
Where We Are:                      not enrolled last
                                     year due to
• Severe shortages entering the       shortages.

• Population growth decreases
  provider-to-population ratios
• Texas population is increasing
  faster than national rate:
     - Expected growth in youth,
       minority and elderly
             Healthcare Workforce
Can Texas meet the demand?

•     3/4 of Texas counties lack adequate number of
•     Decreasing number entering health
•     Professionals leaving healthcare fields
•     Lack well-trained and diverse healthcare
    As age-related and chronic diseases become more prevalent, Texas
    must be able to supply well-trained providers that are available and
    accessible to individuals in their communities.
        Healthcare Workforce
• Create incentives and assistance programs for
  more students, particularly minorities, to become
  healthcare professionals
• Develop incentive plans for Texas universities and
  community colleges to recruit health professions
• Support Texas’ Area Health Education Centers
Who Creates

 Texas Health Institute 03/19/08
             The Seven Stages of
           Public Opinion Formation
   1. People begin to become aware of an issue.
   2. People develop a sense of urgency about an
   3. People start to explore choices for dealing with
      the issue.
   4. Resistance to facing costs and trade-offs kicks
      in, producing wishful thinking.
   5. People weigh the pros and cons of alternatives.
   6. People take a stand intellectually.
   7. People make a responsible judgment morally
      and emotionally.
Daniel Yankelovich, "How Public Opinion Really Works," Fortune, 1992 and “Coming to Public Judgment”,
Syracuse University Press, 1991
    American Hospital Association
    National Framework for Change
•   Focus on wellness
•   Efficient affordable care
•   Highest quality care
•   Best information
•   Health coverage for all…Paid for by all
“Never doubt that a small group
    of thoughtful, committed
  people can change the world.
 Indeed, it is the only thing that
            ever has.”
                  ~ Margaret Mead
Our Mission:
To provide leadership to improve the health of Texans and their
communities through education, research, and health policy development.

Contact Us: www.texashealthinstiute.org / 512-279-3910
            8501 N. MoPac Expressway, Suite 420 / Austin, Texas 78759

Camille D. Miller
THI CEO / President