Health Care Blog

Good News on Innovation and Health Care

Ed. note: This is cross-posted from the HealthCare blog at HealthCare.gov. Read more about data-powered health care here.

A recent New York Times column, Obamacare’s Other Surprise, by Thomas L. Friedman echoes what we’ve been hearing from health care providers and innovators: Data that support medical decision-making and collaboration, dovetailing with new tools in the Affordable Care Act, are spurring the innovation necessary to deliver improved health care for more people at affordable prices.

Today, we are focused on driving a smarter health care system focused on the quality – not quantity – of care. The health care law includes many tools to increase transparency, avoid costly mistakes and hospital readmissions, keep patients healthy, and encourage new payment and care delivery models, like Accountable Care Organizations. Health information technology is a critical underpinning to this larger strategy.    

Policies like these are already driving improvements. Prior to the law, nearly one in five Medicare patients discharged from a hospital was readmitted within 30 days, at a cost of over $26 billion every year. After implementing policies to incentivize better care coordination after a hospital discharge, the 30-day, all-cause readmission rate is estimated to have dropped during 2012 to a low of 18 percent in October, after averaging 19 percent for the previous five years. This downward trend translates to about 70,000 fewer admissions in 2012.

Insurance companies are also now required to publicly justify their actions if they want to raise rates by 10% or more. Since the passage of the Affordable Care Act, the proportion of requests for double-digit rate increases fell from 75 percent in 2010 to 14 percent so far in 2013.

Reforms like these have helped slow Medicare and Medicaid spending per beneficiary to historically low rates of growth.

Mobilizing Use of Health Information Technology

Last week, we reached an important milestone in the adoption of health information technology. More than half of all doctors and other eligible providers and nearly 80 percent of hospitals are using electronic health records (EHRs) to improve care, an increase of at least 200 percent since 2008.

Removing Obstacles to Care for Asian Americans and Pacific Islanders

Asian Americans and Pacific Islanders are the fastest growing ethnic group in the United States. This community comprises many diverse populations with respect to educational and socioeconomic backgrounds, linguistic characteristics, and unique cultural traditions from their countries of origin. The vibrant cultures represented have different styles and patterns of communication for giving and receiving information.  Many are not able to achieve their full health potential as disparities in health care persist, specifically as it pertains to the availability of language assistance services and, historically, Asian Americans and Pacific Islanders have been less likely to have health insurance than the population as a whole.

May is “Asian American and Pacific Islander Heritage Month,” and there is no better time to talk about advancing health equity for all. The Affordable Care Act provides one of the most important levers by which we can advance that vision. The law will remove obstacles to care that many Asian Americans and Pacific Islanders historically have faced and ensure that they will have better access to stable, affordable health insurance and high quality health care suited to their needs.

Access to high quality health care. The Affordable Care Act expands access to preventive care and can help reduce health disparities for Asian American and Pacific Islanders by helping to prevent many diseases that have a disproportionate impact on this group.  Recommended preventive services covered without cost-sharing under the health care law include well-child visits, blood pressure and cholesterol screenings, Pap smears and mammograms for women and flu shots for children and adults.  An estimated 2.7 million AAPI with private insurance currently have access to expanded preventive services with no cost-sharing because of the health care law.  Further, the nearly one million elderly and disabled Asian American and Pacific Islanders who receive coverage from Medicare also have access to an expanded list of preventive services with no cost-sharing including diabetes and colorectal cancer screening and bone mass measurement.  In addition, young Asian American and Pacific Islander adults under age 26 who would have been uninsured now have coverage under their parent’s employer-sponsored or individually purchased health plan. This means that more than 97,000 Asian Americans have gained coverage.

Culturally competent health care, including communication in a language that individuals understand. Nearly 61 million people speak a language other than English at home.  Language barriers impact the ability of individuals to access health care and human services.  Individuals with limited ability to read, speak, write or understand English are less likely to have a regular source of primary care. Language assistance services help provide meaningful access to quality health care.  The health care law expands initiatives to increase  diversity in the health care professions and improve cultural competency of health care providers.

Ending insurance discrimination. In the past, insurance companies could deny coverage to children because of a pre-existing condition such as cancer, asthma, or diabetes.  This discrimination is no longer allowed, and beginning in 2014, insurers are banned from discriminating against anyone with a pre-existing condition.  This is important because, for example, in Hawaii, adult Asian Americans, Native Hawaiians and other Pacific Islanders have high rates of diabetes.

Secure health information. As the agency within the U.S. Department of Health and Human Services that ensures that the privacy practices of several million heath care providers, plans, and clearinghouses adhere to federal health information and privacy laws, my office, the Office for Civil Rights, works tirelessly to enforce the laws which safeguard the privacy and security of health information. Individuals have rights over their health information, including the right to get a copy of their medical record, make sure it’s correct and know who has seen it.  Studies have shown that consumers pay more attention to and become more engaged in their health care when they have access to their own medical information. The Office for Civil Rights will continue its outreach efforts to inform consumers about their privacy rights. 

Increased access, equity of care and patient confidence are major drivers in reducing disparities in all communities, including the Asian American and Pacific Islander community.

Additional Resources: 

Visit us to learn more about the Office for Civil Rights and our work to help protect individuals from discrimination and ensure the privacy of health information.

The Health Care Law and You is a presentation tool developed by the U.S. Department of Health and Human Services to educate community members about the benefits of the Affordable Care Act. This resource has been translated into the following languages:  Spanish, Chinese, Korean, Vietnamese, Tagalog, Hindi, Bengali, Hmong, Khmer, Laotian, Samoan and Tongan.

The Enhanced National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (the Enhanced National CLAS Standards) are intended to advance health equity, improve quality, and help eliminate health care disparities by providing a blueprint for individuals and health and health care organizations to implement culturally and linguistically appropriate services.

The U.S. Department of Health and Human Services (HHS) published its 2013 Language Access Plan ensuring access to the Department’s programs and activities to people with limited English proficiency (LEP). 

Juliet K. Choi is Chief of Staff and Senior Advisor at the U.S. Department of Health and Human Services Office for Civil Rights.