Healthcare Financial News

States vary widely in the quality of health care children receive, as well as children’s access to care, family insurance premiums, equity, and the potential to lead long, healthy, productive lives, according to a new scorecard issued by The Commonwealth Fund. The scorecard assesses how the health system is performing for children across these five dimensions on a state-by-state basis.

The report, U.S. Variations in Child Health System Performance: A State Scorecard, ranked states on 13 indicators for children grouped in categories that include access, quality, costs, equity, and healthy outcomes. Although no single state performed at the top across all categories, some states far surpassed others. While the rate of uninsured children varies widely across states, from 5 percent in Michigan to 20 percent in Texas, the scorecard found that states with the highest rankings on access to care--meaning that they have nearly all of their children insured--were almost uniformly among the best scorers on quality of care and equity measures. However, there was room for improvement in even the highest-ranked states, which fell short of established standards on some indicators. Read the overview.

In an article published in the May/June Health Affairs, economist Paul B. Ginsburg, PhD, of the Center for Studying Health System Change (HSC), discusses the advantages and shortcomings of employer-based health coverage, how individual health insurance could be a viable alternative to employer-based coverage, and why care should be taken not to undermine employers’ role in providing coverage.

In his article “Employment-Based Health Benefits Under Universal Coverage,” Ginsburg notes that a slow decline in the proportion of Americans with employer-based health coverage has fueled concerns about the future role of employers in providing coverage. At the same time, “most recognize that today’s individual market is not an attractive alternative to employer-sponsored coverage,” Ginsburg writes.

Regional insurance exchanges--marketplaces managed by government or a private entity operating under government-established rules where individuals choose coverage offered by competing carriers--potentially could create pooling mechanisms similar to those available to people with employer coverage, according to the article. However, although insurance exchanges have promise, Ginsburg writes that they are “an attractive concept developed by thought leaders. Many design issues will have to be thrashed out in the policy process, and many operational problems are likely to be encountered and will need to be worked through. It would be better to do this learning with the tens of millions of people without access to employer-based coverage than with the entire privately insured population.” Read the press release.