Social Determinants of Health

Healthcare News of Note: Economic burden of racial and ethnic health disparities in the U.S. grew by 41% in 4-year span

June 16, 2023 2:04 pm
  • For individuals with less than a college degree in 2018, the total burden of education-related health disparities reached $978 billion, about two times greater than the annual growth rate of the U.S. economy.
  • New research shows that using new technology and delegating specific tasks to other staff could help healthcare organizations address the nursing shortage.
  • For a hypothetical family of four covered by an employer-sponsored preferred provider organization plan, expected healthcare costs in 2023 total $31,065.

Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.   

1. Study authors: The economic burden of racial, ethnic and education health inequities is ‘unacceptably high’

“Racial and ethnic health disparities in 2018 cost the U.S. economy $451 billion, a 41% increase from the previous estimate of $320 billion in 2014,” the National Institute of Health (NIH) announced in a news release about a National Institute on Minority Health and Health Disparities (NIMHD) study that was published May 16 in JAMA.

For individuals with less than a college degree in 2018, the total burden of education-related health disparities “reached $978 billion, about two times greater than the annual growth rate of the U.S. economy in 2018,” according to the study.

“The economic burden of health inequities is unacceptably high and warrants investments in policies and interventions to promote health equity for racial and ethnic minorities and adults with less than a 4-year college degree,” the study authors wrote.

Key findings

Additional report findings include the following:

  • Most (69%) of the economic burden of racial and ethnic disparities was borne by Black/African American populations due to the level of premature mortality.
  • Black/African American people had the highest economic burden of racial and ethnic health inequities in 32 states and Washington, DC, compared with Hispanic/Latino individuals in nine states, American Indian/Alaska Native in eight states and Native Hawaiian/Pacific Islander in one state.
  • Although most of the burden of education-related health inequities was borne by adults with a high school diploma/GED (61%), a disproportionate share was borne by adults with less than a high school diploma/GED — they comprised only 9% of the population but bore 26% of the burden.

In the news release, NIMHD Director Eliseo J. Pérez-Stable, MD, was quoted as saying: “The exorbitant cost of health disparities is diminishing U.S. economic potential. We have a clear call to action to address social and structural factors that negatively impact not only population health, but also economic growth.”

HFMA resources:

2. How use of automation and improved delegation of tasks might help address the nation’s nursing shortage

Using new technology and delegating specific tasks to other staff could help healthcare organizations “identify new approaches to address the nursing shortage and create more sustainable and meaningful careers for nurses,” according to new research conducted by McKinsey & Co. in collaboration with the ANA Enterprise.

The research “on how nurses are actually spending their time during their shifts and how they would ideally distribute their time if given the chance” was reported by McKinsey on May 29 in the article, “Reimagining the nursing workload: Finding time to close the workforce gap.”

“In looking at ways to redesign care activities, we found the potential to free up to 15 percent of nurses’ time through tech enablement, or automation, and improved delegation of tasks,” wrote the authors.

Tasks that could be delegated, according to the report, include medication preparation, drawing labs, toileting, cleaning patients’ rooms and patient transport.

By translating the net amount of time freed up to the projected amount of nursing time needed, researchers estimated “the potential to close the workforce gap by up to 300,000 nurses.”

What they want to spend more time doing 

The survey also looked at where nurses wanted to allocate more time during a 12-hour shift, including:

2 additional percentage points (from 54% to 56%) on more direct patient care. “Spending sufficient time on patient-care activities promotes both nursing satisfaction and quality of patient care,” wrote the authors, adding: “Furthermore, rushing care and not having sufficient time to meet patients’ needs can contribute to moral distress and burnout.”

2 additional percentage points (from 2% to 4%) on coaching fellow nurses. “Peer-to-peer teaching is an important component of building workplace cohesiveness, improving patient outcomes, and preparing new generations of nurses,” wrote the authors. 

4 additional percentage points (from 3% to 7%) participating in professional-growth activities. “Freeing up nursing time to support organizational initiatives and further professional development may contribute to a nursing staff that is more engaged, feels valued, and has a strong connection to their departments,” wrote the authors.

HFMA resources

Listen to HFMA’s Voices in Healthcare Finance podcast episode “Sleepless in the C-suite, Part 2,” hosted by HFMA’s Erika Grotto. This episode focuses on ways clinical workers need support from their leaders.

3. Healthcare costs increase to more than $31,000 for a hypothetical family of 4

In 2023, healthcare costs for a hypothetical family of four* that is covered by an employer-sponsored preferred provider organization plan reached $31,065, while healthcare costs for the average person reached $7,221, according to a news release by Millman Inc., which produces the Milliman Medical Index (MMI). 

Dave Liner, co-author of the MMI, stated in the release: “Healthcare costs increased 5.6% this year and have increased by 4.8% annually since 2021, which is the sort of year-to-year increase we were seeing before the pandemic. Call it a return to the status quo or a rebound from the pandemic — either way, family healthcare costs have resumed their persistent climb.”

The report authors wrote: “A mix of pressures, including staffing shortages and supply chain challenges, likely contributed to this increase.”

Components of spending

According to the latest MMI, the components of spending for an average person are:

  • 30% Professional services
  • 29% Outpatient
  • 22% Pharmacy
  • 17% Inpatient
  • 2% Other

* “A ‘hypothetical family of four,’ for the purposes of MMI research, consists of a 47-year-old male, a 37-year-old female, and children ages 4 and 1. In reality, family compositions vary, and their healthcare expenses will depend on location, health conditions, and many other factors.”

HFMA bonus content

Read original content from the Summer issue of hfm, including these pieces from some of our columnists: 

Read the June 13 article:  “Medicare coverage and coding updates: New Alzheimer’s drugs to be covered, but not universally,” by Nick Hut, senior editor with HFMA.

Read HFMA’s “Ensuring Access to Medicaid Services” proposed-rule summary, posted June 6 in advance of a July 3 deadline to submit comments to CMS.

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