News of Note: U.S. healthcare ranks last in comparison with 10 other high-income countries in a report by The Commonwealth Fund

• The United States ranks last overall, despite spending far more of its gross domestic product on healthcare than other high-income countries.
• Data on the health status of the LGBT+ community reveals some of the disparities that exist for this group compared with their non-LGBT+ peers.
• Eighteen healthcare organizations want Congress and the Biden administration to enact a set of policy proposals to extend and improve affordable, quality healthcare.

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

1. U.S. healthcare ranks last overall in comparison with other high-income countries in a report by The Commonwealth Fund

“The United States trails far behind other high-income countries on measures of health care affordability, administrative efficiency, equity, and outcomes,” according to The Commonwealth Fund report: “Mirror, Mirror 2021: Reflecting Poorly,” which was published Aug. 4.

The report’s purpose was to compare “the performance of health care systems of 11 high-income countries,” by analyzing 71 performance measures across the five domains mentioned above.

Key findings:

• Norway, the Netherlands and Australia are the top-performing countries overall.
• The United States ranks last overall, despite spending far more of its gross domestic product on healthcare.
• The U.S. ranks last on access to care, administrative efficiency, equity and health care outcomes, but ranks second on measures of care process.

“Care process includes measures of preventive care, safe care, coordinated care, and engagement and patient preferences,” according to the report. “Along with the U.K. and Sweden, the U.S. achieves higher performance on the preventive care subdomain, which includes rates of mammography screening and influenza vaccination as well as the percentage of adults who talked with their provider about nutrition, smoking, and alcohol use. New Zealand and the U.S. perform best on the safe care subdomain, with higher reported use of computerized alerts and routine review of medications.” 

What are top-performing countries doing

“Four features distinguish top performing countries from the United States,” the study authors wrote. Those features are:  

1. Providing for universal coverage and removing cost barriers
2. Investing in primary care systems to ensure that high-value services are equitably available in all communities to all people.
3. Reducing administrative burdens that divert time, efforts, and spending from health improvement efforts
4. Investing in social services, especially for children and working-age adults

Data for the report was drawn from international surveys conducted in each country by the Commonwealth Fund and administrative data from the Organisation for Economic Co-operation and Development and the World Health Organization.

2. KFF study reveals LGBT+ community’s disparity issues

LGBT+ people more commonly report being in fair or poor health than non-LGBT+ people, despite being a younger population, and report higher rates of ongoing health conditions and disability or chronic disease, according to a recent study by the Kaiser Family Foundation (KFF).

“Understanding the health care needs and experiences of LGBT+ people in the United States is important for addressing barriers and facilitating access to care and coverage,” stated the authors of the recent “LGBT+ People’s Health and Experiences Accessing Care” study.

Key findings

Analysis of data from a new KFF survey comparing the experiences of self-identified LGBT+ adults to their non-LGBT+ counterparts revealed:

1. The demographics of the LGBT+ community differ in some ways from that of their non-LGBT+ counterparts, differences that may have implications for health needs and access.     

• LGBT+ adults are younger, with 59% between the ages of 18-35 compared with 38% of non-      LGBT+ people.
•  LGBT+ adults are more likely to be lower income, with 34% having incomes below 200% of the federal poverty level (FPL) compared with 25% of non-LGBT+ people. And while both groups reported similar rates of employment, more LGBT+ adults report they are employed part-time (17% versus 12%)
•   LGBT+ adults are less likely to be married

2. LGBT+ people’s utilization of health services compared with non-LGBT+ people varies considerably by service type.

• For example, LGBT+ women ages 40 to 64 were less likely to report having had a recent mammogram (35%) compared with 64% of non-LGBT women of the same age.
• LGBT+ women ages 21 to 64 were also less likely to report having had a pap smear/test (54%) compared with 60% of non-LGBT+ women of the same age.

Study conclusions

“We find that while in many cases LGBT+ people have similar health and health care experiences to non-LGBT+ people, there are some notable differences, particularly with respect to some poorer health outcomes and negative provider experiences, as well as lower utilization of care in some cases and a higher burden of medical bills,” the study authors wrote.

“While data collection on LGBT+ people is improving, particularly at the federal level, it is still not standard, and as such, knowledge gaps remain, including with respect to health status, health needs, and health care access.”

3. 18 healthcare organizations urge action by Congress and the Biden administration to improve affordable, quality healthcare

Eighteen diverse healthcare organizations want Congress and the Biden administration to enact a set of policy proposals, which the group says will “extend and improve affordable, high-quality health coverage across the full range of healthcare markets,” according to a July 12 press release by Families USA.

“The deadliest pandemic in more than a century and sharpest economic downturn since the Great Depression have made it crystal clear that affordable, high-quality coverage is critical to the entire nation’s well-being, not just individual families,” stated Frederick Isasi, executive director of Families USA, in the release.

4 areas of action for Congress

Congress is being asked as part of its next major legislative package to act in the following four specific areas:

1. Strengthening funding, streamlining enrollment and renewal, and expanding eligibility for Medicaid and the Children’s Health Insurance Program
2. Improving the affordability of coverage that people buy for themselves in the individual market
3. Expanding healthcare coverage to all lawfully present immigrants, without any waiting periods
4. Enrolling people into coverage who qualify for assistance but remain uninsured

Organizations backing healthcare policy action

The 18 organizations backing the policies are: America’s Health Insurance Plans, the American Academy of Pediatrics, the American College of Physicians, the Association for Community Affiliated Plans, Blue Cross Blue Shield Association, Catholic Health Association of the United States, Families USA, Federation of American Hospitals, NAACP, National Birth Equity Collaborative, National Council of Urban Indian Health, National Health Council, National Immigration Law Center, National Partnership for Women & Families, Small Business Majority, Third Way, UnidosUS and Young Invincibles.

HFMA bonus content

Read the Aug. 10 article, “Hospitals sort through the last 18-plus months to report expenses and lost revenue on a pandemic that is not over,” by HFMA’s Shawn Stack for some tips and resources on the PRF reporting process.