Scorecard reminds us it is a matter of where we live
Health researchers have been ringing alarm bells for decades about several aspects of this region and the health of its residents. The 2016 edition of the Commonwealth Fund’s Scorecard on Local Health System Performance continues to bear this out. Each metropolitan area is evaluated on 36 criteria divided into four areas: Access and affordability; prevention and treatment; avoidable hospital use; and costs and healthy lives.
Of the 306 communities measured, most of the communities scoring at the bottom are in the South. In fact, of the 20 lowest scoring communities, 15 are in the South. Louisiana has six cities ranked low: Shreveport, Lake Charles, Lafayette, Alexandria, Houma and Monroe. Mississippi not only has the lowest scoring city, Hattiesburg, but four others near the bottom — Oxford, Gulfport, Meridian and Jackson.
We would like to say how well Georgia is doing on this scorecard, and many of the cities have improved scores, but when you’re near the bottom, there’s nothing to brag about. Macon is at 294. For the sake of this scorecard, Macon is defined as all of Middle Georgia, with a population of 721,275. Rome is 298, Albany is 256, Savannah is 247, Augusta is 229 and Columbus is 207. Atlanta, at 189, has the best ranking in the state.
None of this should be a surprise. Researchers found that states where more people were covered by health insurance scored better. The study said, “As noted previously, Jonesboro, Ark., where almost half the population has low incomes, had the largest decline in uninsured rates between 2012 and 2014. Three lower-income areas saw the largest reduction (9 percentage points) in the share of Medicare beneficiaries receiving high-risk prescription medications, exceeding the national rate of improvement.”
Another area of measurement was the 30-day readmission rates for Medicare beneficiaries, and the scorecard showed more improvement in that area across the country with low-income residents.
In Georgia, one of the issues that will arise again in the next legislative session is whether or not Georgia should expand its Medicaid program. In 2014, Gov. Nathan Deal signed House Bill 990, which took the power to expand Medicaid from the governor’s office and gave it to the General Assembly. He also signed House Bill 943, which prohibited state or local governments from lobbying for Medicaid expansion or from creating state-run insurance exchanges. It forced the University of Georgia to shut down its health insurance navigator program.
The reason the issue will arise again is because the Georgia health care system is in crisis. Large urban hospitals are hurting and rural hospitals are closing. Even Deal, according to the Atlanta Journal-Constitution said, “I still have the same concerns. And you won’t see anyone advocating a wholesale Medicaid expansion, but I do think there will be variations that will be discussed, and I look forward to talking to members of the General Assembly.”
According to the Georgia Budget and Policy Institute, Georgia has some of the strictest eligibility standards of Medicaid in the nation. A family of three can’t earn more than $7,600 annually and qualify, and for what the state does spend, it’s dead last in the nation.
What would Middle Georgia look like if it improved its performance to the level of the best-performing local area for scorecard indicators?
▪ Fewer premature deaths (before age 75) would occur from causes that are potentially treatable or preventable with timely and appropriate care.
▪ 383 fewer hospital readmissions would occur among Medicare beneficiaries (age 65 and older).
▪ 6,236 fewer emergency visits for nonemergent or primary-care-treatable conditions would occur among Medicare beneficiaries.
▪ 66,201 fewer adults (ages 18–64) would have lost six or more teeth because of tooth decay, infection, or gum disease.
The entire scorecard is on the group’s website and you can download area-specific data from the 306 communities. We are fortunate in Middle Georgia to have highly capable medical centers close by, but even within our area there are hospitals that are barely hanging on. There are thousands of Georgians who live outside the “Golden Hour” from a medical facility that could save their lives.
While there are many preventive things we can do individually to assure our own health, we have to look to our elected leadership to ensure the health of our health care facilities.
This story was originally published July 15, 2016 at 9:00 PM with the headline "Scorecard reminds us it is a matter of where we live."