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State Health Reforms Progress Despite Ailing Economy
Date:2/4/2009

08, most notably Massachusetts and Vermont, which continued to implement comprehensive reforms. In addition, Iowa, Minnesota, and New Jersey lawmakers passed legislation last year that will increase coverage and, in some cases, move the states forward in controlling health costs and improving quality of care. Other states, such as Arkansas, Connecticut, Ohio, Oklahoma, Oregon, and Utah, used 2008 to build consensus and create recommendations ranging from coverage expansions for specific populations to substantial system redesign. Some states tried but were unable to pass comprehensive health reform. California, Kansas, New Mexico, and Pennsylvania all fell short in their comprehensive reform efforts in 2008.

Report authors offer multiple insights from scenarios and trends occurring in states in 2008. Among them:

Mounting pressures on state budgets caused by increasing numbers of uninsured. Medicaid enrollment increased by 2.1 percent in 2008. As the economy continues to worsen and unemployment rises, the report predicts that Medicaid enrollment numbers will jump even higher, putting additional burden on the states' already overextended budgets.

Emerging trends among states to address cost and quality, along with access. The report finds that some states (e.g., Massachusetts and Minnesota) are trying to improve value by containing costs and improving quality. Some of the strategies states have undertaken this year include investing in primary care, wellness initiatives, price and quality transparency initiatives, health information technology adoption, reducing preventable hospital readmissions, exploring new paradigms for physician and hospital payment, and efforts to promote patient safety and prevent medical errors.

Renewed efforts to enroll eligible residents in State Children's Health Insurance Programs (SCHIP). Ten states last year passed legislation to expand children's
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SOURCE Robert Wood Johnson Foundation
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