How to improve child health outcomes

How to improve child health outcomes

Louisiana is a national leader in insuring children, with 97 percent of kids in the state having health coverage. But coverage is just one part of improving health outcomes.

Number of the Day

$12 - Hourly minimum wage for employees of Ochsner Health System, starting on Jan. 20. The change, announced Thursday, means 1,200 of the company’s 25,000 employees will get a pay raise. (Source: Times-Picayune)

Louisiana is a national leader in insuring children, with 97 percent of kids in the state having health coverage. But coverage is just one part of improving health outcomes. A new policy brief by LBP’s Jeanie Donovan makes a series of recommendations for how Louisiana can improve its reimbursement policies and tighten oversight of managed care companies in ways that improve child health outcomes:

Despite the positive trends in health insurance coverage rates for kids, Louisiana’s performance on a set of measures called the Child Core Set Quality Measures illustrates that not all children in the state who are enrolled in Medicaid and LaCHIP receive necessary health screenings, treatment and follow-up care. Improving access to health care services for children in these programs could have a substantial impact on both individual and overall population health outcomes in the state. Research findings also suggest that increasing access to early detection and preventive health services for children enrolled in Medicaid and CHIP could result in improvements in school performance and could decrease state health spending in the long run.

These improvements can be measured using the Child Core Set which measure the utilization of medical services. Louisiana does well in certain measure, but is behind in others.

Several of the Child Core Set measures show that Louisiana lags far behind other states and has substantial room for improvement. In 2017, only 17.8 percent of children on Medicaid or LaCHIP had a recommended developmental screening before age 3. While the national median is just 39.8 percent, the highest performing state, Vermont, recorded 81.1 percent of children ages 0 to 3 receiving a developmental screening. Louisiana children also visit emergency departments more often than children elsewhere. In 2017, there were an average 54 emergency department visits for every 1,000 children enrolled in Medicaid or LaCHIP in a given month, compared to the national median of 42.3 emergency visits for every 1,000 enrolled children. In Idaho, the best-performing state, there were just 4.8 monthly emergency room visits per 1,000 children in 2017.


Putting the brakes on tax breaks
The East Baton Rouge Parish School Board has delayed its decision on whether to grant lucrative property tax breaks to manufacturers that adhere to modest job-creation requirements. The school board is one of many local government bodies across the state that’s grappling with new rules for the Industrial Tax Exemption Program (ITEP). The board had been scheduled to adopt new rules that would have granted tax breaks to corporations that agree to create at least 15 new jobs or for projects that benefit the environment. The faith-based group Together Baton Rouge said the environmental provision constituted a major loophole. The Advocate’s Charles Lussier:

Board member Mike Gaudet defended the changes, but said he’s willing to keep working on them for another month. Gaudet said he’s trying to strike the right balance between encouraging economic development and improving school tax revenue. “I don’t want you to think that anyone on this board is trying to give away money to industry,” said Gaudet. Tia Mills, president of the East Baton Rouge Association of Educators, didn’t see it that way, urging that the board to cease giving such exemptions at all when it comes to public schools. “This is the poorest, richest state in the union. We need to do something to change that,” she said. “Stop giving the money away.


Keeping kids out of juvenile detention
Even a short time spent behind bars can have lifelong harmful effects on children. Experts are calling for reforms across the country on juvenile detention policies. It’s why the Annie E. Casey Foundation and others have been working for years to reform juvenile justice systems around the country, with an eye to more pretrial diversion and other programming that keeps children from being locked up. The Annie E. Casey Foundation elaborates on the negative consequences of detention centers in a new blog:

Youth placed into pretrial detention are far more likely to be formally charged, found delinquent and committed to youth corrections facilities than similarly situated young people who remain at home pending their court hearing, according to search. Detained youth are also more likely to be rearrested, adjudicated or convicted of new offenses and incarcerated than youth who remain at home awaiting court or pending placement.

Cost and racial discrepancies are also issues.

African-American, Hispanic, and American Indian youth are far more likely than their white counterparts to be detained, even after controlling for the seriousness of an offense, offending history and other factors. In addition: Temporary confining youth occurs at a significant cost to taxpayers – roughly $1 billion per year nationwide.


Census data tracks internet access by county
Access to reliable internet service can be a barrier for low-income and rural families as our world becomes increasingly dependent on technology. Job applications, reporting requirements for social services and general access to resources and information all require internet access. The U.S. Census Bureau has consistently reported on internet access, but for the first time they are reporting on type of internet access by county. This useful information show the true internet gaps across states, and even across cities that may be heavily segregated by income and race. Michael J. R. Martin from the United States Census Bureau has more:

Counties with lower rates of subscription are prominent throughout the South, especially in the Mississippi River basin, as well as in a number of counties in the Midwest and West. Telfair County, Ga., has the lowest rate of subscription at 24.9 percent out of counties with populations of 10,000 or more. Holmes County, Miss.; Kemper County, Miss.; Apache County, Ariz.; Monroe County, Ala.; McKinley County, N.M.; and Leflore County, Miss., all also have subscription rates at or below 40 percent. … Not surprisingly, higher income counties that are also “mostly urban” have the highest rate of internet subscription, with an average of 79.9 percent of households subscribing to some broadband service


Middle class still bouncing back from recession in some cities
Depending on where you live and your socioeconomic status, the Great Recession may have hurt you twice. The economy is booming, unemployment is low and wages are growing – for some. Large discrepancies in wage growth, particularly when comparing the middle class to other income brackets, are common. Brad Hershbein of the Brookings Institution discusses these discrepancies and why some in the middle class are feeling left behind:

While wages are up for everyone, the gains have been far from equal. It is not too surprising that wage growth was highest in the top quintile—this element of economic polarization is now well known. Wage growth was also reasonably robust at the bottom, above 6 percent, as several minimum wage increases at the national and state levels took effect. However, wage growth in the middle quintiles, especially the second and third, was much weaker. The result is that wages at the bottom and middle have been pushed closer together, while wages at the top have pulled away from everyone else. … Nationally, middle-class workers have lost ground compared to earners at the bottom and the top. But middle-class workers in harder-hit areas also lost ground compared to their counterparts in areas less affected by the Great Recession. If you were unlucky enough to be in the middle class in places like Atlanta, Houston, or St. Louis, instead of Columbus, Kansas City, or San Antonio, the Great Recession hammered you twice. In these places at least, the lingering malaise is warranted.


Number of the day
$12 – Hourly minimum wage for employees of Ochsner Health System, starting on Jan. 20. The change, announced Thursday, means 1,200 of the company’s 25,000 employees will get a pay raise. (Source: Times-Picayune)