1. Future Problem Solving Program of CT Healthcare Access Seminar ACCESS TO HEALTHCARE: BARRIERS TO COVERAGE AND CARE IN CONNECTICUT Susan Cole & Marybeth Bonadies March 21, 2006

2. Office of Health Care Access (OHCA) Connecticut state agency predecessor agency was established by the General Assembly in 1973 Website: http://www.ct.gov/ohca

3. OHCA’s Mission regulating health care system development through the Certificate of Need Program (CON) collecting and analyzing data used to advise policy makers on health care issues Ensure citizens of Connecticut have access to a quality health care delivery system by:

4. Connecticut Facts Connecticut has 3.4 million citizens Connecticut has 169 towns 94% of Connecticut residents have health insurance coverage, leaving 6% uninsured Connecticut has 31 hospitals

5. Connecticut Hospitals

6. Factors that influence access: Resource availability Health insurance status Income Race/ethnicity Employment status

7. What is Certificate of Need? (CON) State mandated program Regulates services offered by health care facilities Regulates major capital expenditures by health care facilities Regulates purchase of certain imaging equipment

8. Certificate of Need What is a healthcare facility? Hospitals, clinics, ambulatory surgery centers, cancer centers, etc. What imaging equipment requires CON authorization? CT scanner, MRI scanner, PET/CT scanner, linear accelerator, and cardiac cath lab

9. CON’s Contribution to Resource Availability Availability of therapeutic services in the community that need to be accessed on a frequent basis Orderly introduction of new technologies and services to Connecticut Guarantee that specialized services are available in a centralized location “center of excellence” Note: Access does not equal convenience

10. Factors that influence access: Resource availability Health insurance status Income Race/ethnicity Employment status

11. Most Connecticut residents have health insurance coverage But an estimated 196,000 uninsured out of 3.4 million people do not

12. Access and the Uninsured…… The uninsured are: less likely to have a regular source of care, make fewer physician visits, and more likely to forego medical care or a prescription when they have and illness or injury.

13. Uninsured more likely to forego necessary care or prescriptions Percent not getting care Source: OHCA 2004 Household Survey

14. Who are Connecticut’s uninsured? Source: 2004 Household Survey

15. Factors that influence access: Resource availability Health insurance statusIncome Race/ethnicity Employment status

16. Low income families more likely uninsured Source: 2004 Household Survey

17. Factors that influence access: Resource availability Health insurance status IncomeRace/ethnicity Employment status

18. Hispanics are over-represented among the uninsured

19. Factors that influence access: Resource availability Health insurance status Income Race/ethnicity Employment status

20. Connecticut’s Health Insurance System Source: 2004 Household Survey

21. “ There are no medical or pension benefits, but our employees’ lounge has excellent free coffee” Eroding Employer based coverage:

22. Implications of barriers to individuals and to society Individual delayed care – poorer health outcomes out of pocket health costs Health Care Providers overburdened hospital emergency departments uncompensated care costs Society higher health care costs strained public health facilities

23. Where does this leave us? Some current approaches: Build on current employer-based system Shift to individual responsibility –consumer directed care Expand public coverage –single payer/universal coverage

24. Many Options to Consider Employer mandates Tax credits Premium Assistance Consumer-directed care Universal coverage

25. A Connecticut health care system that offers a full continuum of high quality health care to all residents in an effective, affordable and accessible manner Access to coverage and care

26. For further information please visit: http://www.ct.gov/ohca