CLEVELAND, Ohio — Many people in Northeast Ohio who lose their jobs in the ongoing economic recession also lose their health insurance, according to Better Health Greater Cleveland’s third community report.
One of the key findings of this year’s report is a 19-percent rise in uninsured patients among doctors’ practices that partner with Better Health, a non-profit organization dedicated to improving the health and value of health care for people who have chronic medical conditions, starting with diabetes.
But a government-sponsored health care plan and a requirement to have health insurance — both part of the nation’s ongoing health care reform debate — might help stabilize the situation, according to Dr. Randall Cebul, director of Better Health Greater Cleveland and an internal medicine doctor at MetroHealth System in Cleveland.
When Investment Rhymes with Canada
Canada has a proud history of achievement in the areas of science and technology, and the field of biomanufacturing and life sciences is no exception.
Losing a job often disrupts health insurance, said Cebul, who also directs the Case Western Reserve University Center for Health Care Research and Policy at MetroHealth. Insurance aimed at getting workers to the next job and employer-sponsored insurance plan, known as COBRA, is expensive. So “people are often going without insurance,” he said.
For patients who have diabetes, that means paying for several prescriptions and blood sugar test strips out of their own pockets, Cebul said. So some patients ration their medications or stop buying supplies.
The loss of a job also can disrupt health care. Some doctors don’t accept uninsured patients, so when patients lose coverage, they must find new doctors. This also disrupts medical information about the patients, Cebul said.
All of the disruption can lead to poor medical outcomes, especially for patients who have chronic diseases, said Cebul, who expects the loss of medical insurance — and jobs — to continue. “That’s the canary in the coal mine,” he said. “So we’re going to see more of that as time goes on. This is happening everywhere. It’s not just Cleveland.”
A so-called public health plan option – a proposed insurance plan sponsored by the federal government — and a mandate that people get insurance would increase the likelihood of patients staying with their doctors and having coverage to pay for medication and tests, Cebul said.
“And of course, if you look at the data in terms of how our patients are doing, the uninsured do worse and they improve less” than patients who have insurance, he said.
For three years, the folks at Better Health Greater Cleveland have gathering data on treatment and outcomes of diabetic patients from medical practices in Northeast Ohio, including those at MetroHealth, Care Alliance,  University Hospitals Family Medicine, Cleveland Clinic and the Louis Stokes Cleveland VA Medical Center.
The Greater Cleveland effort is part of the national Aligning Forces for Quality program, the signature program of the Robert Wood Johnson Foundation.
The Cleveland group is at the cutting edge of providing such data because of the widespread use of electronic health records by partner institutions, said Minna Jung, senior communications officer for the foundation. The data is helping doctors figure out how best to treat diabetes — and eventually other chronic diseases.
A lot of what the foundation is doing under its Aligning Forces for Quality program fits squarely with the nation’s health care reform debate, Jung said. The foundation’s data could help correct what’s wrong with the nation’s health care system and lead to the best care for patients at the lowest prices, she said.
Other findings of the Better Health Greater Cleveland report:
- Partner medical practices achieve above-national-average scores on standards for diabetes care as established by the National Committee for Quality Assurance. These scores are rising.
- Patients who lack insurance or are covered by Medicaid — the federal health insurance for the poor — or those who are racial minorities, poor or less-educated have worse medical outcomes.
- Evidence-based “best practices” can drive improvements in medical care and outcomes.
- Challenges, such as high obesity rates, are complicating measurement and improvement of care quality.
