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Inside this edition:

Long-Term Care for Seniors

Home At Last?

HCCI in Sacramento

Health Care Forum

Dual Use of Services for AI and AN

Untangling Medicare

The Center at Academy Health

Correction: Dentist fact sheet

In the Media

Center News and Notes

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June 2009
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Long-Term Care Costs More than Annual Income for Many California Seniors

In all 58 California counties, long-term health care is far out of reach for the state's most vulnerable citizens: disabled seniors living alone. Combine long-term care expenses with other basic expenses, such as food and rent, and total costs can be twice or nearly three times median income for a senior living alone, according to new data released today by the UCLA Center for Health Policy Research and the Insight Center for Community Economic Development. Yet even as costs soar, Gov. Arnold Schwarzenegger has proposed the elimination of Medi-Cal–funded in-home supportive services for up to 400,000 seniors as a means of closing the state's budget gap.

"When getting help at home costs a year's income, something's wrong," said Steven Wallace, PhD, associate director of the UCLA Center for Health Policy Research. "It means that extended families will be stretched thin to provide care or that the elderly will bankrupt themselves to pay for a service provider."

See the data.

Related: Three Questions for the Expert: Steven Wallace, PhD, Center associate director, discusses the policy changes needed to help stem long-term care costs.

Home at Last? New Policy Brief Describes County Efforts to Create a "Medical Home"

Only 27 percent of non-elderly adults in the United States have a “medical home” – a place where they regularly receive medical care and advice. Shifting from more costly emergency care to the preventative and coordinated care provided by a medical home affects costs, access, quality of care and the overall health status of low-income, uninsured individuals. A new Center policy brief, Health Coverage in the Safety Net: How California’s Coverage Initiative Is Providing A Medical Home to Low-Income Uninsured Adults in Ten Counties, presents interim findings on the efforts of ten California counties to explore the medical home model as part of the state’s Health Care Coverage Initiative (HCCI), a three-year program to expand health care coverage for eligible low-income, uninsured individuals not otherwise covered by Medi-Cal. Among the innovations described are efforts to create electronic health and medical records, modify e-referrals to two-way communication between primary care physicians and other providers and standardize chronic disease registries.

Read the policy brief.

Health Care Coverage Initiative in Sacramento

Center experts presented preliminary findings from California ’s Health Care Coverage Initiative (HCCI) at a June 11 event at the California State Capitol.  With a federal waiver that supports HCCI set to expire in 2010, Center Associate Director Gerald F. Kominski, PhD, (pictured) and Director of Research Planning Nadereh Pourat, PhD, discussed the program’s innovative efforts to expand health care coverage to the uninsured. Joining them were representatives from the California Department of Health Care Services, the California Association of Public Hospitals, Health Management Associates and others. To learn more about the Center’s work with the HCCI program, read our latest policy brief (described above) or contact Gerald Kominski at kominski@ucla.edu.

Center Hosts Health Care Reform Forum

Experts and health industry stakeholders discussed the pros and cons of health care reform before a packed crowd on June 17 as part of the "HCAN UCLA Health Care Reform Forum," hosted on the UCLA campus by the Center.  E. Richard Brown, PhD, Center director and a senior health policy adviser for the Obama presidential campaign, described the president's health care reform proposal in a session introduced by Lisa Pinto, district director for Rep. Henry Waxman (D-CA). Other panelists included: Lark Galloway Gilliam, executive director of Community Health Councils, Anjali Taneja, board member of the National Physicians Alliance, Barbara Blake, state secretary of United Nurses Association of California, Tracy Zeluff, political field director of Service Employees International Union and Lindsey Wade, senior policy associate for the Children's Defense Fund.   

"Dual Use" of Government Health Services Among American Indian and Alaska Native Veterans

In 2003, the Veterans Health Administration and the Indian Health Service executed a Memorandum of Understanding to share health care resources for eligible American Indian and Alaska Native veterans. How well has that “dual use” arrangement worked?  Improvements are needed, conclude the authors of a new article in the Journal of General Internal Medicine.  The authors, including Center research scientist Delight E. Satter, MPH, found that dual use was driven by existing institutional resources, leading patients to actively manage health-seeking behaviors and providers to make often uncoordinated and ad hoc referrals to each other, resulting in delays in care. “Fostering closer alignment between [both agencies] would reduce care fragmentation and improve accountability for patient care,” the authors noted.

Read the journal article: Dual-Use of Veterans Health Administration and Indian Health Service: Health Care Provider and Patient Perspectives.

Untangling Medicare

How hard is it to choose a low-cost Medicare prescription drug plan? Extremely hard, especially if you’re a senior citizen, according to a new study in the journal Health Services Research. The authors, including vice chancellor of academic personnel at UCLA and Center affiliate Thomas Rice, PhD, found that older adults were less likely to identify the plan that minimized their total annual cost and were likely to mistakenly think they had chosen the lowest-cost plan. “Making Part D easier for seniors to navigate should be part of the administration’s and Congress’ efforts to reform health care,” Rice noted.

See the study: How Much Choice Is Too Much? The Case of the Medicare Prescription Drug Benefit.


The Center at Academy Health

Center researchers will present the latest research on cancer screening, discontinuous health insurance, HIV testing and many other topics at the 2009 Academy Health Annual Meeting on June 27-30 in Chicago. Download a complete listing of all Center presentations at AcademyHealth or visit our exhibit table 7A to pick up free copies of the Center's latest publications.