Health care reform through the cancer lens state and private sector reforms for hispanic healthcare
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Health Care Reform Through the Cancer Lens State and Private Sector Reforms for Hispanic Healthcare. Edward E. Partridge, MD National Board President American Cancer Society. National Hispanic Medical Association 15 th Annual Conference March 19, 2011.

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Health care reform through the cancer lens state and private sector reforms for hispanic healthcare

Health Care Reform Through the Cancer Lens State and Private Sector Reforms for Hispanic Healthcare

Edward E. Partridge, MD

National Board President

American Cancer Society

National Hispanic Medical Association

15th Annual Conference

March 19, 2011


Edward e partridge md national board president american cancer society

Through its Body of Work, the American Cancer Society is the leader in the global effort to eliminate cancer disparities

among ALL populations …Because Cancer Doesn’t Discriminate!


Edward e partridge md national board president american cancer society

The Case For Equity


Population distribution by race ethnicity u s 2009

Population Distribution by Race/Ethnicity, U.S. (2009)

Source: U.S. Census Bureau, CPS: Annual Social and Economic Supplements


Uninsured hispanic under age 65 us 1998 2009 3 year annual average

Uninsured Hispanic, under age 65: US, 1998-2009(3 Year Annual Average)

Source: National Health Interview Survey (NHIS)


Leading causes of death among hispanics by underlying cause ages 18 us state 1999 2007

Leading Causes of Death, Among Hispanics by underlying cause, ages 18+: US/State, 1999-2007

Death Rates

Source: The National Vital Statistics System


Chronic conditions ages 18 us 1997 2008 hispanic population

Chronic conditions, ages 18+: US, 1997-2008 - Hispanic Population

%

%

%

%

%

%

%

Percent

%

%

%

%

%

Source: National Health Interview Survey (NHIS)


Incidence and death rates for all cancers combined among hispanics 1992 2006

Incidence and Death Rates for All Cancers Combined among Hispanics 1992-2006

Source: Cancer Facts & Figures for Hispanics/Latinos, American Cancer Society, Atlanta, GA


Edward e partridge md national board president american cancer society

What We Know

  • Suffering and death could be prevented through more systematic methods of health screening and early detection.

  • A disproportionate number of Hispanics and other medically underserved populations are not fully benefiting from available resources.

  • Underlying causes of cancer disparities are interrelated and complex


Edward e partridge md national board president american cancer society

Causes of Cancer Disparities

Can be linked to social determinants of health, such as but not limited to:

  • Inequalities in access to care,

  • Language barriers,

  • Unhealthy environments, and

  • Discrimination


Edward e partridge md national board president american cancer society

  • Disparities In Outcomes Are Related With:

  • Treatment…

  • Hispanics and other minority groups are more likely to be living in poverty and are less likely to receive recommended treatment.

  • Screening…

  • Hispanics and other minority groups are more likely to be uninsured and are less likely to receive timely screening.

  • Incidence…

  • Hispanics and other minority groups are more likely to be diagnosed with later-stage preventable cancers.

  • Mortality…

  • Hispanics and other minority groups are more likely to earn a lower income and are more likely to die from preventable cancers.

  • Risk Factors…

  • Hispanics and other minority groups are more likely to report cancer related risk factors.


Edward e partridge md national board president american cancer society

How Do We Address Disparities?

Focus Areas:

  • Prevention and Early Detection - increasing

    access to cancer screening, diagnosis and treatment

  • Information – data collection and evaluation

  • Quality of Life - Serving with impact

  • Research

    Through…

  • Advocacy

  • System Policy and Practice

  • Cancer Information and Empowerment

  • Resource Navigation

  • Communities of Support

  • Research


Lessons learned

Lessons Learned

Task of Eliminating Disparities – Daunting or not?

1. Technical advances to be delivered not so complex

-- tobacco control

-- age appropriate screening

-- healthy diet, physical activity

2. Populations most at risk

-- geographically focused

3. Patient Protection and Affordable Care Act

-- eliminates barrier to access

4. Communities most at risk eager to engage


Easy to more difficult changes

Easy to More Difficult Changes

Easy1. age appropriate screening

2. tobacco control

3. high quality treatment for all

Difficult4. healthy eating, physical

activity


Community engagement

Community Engagement

Create trust

Eliminate bias

Share power


Strategies to improve cancer screening among hispanics

Strategies to Improve Cancer screening among Hispanics

  • Effective communication initiatives are needed to close this knowledge gap.

  • Social support may improve participation in screening.

  • Local outreach programs and culturally targeted interventions by lay Hispanic health advisors along with physician encouragement are also effective strategies for improving cancer screening participation rates


Edward e partridge md national board president american cancer society

A number of provisions in the Affordable Care Act will help reduce these disparities and increase access to culturally competent care for Hispanics


Edward e partridge md national board president american cancer society

How Does the Patient Protection and Affordable Care Act Help?

  • Expanding Coverage

    • Private insurance

    • Medicaid

    • Medicare

  • Enhancing Prevention

  • Improving Quality of Life


Implementation expanding coverage medicaid

ImplementationExpanding Coverage: Medicaid

Expands coverage to all persons under 133% FPL (up to $29,327 for a family of four)

Simplifies enrollment into Medicaid

Incentive programs to encourage participation in chronic disease preventive programs

Increases access to cessation drugs


Implementation addressing disparities

Implementation Addressing Disparities

Qualified health plans must provide materials in appropriate languages

Strategy for increased access to language translation services


Implementation state activity

Implementation: State activity

Contracting of high-risk pools

Creation of the exchanges

Creation of state-based ombudsman programs

Protecting mandates and Breast and Cervical program until at least 2014


Edward e partridge md national board president american cancer society

YOUR ROLE


Implementation to do list

Implementation: To do list

Learn what’s in the bill

Identify state publications that will update you

Develop a relationship with your State and Local officials, i.e. State Insurance Commissioner and Medicaid Director


Implementation resources

Implementation: Resources

ACS CAN Web page: http://www.acscan.org/


Thank you

THANK YOU


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