Ohio Health Policy News

Ohio ranks near bottom in latest HPIO Health Value Dashboard

Ohio ranks 47 in the nation in health value compared to other states and D.C. according to the latest edition of the Health Value Dashboard, which was released earlier this week by the Health Policy Institute of Ohio.

“Ohioans live less healthy lives and spend more on health care than people in most other states,” according to the Dashboard.

Ohio has consistently ranked near the bottom on health value in each of the four editions of the Dashboard. Ohio’s overall health value ranking was 47 in 2014, 46 in 2017 and 46 in 2019. 

The Dashboard found that Ohio’s healthcare spending is mostly on costly downstream care to treat health problems. This is largely because of a lack of attention and effective action in the following areas:

• Children. Childhood adversity and trauma have long-term consequences
• Equity. Ohioans with the worst outcomes face systemic disadvantages
• Prevention. Sparse public health workforce leads to missed opportunities for prevention

The Dashboard is a tool to track Ohio’s progress toward health value — a composite measure of Ohio’s performance on population health and healthcare spending. In ranked profiles, the Dashboard examines Ohio’s rank and trend performance relative to other states across seven domains. In addition, through a series of equity profiles, the Dashboard highlights gaps in outcomes between groups for some of Ohio’s most systematically disadvantaged populations.

The Dashboard includes examples of nine evidence-informed policies that could be adopted by Ohio policymakers and private-sector partners to make Ohio a leader in health value.

State announces new Medicaid managed care contracts

The DeWine administration announced the winners of contracts to lead sweeping changes in the $20 billion Medicaid managed care system (Source: “Six companies will split $20B in managed-care work under biggest contract in Ohio history,” Columbus Dispatch, April 9).

In what was labeled as likely the largest pact in Ohio state government history, six companies are being hired to coordinate the federal-state health insurance for more than 3 million low-income or disabled Ohioans.

"What is really the revolutionary component here is that we have looked at all of the most cutting-edge practices, and we are pushing our system to the next generation," said Ohio Medicaid Director Maureen Corcoran.

"The entire country is watching us because there are some really important things we are doing differently."

DeWine plans to target COVID-19 vaccines to areas with case spikes, higher demand

As daily coronavirus cases have begun to rise in Ohio, the state will rush shots to areas with increased spread, Gov. Mike DeWine announced Thursday (Source: “Ohio will rush coronavirus vaccines to areas with case spikes,” Cleveland Plain Dealer, April 1).

That may head off a fourth wave that Ohio physicians have warned about, spurred by more contagious variants of the virus.

“As we vaccinate more and more people, it will be harder and harder for this virus to travel from person to person,” he said. “But, you know, in the next month, next two months, we’re concerned.” 

In addition to sending doses to locales across the state with increasing cases, DeWine announced more efforts to increase the overall number of Ohioans who are vaccinated. He said that each week, the state will look at where vaccine demand is greatest and allocate more doses to those areas.

Addressing racial disparities in infant mortality requires dismantling structural racism

Black babies in Ohio are born too early and too small — factors that contribute to dying before their first birthdays at a rate twice that of white babies (Source: “Black babies dying at alarming rate: How can their lives be saved?,” Dayton Daily News, March 14, 2021).

While disparities in income and educational attainment play a role, Black mothers with higher incomes and education are still more likely to live in disadvantaged neighborhoods, face biases from health care professionals and toxic stress from racism that erodes health on a cellular level, according to the Health Policy Institute of Ohio. Some research indicates the health impacts of that stress can be passed on.

Policymakers need to dismantle structural racism with reforms that create equitable access for communities of color to housing, jobs, education and quality, less-biased health care, say experts at HPIO. In the short-term, local groups should continue connecting minority and at-risk moms with assistance services.

Vaccine supply expected to increase as eligibility widened

An expected 25% increase in the number of COVID-19 vaccines in coming weeks led the state to make everyone 16 and older eligible to get inoculated starting March 29, Gov. Mike DeWine said (Source: “State’s vaccine supply to increase 25 percent,” (Warren) Tribune Chronicle, March 19).

The state is receiving about 400,000 vaccine doses each week, and that will go up to 500,000 a week starting March 29, he said Thursday.

Beginning today, the minimum age to be eligible for the vaccine is going from 50 to 40. Also, those with certain medical conditions are eligible today. Starting March 29, all those who are at least 16 years old will be eligible for the vaccine.

Of the state’s 88 counties, 62 are at Level 3, 21 are at Level 2 (orange) and 5 are at Level 1 (yellow). No counties are at the highest Level 4 (purple).

DeWine: Ohio on track to open vaccines to all adults by May 1

Ohio is on track to open access to COVID-19 vaccines to all adults by President Biden's May 1 milestone and could lift restrictions in the next seven to eight weeks, Gov. Mike DeWine said Friday (Source: “Gov. Mike DeWine: Coronavirus restrictions could be lifted 'in 7 to 8 weeks',” Columbus Dispatch, March 12).

President Biden said Thursday he wants states to make all adults eligible for the vaccine by May 1. Biden noted that does not mean all Americans will immediately receive a vaccine after that date, but that "you’ll be able to get in line beginning May 1."

"Within a month, it’s going to be pretty open," DeWine said Friday.

On Thursday, Ohio's incidence rate was 155 new cases per 100,000 residents during the past two weeks – down from 179 the week before. DeWine said when that rate reaches 50, he will lift all state health orders including a mask mandate and restrictions on bars, restaurants, entertainment venues and more.

"We certainly could be out of this in seven or eight weeks," DeWine said. "What we don’t really know is the impact this variant is having or will have as it spreads throughout the state."

Ohio to create statewide support system for child and adolescent behavioral health

Ohio state agencies have announced plans to create a statewide center that will offer support to child and adolescent behavioral health programs and agencies, including providing services to keep children out of foster care (Source: “Ohio looks to form new statewide support system for child and adolescent behavioral health,” Cleveland Plain Dealer, March 12).

Ohio’s Child and Adolescent Behavioral Health “Center of Excellence” will offer training and technology and administrative services, including increased access to government support through telehealth. Multiple departments, including the Ohio Department of Job and Family Services and the Ohio Department of Mental Health and Addiction Services, created the request for qualified contractors to help develop the center.

Case Western Reserve University’s Center for Innovative Practices, through a two-year, $3.6 million contract, will organize the creation and operations.

Ohio begins adding 4k deaths to COVID-19 totals following data collection error

Ohio Department of Health officials announced this week that they had overlooked about 4,000 deaths that occurred over the past several months and would begin reporting them to the public this week (Source: “Ohio Begins Adding In 4,000 Overlooked Covid Deaths,” New York Times, Feb. 12).

The first 650 or so of Ohio’s older deaths were reported Thursday, accounting for about 17% of all coronavirus deaths announced nationwide that day. On Friday the Ohio Department of Health reported about 2,500 additional deaths. The backlog in Ohio was expected to inflate the national death average in the coming days.

“You’ll see a jump today, tomorrow, maybe the next day,” Gov. Mike DeWine said at a news conference on Thursday. “We’re not sure exactly how many days it’s going to take, but you’re going to see a distorted number.”

During a routine employee training event, Ohio health officials discovered that thousands of deaths, some of which dated back to October, had not been properly merged between one reporting system and another, according to an ODH press release. “This was a failure of reconciliation not taking place,” Gov. DeWine said, “so we’re getting that straightened out.”

Daily vaccination rate increasing in Ohio

More than 1.1 million Ohioans have begun the two-shot vaccination process against COVID-19, just 11 months after the state health department first detected the new coronavirus in Ohio (Source: “Vaccinations speed up in Ohio as the coronavirus recedes,” Ohio Capital Journal, Feb. 11).

An analysis of state data shows the seven-day moving average of the number of Ohioans starting the vaccination process has slowly and steadily risen between the first shots Dec. 14 and early February.

About 30,000 state residents per day are starting the process, according to a seven-day moving average.

State health officials expect this figure to rise as they iron out kinks in a complex and temperature-sensitive supply chain, the two vaccines on the market ramp up production, and the Johnson & Johnson vaccine presumably enters the market in the coming weeks.

HPIO analysis: 1 in 8 Ohio vaccinations lacks data on patient’s race, 1 in 4 lacks ethnicity data

New analysis by the Health Policy Institute of Ohio has found that the race of COVID-19 vaccine recipients is unknown for more than one in eight vaccinations administered in Ohio and ethnicity is unknown in more than one in four.

This lack of data makes it challenging for policymakers to determine whether vaccine efforts are effectively reaching communities of color.

“Complete data collection on race and ethnicity is foundational to end the pandemic,” said Amy Rohling McGee, president of HPIO.” All vaccine providers should be required to ask for this information, and ‘decline to respond’ should be an option for the recipient. Vaccine providers need to explain that the data will be used to make sure that all Ohioans are being reached, especially Ohioans of color who have been disparately impacted by COVID-19.”

Complete data is critical for developing plans for equitable access to vaccines for all Ohioans.

”Data can drive decision-making and ensure that vaccination sites are easy to access and located in communities that have been most impacted,” McGee said. “Evaluation of current and future vaccination strategies requires timely and accurate data.”

Gaps in data have been an ongoing challenge in Ohio’s response to the COVID-19 pandemic. In addition to vaccines, Ohio also has a significant number of cases, hospitalizations and deaths listed as “unknown” for race and ethnicity (see graphic below).