Work of Voinovich School faculty reveals Ohio’s health care system improved, but has long way to go

Faculty at the Voinovich School of Leadership and Public Affairs are leading an effort to improve Ohio’s health care system. Ani Ruhil, associate professor, and Francesca Gordon, applied research professor, worked with the Health Policy Institute of Ohio (HPIO) over the course of the past several months to produce the organization’s fourth annual report on health care in Ohio.

The report analyzed 118 metrics associated with the following categories: the quality of the health care system; public health and prevention; access to health care; social and economic environment; and, physical environment. For each metric, the states are ranked, and these rankings are then averaged to produce the overall rankings for population health, health care costs, and health value – a composite measure that reveals the efficiency of the dollars the state spent on achieving a healthy population.

This year’s report demonstrated that Ohio has improved on many metrics over the past few years – but also that Ohio has a long way to go. The state ranked 43rd in terms of population health and 31st in terms of health care spending – meaning 42 states are healthier and 30 spend less. That combination leaves Ohio’s composite score with considerable room for improvement, as Ohio ranks 46th in terms of health value. However, although many metrics such as average monthly marketplace premiums and child immunization rates deteriorated, Ohio also progressed in substantial areas – perhaps most vitally: access to health care. The state’s improved health care access may be partially attributed to the increasing strength of Ohio’s social and economic environment, as the state saw significant reductions in the unemployment rate. However, increased access to health care, while it may be a prerequisite to a healthy population, offers no guarantees.

"Ohio performs well on access to care, but poorly on population health," HPIO President Amy Rohling McGee said. "Access to care is critical for people who are sick, experience an injury or have a chronic health condition. However, access alone is not sufficient to improving overall health. Ohio performs poorly on other important factors that impact health value."

This said, Ohio is moving in the right direction. As with most of the country, Ohio witnessed more improvement than regression in metrics. In addition to the accessibility of health care, metrics such as youth tobacco use, stroke care, effectiveness of heart failure treatment, and percentage of children exposed to second-hand smoke were all greatly improved. Furthermore, thanks in part to the dashboard, the next steps to better health care and health value are clear.

"The good news is that we know what works to improve health behaviors and support healthy communities," McGee said. "We need to build on the improvements that have been made in Ohio and continue to implement evidence-informed solutions to address Ohio's greatest health challenges."

Regarding the impact the 2017 report will have, Ruhil said, “It all depends on what the state thinks is a priority, but without a dashboard such as this one that monitors how we’re doing, it’s impossible to keep track of any progress or regression that results. In the end, we hope this will shape state policy, even if it’s just drawing the attention of policy-makers to a certain issue.”

The state of Ohio directly considered the results of the 2014 dashboard, inviting the HPIO to testify on the document at the Joint Medicaid Oversight Committee, the Senate Health and Human Services committee and the House Health committee. The dashboard then informed policies produced by the state in its response to issues such as tobacco-use, one of the metrics that witnessed the most improvement this year.

Because of the tangible benefits the health value dashboard has delivered in the past, Ruhil confirms that, “this project shows the Voinovich School’s continuing contribution to the health of the region.”