DENVER – Colorado no es el modelo a seguir en cuanto a vida saludable, particularmente en lo tocante a la salud de los niños del estado. Eso es lo que dice un reporte publicado este miércoles por la Colorado Health Foundation (Fundación de la Salud de Colorado, CHF por sus siglas en inglés), el cual señala que las deficiencias en el cuidado parental y en la educación física escolar, más el aumento de obesidad en todo el estado, son factores determinantes del problema.
A pesar de la riqueza de oportunidades de recreación al aire libre, Colorado está muy retrasado en cuanto a la salud de sus residentes. Es por eso que el reporte califica con una “C” la salud de los niños, cosa que pudiera sorprender a quienes ven a Colorado como la meca para la gente que lleva una vida activa. Shepard Nevel, Vice Presidente de Evaluación de Políticas y Comunicaciones en la CHF, dice que el estado está en la posición perfecta para mejorar su calificación promedio.
En cierto modo a Colorado no le está yendo tan bien como esperábamos que nos fuera por ser un estado de alto rendimiento, pero tenemos las soluciones a la mano y podemos hacer cambios muy específicos.
El reporte revela que más del 17 por ciento de las mujeres embarazadas de Colorado reciben cuidados prenatales luego del primer trimestre, o no lo reciben en absoluto y el estado ocupa el lugar 24 nacional en actividad física infantil. Es uno de los cuatro estados en los que la educación física no es obligatoria en las escuelas, y a los maestros no se les exige que tengan preparación alguna en el área de la materia.
Robert Berry es director de atletismo, bellas artes, educación física y salud en el Valle Saint Vrain. Nos explica que su Distrito Escolar pone los recursos para la educación física y va más allá, con instrumentos de evaluación, capacitación y registro de indicadores de la condición física.
Nuestros estudiantes están mucho más involucrados, y también creo que lo que ha logrado es un ligero cambio en la filosofía de la Educación Física. Ya no va al concepto de equipo, sino de la condición física personal.
Nevel aporta su convencimiento de que el cambio puede comenzar con los coloradinos mismos.
Algo que pueden hacer los padres es ser la voz de los niños de nuestras escuelas, y en segundo lugar creo que todos nosotros, padres y no padres, podemos pensar en lo que podemos hacer para participar más en actividad física y comer más saludable.
El reporte de la Colorado Health Foundation (Fundación de la Salud de Colorado) refleja que a la salud de los adultos también le haría bien una mejoría. La tasa de obesidad en Colorado se ha duplicado en menos de 20 años, aunque hay más adultos mayores actuando para mantenerse en forma; y agrega que es el grupo con mayor tasa de actividad física, en comparación con sus pares de otros estados.
El reporte está disponible en coloradohealth.org.
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A recent report examined how some rural Tennessee hospitals have managed to stay afloat despite financial challenges.
The report includes interviews from staff at five different rural hospitals, which range in size from 25 to 125 beds.
Judy Roitman, executive director of the Tennessee Health Care Campaign, said some of the hospitals are drowning in uncompensated care. She explained as part of their research, they did an interview with a CEO from a rural hospital in Kentucky who expressed the importance of Medicaid expansion.
"Kentucky has expanded its Medicaid program and Tennessee has not," Roitman pointed out. "He said that's the key to our stability is actually having the funds coming in to treat these patients. And the CEOs and others in Tennessee hospitals said it would make a huge difference to have that federal funding."
Roitman added the federal government is offering Tennessee a nine-to-one match. If Tennessee were to expand Medicaid, at least 330,000 people would gain access to coverage.
Roitman pointed out the report suggested further steps hospitals could take, including examining how they are reimbursed for services provided. She noted private insurance plans tend to provide the highest reimbursement rates, and said more funding is needed to support TennCare, which does not cover enough of the cost.
"TennCare is all managed by managed-care organizations," Roitman explained. "They negotiate with every hospital about how they're going to reimburse and the big hospitals have some leverage to demand better payment and the smaller hospitals are just, they're just not getting paid."
Roitman added the report credited strong community engagement and effective hospital leadership as key factors in staff retention. Robust management and maintaining an engaged workforce significantly affect a hospital's viability, according to the report.
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Medicare and Medicaid are key sources of health coverage for many Americans and some people qualify for assistance under both programs. With lagging enrollment for the unique plans, outreach efforts are underway.
According to KFF Health News, only about three in 10 people who qualify for Dual-Eligible Special Needs Plans were enrolled in 2021. Experts said the option is designed for people who need additional help because of disabilities, certain health conditions or their age.
Dr. Gina Williams, associate medical director for UnitedHealthcare, said the plans try to take a dynamic approach to serving those eligible.
"Everything from managing your wellness to managing your behavioral health needs and then everyday needs," Williams outlined. "It's kind of a more comprehensive package for people who need a little bit more support."
Everyday needs include meal benefits and bathroom safety devices. The National Council on Aging said D-SNPs aim to provide a more streamlined coordination of care because there is assistance in arranging the services. Wisconsin's enrollment numbers are similar to the national rate, at 28%.
Christine Huberty, lead benefit specialist and northern region supervising attorney for the Greater Wisconsin Agency on Aging Resources, said a tricky component of the plans is navigating provider network restrictions. A rural resident might have to travel farther to see a doctor covered under the plan and she cautioned it warrants careful research when enrolling.
"I would say first and foremost, look at the provider network restrictions," Huberty advised. "Look at what's available in your area."
Meanwhile, Williams noted the push to get more eligible people to sign up coincides with more awareness around preventive care in a post-pandemic world.
"Everybody's kind of going into a phase where they're not only thinking about acute illness, but they're thinking about overall care," Williams observed. "What was the impact of the pandemic from a psychological standpoint? Do you need more support and then you also need more coordination of benefits?"
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In Mississippi and across the country, Community Health Centers are getting a funding increase, thanks to Congress passing a bipartisan spending package.
Community Health Centers in Mississippi serve patients without regard to their insurance status or ability to pay. More than 20 locations in the state provide medical care to more than more than 380,000 people.
Joe Dunn, senior vice president of public policy and advocacy for the National Association of Community Health Centers, said roughly one in 11 Americans gets their care from this type of clinic.
"Community Health Centers are the largest primary care network in the nation, providing care for 31 million Americans," Dunn pointed out. "This network is critically important, because they provide primary care, behavioral health, dental; just an array of services that are so critically needed."
Dunn emphasized more can be done. Research shows more than 100 million Americans need better access to primary care. Community Health Centers in Mississippi also support more than 4,000 jobs and about $678 million dollars in economic activity in the communities where they're located.
Dunn noted the increased funding from Congress will help the clinics provide more comprehensive care and reach more underserved patients, especially in rural communities, which ends up saving the state money.
"By incentivizing people to go get primary care, you alleviate more downstream costs," Dunn emphasized. "There's fewer hospitalizations and complications from chronic conditions, based on preventive screening and care at the outset."
The Congressional Budget Office reports the increase in funding for Community Health Centers just through the end of this year will reduce federal spending on public health insurance programs by more than $700 million.
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