Aim Media Indiana
A new report from the IU Richard M. Fairbanks School of Public Health sheds light on the increasingly dire outlook for Hoosier health care in regards to cost, access and quality.
According to the report, Indiana continues to perform worse than the national average in most health outcomes, which have declined over time. Indiana’s mortality rate is nearly 16% higher than the national average, led by an 81% increase in drug deaths since 2020. In addition, the state has higher rates of nearly all chronic diseases, including cardiovascular disease, diabetes, and obesity. Since 2020, cardiovascular disease prevalence increased 30% in Indiana, while the prevalence of diabetes and childhood obesity rose 27% and 24% respectively.
While still higher than the national average, maternal mortality declined 38% and infant mortality declined 2% in Indiana since 2020, according to the report. That has been attributed to the state’s concerted efforts to expand funding for maternal health coverage and programming. The state’s recent $225 million public health investment, a 1,500% increase in statewide funding, is projected to significantly improve overall health outcomes, according to the study.
The study also points out that economically, Indiana’s total per-capita health care spending, including spending for hospital care, physician services, and pharmaceuticals, is nearly identical to the national average and in-line with neighboring states. On average, Hoosiers spend 10.7% of their median income on health care, which ranks below the national average and decreased 7% since 2020.
Indiana differs from other states in its high prevalence of self-insured health plans, the report found. Sixty-six percent of Indiana’s private sector employees are enrolled in self-insured plans, which ranks 20% higher than the national average.
“Over the past few years, self-insurance has grown in Indiana, even while it has declined in the U.S. and each of our neighboring states,” said Dr. Nir Menachemi, dean of the Fairbanks School of Public Health and co-author of the report. “Self-insured employers lack the market power to effectively negotiate prices, and studies show that self-insured plans pay higher prices for the same services. Addressing this market dynamic may result in lower prices.”
The study states high-deductible health plans (HDHPs) are also dominant in Indiana. According to the report, nearly 64% of Hoosier employees are enrolled in HDHPs, which increased 23% since 2020 and ranks higher than the national average.
“The prevalence of high-deductible health plans may partially explain patients’ higher out-of-pocket costs in Indiana, despite our overall average ranking in health care spending,” said Menachemi.
Fairbanks researchers also note that Indiana has a greater shortage of physicians, both in general practice and specialty care, than the rest of the nation, in addition to lower utilization of value-based care payment models.
“Moving toward greater use of value-based payment models, including bundled payments and accountable care in settings where the evidence supports them, may contribute to more cost-effective, patient-centered health care,” said Menachemi.
In the midst of all those numbers is the basic fact that Hoosiers aren’t as healthy as we need to be, and we’re spending too much of our hard-earned dollars on increasingly more expensive health care, and we don’t have adequate health insurance to help us pay for it. And we lack the number of needed physicians and health care workers to take care of us.
While our General Assembly has begun to throw some money at Indiana’s health care crisis, such as enacting hospital price transparency requirements, encouraging competition in the health care industry, implementing the state’s All Payer Claims Database for consumers to compare health care prices, and installing guardrails around previously unregulated market participants such as pharmacy benefit managers, it’s not enough.
It’s time to get serious about healthy lifestyles in Indiana — these statistics show we are taking baby steps when we need to be running toward better health.