1 1 Commonwealth Fund Scorecard on Health System Performance, 017 Florida Florida's Scorecard s (a) Overall Access & Affordability Prevention & Treatment Avoidable Hospital Use & Cost 017 Baseline 39 39 41 44 45 45 41 3 Healthy Lives 0 0 Equity 33 4 Number of indicators where Florida improved, worsened or stayed the same (b) Little/ 1 3 4 of 39 Total Indicators of 5 Access & Affordability Indicators 7 5 3 of 15 Prevention & Treatment Indicators of 9 Avoidable Hospital Use & Cost Indicators 1 9 Income Equity 4 1 8 1 of 10 Healthy Lives Indicators Race/Ethnicity Equity 6 5 6 9 4 1 Children ages 0 18 uninsured Adults ages 19 64 uninsured of 17 Income Equity Indicators Before and after implementation of the Affordable Care Act (ACA) coverage expansions of 14 Race Equity Indicators in past 499,891 3,6,35 3,17,860 31,193,300,40,71,65 (before ACA coverage expansions) Estimated impact of state improvement (c) 44,10 (after ACA coverage expansions) If Florida improved to the level of the best-performing state for this indicator, then: 1,745,54 more adults (age 18 and older) would have a usual source of care to help ensure that care is coordinated and accessible when needed 936,814 more adults would receive age- and gender-appropriate recommended cancer screenings more children (ages 19-35 months) would receive all recommended vaccines 76,510 4,840 10,98 fewer Medicare beneficiaries would receive an unsafe medication fewer premature deaths (before age 75) would occur from causes that are potentially treatable or preventable with timely and appropriate care fewer emergency department visits for nonemergent or primary-care-treatable conditions would occur among Medicare beneficiaries 1
Commonwealth Fund Scorecard on Health System Performance, 017 Table 1. Health System Performance Indicator by Dimension Dimension and indicator ACCESS & AFFORDABILITY Adults ages 19 64 uninsured Best state 0 13 4 49 0 Substantial change over time (a) Children ages 0 18 uninsured 7 5 1 36 1 8 in past 17 13 7 48 1 16 Individuals under age 65 with high out-of-pocket medical costs relative to their annual household income -15 15 14 10 7 At-risk adults without a routine doctor visit in past two s 1 13 6 19 14 14 Adults without a dental visit in past 17 16 11 37 18 15 PREVENTION & TREATMENT Adults with a usual source of care 78 78 89 73 76 Adults with age- and gender-appropriate cancer screenings 67 68 77 8 68 69 Adults with age-appropriate vaccines 38 51 51 8 36 Children with a medical home 011/1 50 54 69 45 Children with a medical and dental preventive care visit in the past Children with emotional, behavioral, or developmental problems who received needed mental health care in the past Children ages 19 35 months who received all recommended doses of seven key vaccines Medicare beneficiaries who received at least one drug that should be avoided in the elderly Medicare beneficiaries with dementia, hip/pelvic fracture, or chronic renal failure who received a prescription drug that is contraindicated for that condition Medicare fee-for-service patients whose health provider always listens, explains, shows respect, and spends enough time with them Risk-adjusted 30-day mortality among Medicare beneficiaries hospitalized for heart attack, heart failure, pneumonia, or stroke Central line-associated bloodstream infections (CLABSI), Standardized Infection Ratio Hospitalized patients given information about what to do during their recovery at home Hospitalized patients who reported hospital staff always managed pain well, responded when needed help to get to bathroom or pressed call button, and explained medicines and side effects Home health patients who get better at walking or moving around Home health patients whose wounds improved or healed after an operation High-risk nursing home residents with pressure sores Long-stay nursing home residents with an antipsychotic medication 011/1 60 68 81 45 011/1 58 61 86 35 07/ - 06/ 67 7 81 46 14 13 7 38 19 18 10 75 14. 76 14.5 69 66 80 30 13.1 11 0. 8 64 68 74 45 9 90 95 5 07/010-06/ 85 87 90 41 7 8 6 6 3 6 18 17 8 34 39 65 9 70 6 6 70 16 17 1 1 76 76 13.1 13. 0.6 83 86 63 68 61 89 1
Commonwealth Fund Scorecard on Health System Performance, 017 Table 1. Health System Performance Indicator by Dimension (continued) Dimension and Indicator Best state Substantial change over time (a) AVOIDABLE HOSPITAL USE & COST Hospital admissions for pediatric asthma, per 100,000 children 157 107 7 39 011 145 107 Hospital admissions among Medicare beneficiaries for ambulatory care sensitive conditions, ages 65 74, per 1,000 beneficiaries (b) 7 1 33 8 Hospital admissions among Medicare beneficiaries for ambulatory care sensitive conditions, age 75 and older, per 1,000 beneficiaries (b) 7 66 35 34 68 70 Medicare 30-day hospital readmissions, per 1,000 beneficiaries 30 7 10 31 34 34 Short-stay nursing home residents readmitted within 30 days of hospital discharge to nursing home 19 11 46 0 Long-stay nursing home residents hospitalized within a sixmonth period 16 5 47 3 17 Home health patients also enrolled in Medicare with a hospital admission 15.9 16. 13.9 16 15 16 Potentially avoidable emergency department visits among Medicare beneficiaries, per 1,000 beneficiaries 185 185 1 7 179 188 Total reimbursements per enrollee (ages 18 64) with employer-sponsored insurance $4,53 $4,569 $3,17 33 $4,459 $4,489 Total Medicare (Parts A & B) reimbursements per enrollee $10,434 $8,819 $5,59 50 $10,597 $8,854 HEALTHY LIVES Mortality amenable to health care, deaths per 100,000 population Years of potential life lost before age 75-14 80.3 84. 54.3 7 011-1 80.3 84 6575. 6447.3 4891.6 6 6555.9 641.3 Breast cancer deaths per 100,000 female population 19.7 0.6 14. 19 0.6 1.4 Colorectal cancer deaths per 100,000 population 13.3 14.3 10.9 14 13.8 14.9 Suicide deaths per 100,000 population 13.9 13.0 7.8 4 14.3 1.6 Infant mortality, deaths per 1,000 live births 6.1 6.0 4. 5 6.1 6.0 Adults ages 18 64 who report fair/poor health or activity limitations because of physical, mental, or emotional problems 6 6 0 7 8 6 Adults who smoke 16 17 9 15 17 18 Adults ages 18 64 who are obese (BMI >= 30) 7 0 15 7 Children ages 10 17 who are overweight or obese (BMI >= 85th percentile) 011/1 8 31 13 Adults ages 18 64 who have lost six or more teeth because of tooth decay, infection, or gum disease 11 10 6 34 11 10 3
Commonwealth Fund Scorecard on Health System Performance, 017 Table. Equity Indicator The Equity profile displays gaps in performance for vulnerable populations for selected indicators. An equity gap is defined as the difference between the national for a particular indicator and the for the state's most vulnerable by income and race/ethnicity. For all equity indicators, lower s are better; therefore, a positive or negative gap value indicates that the state's most vulnerable is better or worse than the for a particular indicator. Equity Type and Indicator Change in vulnerable (b) LOW-INCOME Uninsured ages 0 64 33 13-0 47 46 0-6 in past 13-16 46 34 16-18 At risk adults without a doctor visit 16 13-3 5 18 14-4 Adults without a dental visit in past 8 16-1 44 5 15-10 Adults without a usual source of care 8-6 34 34 4-10 Adults without age- and gender-appropriate cancer screenings 40 3-8 40 41 31-10 Adults without age-appropriate vaccines 76 6-14 51 76 64-1 Children without a medical home 011/1 6 46-16 47 Children without a medical and dental preventive care visit in the past 011/1 48 3-16 48 Children ages 19 35 months without all recommended vaccines (c) 3 8-4 3 36 3-4 Elderly patients who received a high-risk prescription drug 18 13-5 38 19 17 - Hospital admissions for pediatric asthma, per 100,000 children 14 107-107 199 143-56 Medicare admissions for ambulatory care sensitive conditions (d) 108 44-64 43 106 48-58 Medicare 30-day hospital readmissions, per 1,000 beneficiaries (d) 94 35-59 51 99 43-56 Potentially avoidable ED visits among Medicare beneficiaries, per 1,000 beneficiaries (d) 345 185-160 6 38 188-140 Adults with poor health-related quality of life 41 6-15 39 6-13 Adults who smoke 17-5 1 0 18 - Adults who are obese 3-3 7 33-4 Adults who have lost six or more teeth 17 10-7 3 17 10-7 RACE/ETHNICITY (e) Uninsured ages 0 64 (Hispanic ethnicity) 8 13-15 18 43 0-3 in past (other 7 13-14 44 7 16-11 At risk adults without a doctor visit (Hispanic ethnicity) 19 13-6 1 19 14-5 Adults without a dental visit in past (black 4 16-8 8 15-14 Adults without a usual source of care (Hispanic ethnicity) 3-10 11 40 4-16 Adults without age- and gender-appropriate cancer screenings (other 38 3-6 4 38 31-7 Adults without age-appropriate vaccines (Hispanic ethnicity) 80 6-18 50 76 64-1 Children without a medical home (black 011/1 68 46-4 4
Commonwealth Fund Scorecard on Health System Performance, 017 Table. Equity Indicator (continued) The Equity profile displays gaps in performance for vulnerable populations for selected indicators. An equity gap is defined as the difference between the national for a particular indicator and the for the state's most vulnerable by income and race/ethnicity. For all equity indicators, lower s are better; therefore, a positive or negative gap value indicates that the state's most vulnerable is better or worse than the for a particular indicator. Equity Type and Indicator RACE/ETHNICITY (continued) Children without a medical and dental preventive care visit in the past (other Children ages 19 35 months without all recommended vaccines (Hispanic ethnicity) (c) 011/1 44 3-1 38 1 8 7 Change in vulnerable (b) 41 3-9 Mortality amenable to health care (black -14 138 84. -53.4 17 011-1 139 84-54.6 Infant mortality, deaths per 1,000 live births (black -13 1 6.0-4.5 19 010-11 1.6 6.5-6.1 Adults with poor health-related quality of life (Hispanic ethnicity) 7 6-1 4 30 6-4 Adults who smoke (other 16 17 1 5 15 18 3 Adults who are obese (black 34-5 13 35-6 Adults who have lost six or more teeth (black 10 10 0 8 1 10 - Table 3. Summary of Equity Indicator Change CHANGE IN EQUITY GAP Equity Dimension Low Income Race/Ethnicity 017 Scorecard s Indicators with trends No change in gap Gap narrowed/ vulnerable improved Gap widened/ vulnerable worsened 33 31 9 15 7 49 17 5 6 6 19 14 4 9 1 Notes: Cover Page. (a) The 017 Scorecard s generally reflect or data; Baseline s generally reflect or data. The Baseline s generally align with Baseline s reported in the December Scorecard report. The 017 Scorecard added or revised several performance measures relative to what was reported in the December Scorecard report; overall and dimension s are not strictly comparable between these reports. (b) or worsened denotes a change of at least one-half () of a standard deviation (a statistical measure of variation) larger than the indicator s distribution among all states over the two time points. No change denotes no change in or a change of less than one-half of a standard deviation. The Equity dimension is sepad into two sub dimensions, Income and Race/Ethnicity. For interpretation of changes in the Equity dimension, see Table, note (b) below. (c) The table shows the estimated impact if this state's performance improved to the of the best-performing state for selected Scorecard indicators. Benchmark states, those with the best, have an estimated impact of zero (0). Table 1. (*) not available for this state. () Historical data not available or not comparable over time. (a) Substantial change (improvement or worsening) refers to a change between the baseline and current time periods of at least standard deviations. (b) Hospital admissions among Medicare beneficiaries for ambulatory care sensitive conditions are displayed here sepaly for two age ranges, but counted as a single indicator in tallies of improvement. Table. (*) not available for this state. () Historic data not available or not comparable over time. (a) Gaps measure the difference between the most vulnerable in this state, by income or race/ethnicity, and the national for each indicator. (b) Improvement indicates that the gap between this state's vulnerable population and the has narrowed AND that the vulnerable in this state has improved. Worsening indicates that the gap between this state's vulnerable population and the has widened AND that the vulnerable in this state has worsened. No change indicates that either the gap narrowed but the vulnerable worsened, or the vulnerable improved but the gap widened. (c) Different data s were used in the equity analysis than were reported for the entire state population. (d) Measures constructed from 0% Medicare sample for the equity analysis. for equity analysis provided by A. Jha, Harvard School of Public health. Refer to the 017 Scorecard report appendix for source information for entire state population. (e) Gaps are based on the state's non white population with the largest observed difference from the. The racial/ethnic minority with the largest gap is noted for each indicator. Race/ethnicity is generally defined as white race (non-hispanic), black race (non-hispanic), Hispanic ethnicity (can include individuals of any, and other race (non-hispanic) which includes individuals who self-identify as being some race/ethnicity not otherwise categorized. 5