5 Things Arizona: Republican primary, Access Monitoring Report, 5 Slides

I hope you’re dodging the heat as best you can these days. If you’re a weather geek, you can check out a few interesting blogs (herehere) that help provide you with good knowledge for your next trivia night, from monsoons to cumulus.

The downward trend in COVID cases is a welcome sign. Arizona’s reproductive factor is as low as it’s been since the initial lockdown. Note that it moved below 1 on June 23rd, meaning the tapering that we’re seeing now is a result of the actions over the last full month.

Your actions today lead to data trends a month from now. That’s a long data feedback loop.

 

 

 

 

With help from Michael Goldberg

1. Health care center stage in Republican primary

Sen. Heather Carter, Vice Chair of the Senate Health Committee, is facing a Republican primary challenge from Rep. Nancy Barto, Chair of the House Health Committee, in the August 4th Arizona primary. Barto is seeking to reclaim the seat she held from 2012-2018 before term limits prevented her from seeking re-election. The race has been looked at as an ideological battle between Carter, considered a moderate, and Barto, who has been called a staunch conservative.

Barto is attacking Carter from the right on health care, criticizing her for voting to expand Medicaid and for not opposing the ACA mandates. Barto is in favor of enhancing Medicaid work requirements and has voted against the ACA mandates. Carter has raised $358K while Barto has raised $190K.

 

2. Five Slides: The Health Care System’s Response to COVID in AZ

On Wednesday, August 5, from 12:00 – 1:00 pm MST, we host Ann-Marie Alameddin (CEO, Arizona Hospital and Healthcare Association), Will Humble (Executive Director, Arizona Public Health Association), and Roland Knox (CEO, Mt. Graham Community Hospital) to talk through how the Arizona health care system is continuing to respond to COVID. This Virtual Conversation will feature “5 Slides” brought by our guests and our team at State of Reform, which will feature some of the most pressing things on our guests minds.

We’ll also host a Virtual Conversation on building an anti-racist organization and culture in health care. That’s coming up on Monday, and features two of the more thoughtful people I know on the subject: Ben Danielson, MD, Medical Director at Odessa Brown Children’s Clinic and Melissa Gonzales in the Chief Diversity Office at Genentech.

 

3.  A snapshot of AHCCCS access

In FY 2019, about 1,900,000 enrolled beneficiaries received coverage from AHCCCS, or 26% of Arizona’s 7.2 million population, according to the 2020 Access Monitoring Review Plan released by AHCCCS. Approximately 87% of beneficiaries are enrolled in managed care. The remaining 13%, or approximately 236,000 members, received services through the state’s Fee-for-Service program. Overall, spending amounted to $13.7 billion for Arizona’s Medicaid recipients in FY 2019.

54% of Medicaid beneficiaries are female. Females also make up approximately two-thirds of the TANF population among Medicaid beneficiaries. As of September 30, 2019, Arizona had 37 Medically Undeserved Areas. AHCCCS currently contracts with all but 2 of the state’s hospitals – a roster which includes 89 general acute care hospitals (including 11 Indian Health Services/638 tribal hospitals), 20 psychiatric hospitals, 6 long-term acute care hospitals, and 12 rehabilitation hospitals.

 

4. COVID hospitalizations on the decline

As of Sunday, COVID hospitalizations in Arizona declined by about 14% from the previous week to a seven-day average of 2,919, according to the Atlantic’s COVID Tracking Project. Data from yesterday shows 2,564 total hospitalizations. For most of July, hospitalizations topped 3,000.

While researchers at Arizona State University said this trend will lead to a lower transmission rate, they cautioned that a reporting lag has the ability to distort the interpretation of events. In a copy of a presentation given to State of Reform, they also said that detecting outbreak clusters would be a challenge: “[The] inability of contact tracing to be effective – due to delays in test results – leads to further undetected cases and unknown transmission chains that ultimately first appear in the hospital.”

5. AZ Medicaid enrollment growth in context

Arizona Medicaid/CHIP enrollment increased by 555,974 individuals (45%) between the “Pre-Open Enrollment” period (July 2013 – Sept 2013), which was also pre-Medicaid expansion, and March 2020. This from a recent update from Health Management Associates.The increase in total number of individuals represents the fifth largest increase in the country.

Arizona also has the sixth largest percent growth in Medicaid/CHIP enrollment since March 2019 at 2.6%.  As of July 1, Arizona Medicaid enrollment topped 2 million, an increase of about 140,000 since March. From 2019 to 2020, Arizona saw a 4.6% decrease in Qualified Health Plan selections.