February 4, 2022

Improving Outcomes for People with Disabilities

Teresa Kobelt, Director, Office of Policy, OCALI

OCALI exists to inspire change and promote access to opportunities for people with disabilities – it’s all we do, it’s everything we do. Across the lifespan, we work to ensure people with disabilities can live their best lives for their whole lives and we do it with partners.

From “birth to earth,” people with disabilities (PWD) experience access barriers, and health care is no exception. PWD have poorer health outcomes than any other group. They lack adequate provider networks and report significant unmet healthcare needs and philosophical barriers to care. These barriers bear out in the data:

  • In FY2018, only 50% of total eligibles who should have received an initial or periodic screen did.[i]
  • Rates of emergency department (ED) use are 2 to 3 times higher among children and youth with special health care needs.[ii]
  • Adults with disabilities are more likely than their nondisabled peers to be inactive, have high blood pressure, smoke, and be obese.

Not only do people with disabilities experience poor outcomes, but they also experience the highest costs of care. We spend billions of dollars for those results:

  • Ohio’s 2018 Medicaid average per capita spend for non-disabled adults: $6025. For people with disabilities: $16,909.
  • Annual per-enrollee Medicaid spending is more than 7x higher for children who qualify through a disability pathway ($17,831) than for those who become eligible some other way($2,484).
  • Nationally, public insurers paid 69% of disability associated healthcare expenditures (DAHE). More than half (54%) of all Medicare expenditures and almost three quarters of all Medicaid expenditures (72%) were associated with disability.[iii]
  • Estimates put Ohio’s DAHE at $18.9 billion per year.

When I shared this information with the Ohio Association of Health Plans (OAHP) and their members, I met willing, committed, enthusiastic partners who said, “Let’s do something about this!”

So, we did.

Over the past year, OAHP and OCALI convened a diverse group of stakeholders representing people with disabilities, family members, researchers, providers, payors, and community partners to address these barriers. The result: “Improving Outcomes for People with Disabilities” (IOPWD). Using the Core Competencies on Disability for Health Care Education as its foundation, the virtual roundtables address many of the physical and philosophical access issues experienced by PWD.

The current pandemic further demonstrates the need for this series. PWD have been disproportionately impacted by COVID. Discussions about rationing of care, accessible vaccination locations or testing kits, and what lives are “okay” to lose amplify these barriers.

The series kicks off February 8 at noon. If you have not already, take a moment to register now. In 2022, join us in our commitment to improve the health care outcomes of people with disabilities. Inspire change, promote access, and ensure people with disabilities can live their best, healthiest lives for their whole lives!

[i] Form CMS-416 FY2018 Report

[ii] HRSA

[iii] Khavjou OA, Anderson WL, Honeycutt AA, Bates LG, Razzaghi H, Hollis ND, Grosse SD. National Health Care Expenditures Associated With Disability. Med Care. 2020 Sep;58(9):826-832. doi: 10.1097/MLR.0000000000001371. PMID: 32826747; PMCID: PMC7505687.