Wyoming

Wyoming’s healthcare bill keeps going up.

• Wyoming spent $2.7 billion on healthcare in 2004, and the bill keeps going up, at an 8% average annual increase between 1991 and 2004.[1]
• Wyoming spent $5,265 (in 2004) per capita on healthcare, more than twice the nation’s average per capita spending on food ($2,207).[2]
• Yet 15% of residents (about 75,000 people) in Wyoming remain uninsured.[3]
• People in Wyoming who purchase employer-based health insurance pay higher premiums than the average cost nationally. On average, Wyoming workers pay $3,960 for single coverage (compared to $3,336 nationally) and $9,790 for family coverage (compared to $8,536 nationally).[4]
• Between 2002 and 2005, family premiums in Wyoming increased 23.6%, while median earnings of people purchasing family coverage only increased by 11.67%.[5]
• People who buy health insurance through their small business (between two and fifty employees) cannot be excluded due to health condition and the state has issued some cost protections for premium rates.[6]
• The self-employed and people who must buy individual policies have few protections. They may pay very high rates or be permanently denied coverage due to health status or other factors. Insurance companies can permanently exclude coverage for pre-existing conditions due to a health condition, body part, or body system.[7]
• The state has a high risk pool program for people who can’t afford individual private insurance or who are denied coverage ‘WHIP’ but it offers no family coverage and individuals must pay at least a $1,000 annual deductible with up to $2,000 out-of-pocket per year, or a $5,000 annual deductible with up to $5,000 out-of-pocket per year. Except for people who were continuously covered for 18 months under a group plan prior to joining the pool, WHIP excludes coverage for all pre-existing conditions (including pregnancy) for 12 months.[8] 

Wyoming faces challenges in delivering rural healthcare services.

• According to the Wyoming Healthcare Commission, 17 out of 23 counties are currently below the national average physician to population ratio of 2.81:1,000. Eight of these counties are less than 1:1,000 with the two counties of greatest need at about 25% of the national average physician to population ratio.[9]
• The Rural Policy Research Institute reports that, when ranked in comparison to other states on a set of 24 quality improvement indicators, Wyoming ranked tenth in 1998-1999 but twenty-first in 2000-2001.[10]
• Compared to other states, Wyoming offers fewer rural training programs for family physicians.[11]
• The Wyoming Department of Health will award up to $80,000 in state funds to assist hospitals, clinics, physicians and other appropriate Wyoming agencies in physician recruitment.[12]

Patients in Wyoming receive average care in most settings, according to standardized quality measures.

• Pneumonia patients in Wyoming receive antibiotics within 4 hours of hospital admission at a slightly higher rate than the national average (78% of Wyoming patients compared to 76% nationally).[13]

• Yet a lower percentage of heart attack patients receive a beta-blocker within 24 hours of admission (89% of patients in Wyoming compared to 93% on average elsewhere).[14]
• A much lower percentage of heart failure patients in Wyoming receive a common heart evaluation than the national average (66% of Wyoming patients compared to 91% on average in other states) and nearly a third of heart failure patients do not receive the recommended care they need, according to a national standard.[15]
• Nearly 1 in 10 Wyoming nursing home patients have had a catheter left in their bladder too long, higher than the average nationally (5%), which puts them at a high risk of infection.[16]
• A lower percentage of home health patients in Wyoming (32%) improve at taking their oral medications than the national average (39%).[17]

Too many patients are injured by unsafe care.

• Wyoming has no hospital infection reporting law. No hospital infection rates are available.
• Although the true number of patients harmed by medical errors in each state is neither collected nor reported to the public, the Institute of Medicine estimates as many as 98,000 Americans die from these preventable mistakes each year. These errors range from doing surgery on the wrong part of the body to serious bed sores to getting the wrong dose of medication.[18]
• Potentially preventable medical errors that occur during or after surgery cause 10 percent of surgery-related deaths and may cost employers nearly $1.5 billion a year.[19]

Wyoming faces challenges with preventative screenings for its residents.

• Approximately 32% of women in Wyoming age 40 and over did not have a mammogram in the last 2 years, compared to 26% nationwide. 23% of Wyoming women did not have a pap smear in the last 3 years, compared to 19% nationwide.[20]
• About 70% of Wyoming men age 50 and over did not have a colonoscopy in the last 5 years, compared to 60% on average nationwide.[21]

Footnotes:

[1] http://www.statehealthfacts.org/profileind.jsp?ind=592&cat=5&rgn=52; http://www.statehealthfacts.org/profileind.jsp?ind=595&cat=5&rgn=52

[2] http://www.statehealthfacts.org/profileind.jsp?ind=596&cat=5&rgn=52; http://www.ers.usda.gov/publications/eib23/eib23fm.pdf  Average yearly expenditure on food in U.S. urban households in 2004.

[3] http://www.statehealthfacts.org/profileind.jsp?cat=3&sub=39&rgn=52 (2005-2006).

[4] http://www.statehealthfacts.org/profileind.jsp?cat=5&sub=67&rgn=52 Reflects 2006 data.

[5] http://www.rwjf.org/files/research/042508ctuwfinalembargoed.pdf

[6] http://www.statehealthfacts.org/profileind.jsp?cat=7&sub=86&rgn=52

[7] http://www.statehealthfacts.org/profileind.jsp?cat=7&sub=87&rgn=52; http://healthinsuranceinfo.net/getinsured/wyoming/individual-health-plans/individual-health-insurance-sold-by-private-insurers/

[8] http://www.statehealthfacts.org/profileind.jsp?cat=7&sub=89&rgn=52; http://insurance.state.wy.us/WHIP/2007-2008%20forms/Whipbrochure042008.pdf

[9] http://www.health.wyo.gov/rfhd/rural/Physician_Recruitment.html January 2008

[10] http://www.wyominghealthcarecommission.org/images/reports/07-24-07RUPRI%20Summary%20Report%20Final%20July%2019,%202007.pdf pp.3.

[11] http://depts.washington.edu/wwamiric/pdfs/monograph/RuralCh4Comparisons.pdf  pp.41

[12] http://www.health.wyo.gov/Media.aspx?mediaId=5139

[13] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=WY&level=5&region=0&compGroup=N Reflects 2005 data.

[14] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=WY&level=2&region=0&compGroup=N (2005).

[15] Ibid 8. 69% of Wyoming heart failure patients receive recommended hospital care compared to 89% on average nationally.

[16] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=WY&level=6&region=0&compGroup=N (2006). http://www.cdc.gov/ncidod/dhqp/gl_catheter_assoc.html

[17] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=WY&level=4&region=0&compGroup=N (2006).

[18] Institute of Medicine, To Err is Human, Kohn, Linda, Corrigan and Donaldson, 2000, pp.26, 35.

[19] http://www.ahrq.gov/news/press/pr2008/surgerrpr.htm AHRQ July 2008 study based on a nationwide sample of more than 161,000 patients age 18 to 64 in employer-based health plans who underwent surgery between 2001 and 2002.

[20] http://statesnapshots.ahrq.gov/snaps07/meter_metrics.jsp?menuId=4&state=WY&level=1&region=0&compGroup=N (2005).

[21] http://www.cdc.gov/nccdphp/publications/factsheets/ChronicDisease/wyoming.htm