State Report: Arizona

Commonwealth Fund State Performance ranking: 26

CMS WILL LAUNCH AN online personal health record (PHR) pilot program for Medicare beneficiaries in Arizona and Utah in January as part of an ongoing effort by the Bush administration to encourage use of healthcare information technology. Under the program, the PHRs will include as much as two years of Medicare data. Medicare beneficiaries will have the ability to add information to their PHRs and share them with physicians, pharmacists and other healthcare providers.

A measure that would prohibit enactment of any law in Arizona that requires people to obtain health coverage appeared on the November ballot. Proposition 101 would forbid any Arizona law that "restricts a person's freedom of choice of private healthcare systems or private plans of any type." In addition, the initiative would bar any state law that would require people to contribute to healthcare programs for refusing to participate. The outcome of the vote was unknown at presstime.

The Arizona legislature and Gov. Janet Napolitano have eliminated a temporary medical coverage program to save about $8.35 million as the state tries to reduce a $2 billion fiscal year 2008-2009 budget deficit. The program, which ended July 15, provided temporary healthcare coverage for people who are ineligible for Medicare or the Arizona Health Care Cost Containment System (AHCCCS). Medicare requires people to wait two years after receiving a disability determination before enrolling in the program. The Arizona initiative was designed to assist people with disabilities during that period by allowing them to pay a premium to gain coverage through AHCCCS.

American Indians have a higher rate of stroke than other groups, which can be attributed to a high prevalence of diabetes, according to a study to be published in Circulation. The report is the first to detail stroke prevalence and risk factors for American Indians. American Indians' mortality rate after a first stroke was 32%, nearly 1.5 times higher than the rates in African Americans or whites.

Banner Page Hospital has introduced a number of measures to reach out to patients from a nearby Navajo reservation. Some native Americans distrust modern medicine and providers' lack of understanding of their culture. To combat that, the 25-bed hospital has incorporated some American Indian traditions, such as making sure the newly renovated emergency department entrance faces the east, where the Navajo believe life originates.

The hospital also provides a traditional Navajo "dwelling place" to conduct ceremonies and incorporate the work of medicine men. Hospital meals now include some traditional Navajo foods.

MHE Sources: Centers for Medicare & Medicaid Services; Urban Institute; Kaiser Family Foundation; U.S. Census Bureau; The Commonwealth Fund.

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