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Results for prisoners, medical care

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Author: Pew Charitable Trusts

Title: Managing Prison Health Care Spending

Summary: Nationwide, spending on both health care and corrections is putting serious pressure on state budgets. Medicaid-the largest component of states' health care spending-has been the fastest-growing part of state expenditures over the past two decades, with corrections coming in just behind it. Despite increasing interest among policymakers and taxpayers in improving outcomes and controlling costs in health care and corrections, the intersection of these two areas-health care for prison inmates-has garnered comparatively little attention. To better understand spending for inmate health services, researchers from The Pew Charitable Trusts analyzed cost data from the 44 states included in a study by the federal Bureau of Justice Statistics, or BJS. Pew found that prison health care spending in these 44 states totaled $6.5 billion in 2008, out of $36.8 billion in overall institutional correctional expenditures. Most states' correctional health care spending increased substantially from fiscal 2001 to 2008, the years included in the BJS report: Spending increased in 42 of the 44 states, with median growth of 52 percent. In a dozen states, prison health expenditures grew 90 percent or more. Only Texas and Illinois experienced inflation-adjusted decreases in this spending area. Per-inmate health care spending rose in 35 of the 44 states, with 32 percent median growth. In 39 of the states, prison health care costs claimed a larger share of their total institutional corrections budgets, increasing, on average, from 10 percent in fiscal 2001 to 15 percent in fiscal 2008. Maine, Nevada, North Dakota, Oklahoma, and West Virginia were the only exceptions. This significant growth reflects, in part, the rise in prison populations nationally. From 2001 to 2008, the number of sentenced prisoners in correctional institutions increased by 15 percent, from 1,344,512 to 1,540,100. This rise was part of a multi-decade trend; the number of Americans in prison nearly tripled from 1987 to 2007. The dramatic increase was driven in part by tougher sentencing laws and more restrictive probation and parole policies that have put more people in prison and held them there longer. This trend, however, has recently begun to reverse in about half of the states as sentencing and corrections reforms have spurred reductions in prison populations. The sheer number of state prisoners does not explain all of the increased spending. Higher per-inmate expenses and the expanding slice of corrections budgets devoted to health care suggest that other factors are also pushing costs up, including: Aging inmate populations; Prevalence of infectious and chronic diseases, mental illness, and substance abuse among inmates, many of whom enter prison with these problems; and challenges inherent in delivering health care in prisons, such as distance from hospitals and other providers. Inmates' health, the public's safety, and taxpayers' total corrections bill are all affected by how states manage prison health care services. Effectively treating inmates' physical and mental ailments, including substance abuse, improves their well-being and can reduce the likelihood that they will commit new crimes or violate probation once released. In addition to examining spending data, Pew researchers interviewed correctional health care experts across the country to identify innovative strategies to deliver health care to inmates, protect public safety, and control costs. This report examines Pew's findings on state prison health care spending and explores the factors driving costs higher. It also illustrates a variety of promising approaches that states are taking to address these challenges by examining four strategies that were frequently cited during the expert interviews: the use of telehealth technology, improved management of health services contractors, Medicaid financing, and medical or geriatric parole. These examples offer important lessons as policymakers seek the best ways to make their correctional health care systems effective and affordable.

Details: Washington, DC: Pew Charitable Trusts, 2013.

Source: Internet Resource: Accessed November 7, 2013 at: http://www.pewstates.org/uploadedFiles/PCS_Assets/2013/SHCS_Pew-Managing_Prison_Health_Care_Spending_Report.pdf

Year: 2013

Country: United States

URL: http://www.pewstates.org/uploadedFiles/PCS_Assets/2013/SHCS_Pew-Managing_Prison_Health_Care_Spending_Report.pdf

Shelf Number: 131609

Keywords:
Cost Analysis
Costs of Corrections
Inmate Health Care (U.S.)
Prisoners, Medical Care