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A Weekly Health Policy Round Up From Health Affairs            

**February 9, 2020**

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IN THE JOURNAL

NEW ISSUE:

OPIOIDS, INVESTING IN SOCIAL DETERMINANTS & MORE

The February issue of Health Affairs includes a cluster of studies that
explore how health systems invest in addressing the social needs of
their patients. It also covers topics such as opioids, the prominence of
guns in political advertising, and a variety of issues related to
Medicaid and Medicare.

The culture of health content in the February issue was supported by the
Robert Wood Johnson Foundation.

Read the February 2020 table of contents.

Listen to a two-minute introduction of the issue from Editor-in-Chief
Alan Weil.

Read "From the Editor in Chief."

CULTURE OF HEALTH

Quantifying Health Systems' Investment In Social Determinants Of
Health, By Sector, 2017-19

By Leora I. Horwitz, Carol Chang, Harmony N. Arcilla, and James R.
Knickman

Leora Horwitz and coauthors find that the increasing interest in social
determinants of health has been accompanied by health systems' direct
investments of at least $2.5 billion toward addressing these issues in
the period 2017-19. The largest share of these programs focused on
housing, with employment and education the next-largest categories.Read
More >>

Upstream With A Small Paddle: How ACOs Are Working Against The Current
To Meet Patients' Social Needs

By Genevra F. Murray, Hector P. Rodriguez, and Valerie A. Lewis

Accountable care organizations (ACOs) have a financial incentive to
invest in overcoming the social barriers their enrollees face if those
investments will reduce health costs. Using qualitative data from
twenty-two ACOs, Genevra Murray and coauthors identify three challenges
these organizations faced: insufficient data on the social needs of
their patients, difficulty developing community-based partnerships, and
financial challenges related to the lag between investments and
financial returns. Read More >>

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Evidence-Based Community Health Worker Program Addresses Unmet Social
Needs And Generates Positive Return On Investment

By Shreya Kangovi, Nandita Mitra, David Grande, Judith A. Long, and
David A. Asch

Tackling the issue of return on investment head-on, Shreya Kangovi and
coauthors show positive returns based on results from a randomized
controlled trial of the community health worker intervention program
called Individualized Management for Patient-Centered Targets (IMPaCT).
Using these workers to address the unmet social needs of high-risk
patients generated an annual return to Medicaid (the payer) of $2.47 for
each dollar spent.
Read More >>

Health Care Spending And Use Among People Experiencing Unstable Housing
In The Era Of Accountable Care Organizations

By Katherine A. Koh, Melanie Racine, Jessie M. Gaeta, John Goldie,
Daniel P. Martin, Barry Bock, Mary Takach, James J. O'Connell, and
Zirui Song

Katherine Koh and colleagues examine the impact of homelessness and
unstable housing on health care spending and use. They compare those
continuously enrolled in the Boston Health Care for the Homeless Program
with those enrolled in Massachusetts Medicaid with no evidence of
experiencing homelessness. The authors find that in the period
2013-15, "average annual unadjusted total spending for people who
experienced episodes of homelessness was 2.5 times greater than that
among the comparison population."
Read More >>

HEALTH EQUITY

Legacies And Lessons: A Final Conversation With Fitzhugh Mullan

By Susan B. Hassmiller

The late academic, physician, policy maker, and writer discusses his
career achievements, lessons for the future, and cancer.Read More >>

THIS WEEK ON THE BLOG

FOLLOWING THE ACA

Unpacking The Timing Of Texas

By Katie Keith (2/6/20)

Yesterday, the Supreme Court of the United States announced that it will
consider whether to hear the appeals in California v. Texas and House v.
Texas during its conference on February 21, 2020. Read More >>

The 2021 Proposed Payment Notice, Part 3: Risk Adjustment

By Katie Keith (2/3/20)

This post covers the proposed changes to the risk adjustment program.
Read More >>

GLOBAL HEALTH

What Questions Should Global Health Policy Makers Be Asking About The
Novel Coronavirus?

By Lawrence O. Gostin (2/3/20)

The world needs to be prepared for the possibility that this
international outbreak will not be contained in the foreseeable future.
Here are some key questions that global health policy makers should be
asking. Read More >>

CONSIDERING HEALTH SPENDING

How A Medicare Part D Inflation Penalty Would Lower Drug Spending For
Patients, Taxpayers, And Employers

By Anna Anderson-Cook, Kevin Love, Andrea Noda, and Mark E. Miller
(2/5/20)

In this post, we analyze potential manufacturer pricing responses to
reinforce that patients, taxpayers, and employers would all save money
if the inflation penalty were to become law. Read More >>

PHARMACEUTICALS AND MEDICAL TECHNOLOGY

We Still Don't Know Who Makes This Drug

By Rena M. Conti, Ernst R. Berndt, Neriman Beste Kaygisiz, and Yashna
Shivdasani (2/7/20)

Here, the authors discuss three interrelated information deficits
plaguing the US generic prescription drug industry and its oversight:
Key details on manufacturing site, volume, and capacity are currently
shielded from public view. Read More >>

HEALTH EQUITY

How Can We Dismantle Health Equity Barriers In Research?

By Lynne Garner, Nancy C. Yedlin, and Jennifer Salopek (2/5/20)

How can funders of research dismantle health equity barriers in grant
application, grantee selection, and other processes? They should work to
root out biases that may be hidden in those processes and may be
inadvertently promoting inequities, say these authors affiliated with a
national foundation. They discuss that foundation's steps to promote
greater equity by raising awareness and revising procedures, as a number
of other funders are doing.
Read More >>

MEDICAID

The Medicaid Block Grant (Experiment) Cometh

By Sara Rosenbaum, Alexander Somodevilla, Morgan Handley, Maria
Velasquez, and Rebecca Morris (2/7/20)

The "Healthy Adult Opportunity" demonstration opens a new phase in
Section 1115 experimentation, one that appears to push 1115 beyond
previous flexibility and innovation limits. The design of the
demonstration raises the question of whether, under its terms, the poor
will gain enough to make it a valid use of Section 1115 powers. Read
More >>

It's Past Time To Provide Continuous Medicaid Coverage For One Year
Postpartum

By Emily Eckert (2/6/20)

The United States is the only industrialized nation with a maternal
mortality rate that is on the rise, increasing 26 percent between 2000
and 2014. Read More >>

TELEHEALTH

How Telehealth Can Expand Community Clinic Access And Specialist
Capacity

By Cory Simpson (2/6/20)

Despite the challenges inherent in telehealth, the rapid expansion of
teletriage for high-demand specialties such as dermatology can be
harnessed to accelerate access to specialist-recommended care for the
many patients waiting for in-person appointments.
Read More >>

PUBLIC HEALTH

Delhi In A Chokehold: Air Pollution As A Public Health Emergency

By Kashish Aneja, Margherita Cina, Juliette McHardy, and Larry Gostin
(2/5/20)

With air pollution in Delhi reaching new peaks, solutions must include
unconventional and unpopular measures that tackle short- and long-term
causes and benefit all residents of the city. Read More >>

PAYMENT

When Site-Of-Service Policy And Payment Reforms Converge: The Case Of
Joint Replacement Surgery

By Joshua M. Liao and Amol S. Navathe (2/3/20)

As we describe via the case of joint replacement, overlaying
site-of-service changes on existing payment models can create complex
challenges, including greater risk for inappropriate patient selection,
distorted performance compared to historical baselines, and potentially
decreased alternative payment model engagement.Read More >>

MILITARY HEALTH SYSTEM

The Social Determinants Of Suicide In The Military

By Kristin Russell, Chris Hunter, and William Shrank (2/4/20)

Health care initiatives that take the unique needs of the US military
population into account are essential, and efforts to reduce military
suicides must include tailored interventions to address loneliness. Read
More >>

LEGAL AND REGULATORY ISSUES

Supreme Court Allows Public Charge Rule To Take Effect While Appeals
Continue

By Wendy E. Parmet (2/3/20)

After almost three years of anticipation, immigrants and their health
care providers will now need to adjust to a rule that is widely expected
to cause millions of noncitizens to disenroll from or forgo Medicaid and
other public health benefits. Read More >>

HEALTH AFFAIRS BRANDED POST

The Value of Medicare Advantage: 21st Century Care

By Allyson Y. Schwartz and Gaurov Dayal (2/4/20)
Supported by theBetter Medicare Alliance

Here's a startling fact: the Centers for Disease Control and
Prevention found that Americans made a record-setting 145.6 million
visits to hospital emergency rooms in 2016 alone, the most recent year
for which this data is available. Read More >>

HEALTH AFFAIRS REQUEST FOR ABSTRACTS-Climate and Health

**Health Affairs** is planning a theme issue on climate and health, to
be published in December 2020. We thank the Kresge Foundation and the
Robert Wood Johnson Foundation for their generous support of this issue.

We primarily seek empirical work-original research, systematic
reviews, well-designed case studies-that presents evidence and
analysis aimed at contributing to our knowledge. Papers should have a
strong policy orientation, and we will put a premium on work that
supports future planning and decision making. We are interested in
reports of successful and failed initiatives and will also consider a
small number of commentaries and overview papers to supplement the
empirical work and provide context.

**Deadline: February 24, 2020**
Preparation and formatting guidelines

Submit abstracts via our online submission form

**Queries:** [email protected]

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About Health Affairs

Health Affairs is the leading peer-reviewed journal
at the intersection of health,
health care, and policy. Published monthly by Project HOPE, the journal
is available in print and online. Late-breaking content is also found
through healthaffairs.org , Health Affairs Today
, and Health Affairs Sunday
Update .  

Project HOPE is a global health and
humanitarian relief organization that places power in the hands of local
health care workers to save lives across the globe. Project HOPE has
published Health Affairs since 1981.

Copyright © Project HOPE: The People-to-People Health Foundation, Inc.

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