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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 & MOREThe 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 HEALTHQuantifying 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 >>
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THIS WEEK ON THE BLOGFOLLOWING THE ACA
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 the Better 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 >>
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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.
Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, United States
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