New Health Equity Forefront Series Sponsored by CVS Health
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Dear John,

Today, we released our July issue. But first, we are excited to announce
that our Impact Factor jumped to 9.7 in 2022. And, we remained the
undisputed #1 rank for Health Policy and Services category.

Read the top article that contributed to this score, "Strong Social
Distancing Measures In The United States Reduced The COVID-19 Growth
Rate
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Read The New Issue
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The July issue of Health Affairs
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provides new evidence related to the Medicare Advantage (MA) program,
assesses Medicare's value-based payment programs, examines options for
improving care for patients with cancer, reveals the effects of Medicaid
expansion on state-level funding for substance use disorder (SUD)
treatment, and more.

Medicare

Deborah Peikes and coauthors analyze 2019-20 survey data regarding the
health-related social needs (HRSNs) of enrollees in a large, national MA
plan
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Eighty percent of dually eligible Medicare and Medicaid enrollees
reported at least one HRSN; the three most common needs were financial
strain, food insecurity, and poor-quality housing.

Forty-eight percent of Medicare-only enrollees reported one or more
HRSNs, and more than 10 percent reported three or more.

Integrating care for dually eligible Medicare and Medicaid enrollees has
been a long-standing policy goal, and Dual-Eligible Special Needs Plans
(D-SNPs) are the dominant integrated care mode for this population.

Yanlei Ma and coauthors examine trends in enrollment in D-SNP look-alike
plans
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which they call "a potential threat to national and state integration
efforts" because look-alike plans are not subject to the same state
and federal requirements regarding care integration as D-SNPs.

They find that the number of look-alike plans with at least 80 percent
enrollment of dual eligibles grew from six plans in 2013 to fifty-eight
in 2020, and the number of dual-eligible enrollees in these plans
increased elevenfold.

Jane Zhu and coauthors explore the breadth of psychiatrist networks
within MA plans
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They find that "on average, psychiatrist network breadth was much
narrower in MA than in Medicaid managed care and [Affordable Care Act
(ACA)] plan markets in 2019."

Although nearly two-thirds of psychiatrist networks in MA plans were
narrow, defined as including fewer than 25 percent of the providers in
the county, 40 percent of networks in Medicaid managed care and ACA plan
markets were narrow.

Charles Kahn III and colleagues examine the three primary programs
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that make up the Centers for Medicare and Medicaid Services' (CMS's)
approach to hospital value-based payment, updating earlier work to
explore how penalties imposed in fiscal year 2021 relate to hospital,
patient, and community factors.

They find that "patient and community health equity risk factors are
associated with hospital penalties, albeit inconsistently" and
conclude that "these types of variables should be considered in CMS
health equity efforts because not doing so may penalize hospitals that
serve more vulnerable populations and communities."

Read More
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Cancer Care

Immune checkpoint inhibitors are a class of drugs commonly used in
cancer therapy and typically administered using "one-size-fits-all"
flat doses.

Alex Bryant and coauthors use a patient-level simulation of weight-based
dosing on Veterans Health Administration data and conclude that this
approach, along with common stewardship policies across pharmacies,
could generate $74 million in annual savings for the Veterans Affairs
health system
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Xuesong Han and coauthors examine the relationship between Medicaid
expansion and palliative care
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uptake among people with advanced-stage cancers.

They find that "state-level Medicaid expansion under the ACA was
associated with greater increases in receipt of guideline-recommended
palliative care among patients undergoing initial treatment for newly
diagnosed stage IV cancers."

Describing his experience navigating choices
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related to his cancer treatment, Tom Doyle in Narrative Matters asks
whether, by using formal decision aids, "medicine and policy makers
can do a better job of providing patients the resources necessary" to
select the care that is right for them.

Read More
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Medicaid

Medicaid is the largest source of funding for SUD services in the US,
and Medicaid expansion yielded a large increase in that spending.

Christina Andrews and coauthors analyze changes in state funding for SUD
treatment during 2010-19
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They find "evidence that states that expanded Medicaid cut state
spending for SUD treatment and prevention, with the effect of shifting
some of the financial burden for financing these activities from the
state to the federal level."

With an eye toward understanding what will happen as continuous Medicaid
eligibility comes to an end, Erica Eliason and coauthors examine
postpartum coverage loss just before the COVID-19 pandemic
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Based on survey data from seven states, they find that approximately
one-third of prenatal Medicaid enrollees did not have continuous
Medicaid coverage through the late postpartum period, and of those who
lost Medicaid during the early postpartum period, nearly two-thirds
remained consistently uninsured.

Greta Bushnell and coauthors examine antipsychotic use in children
enrolled in Medicaid between 2008 and 2016
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They conclude that antipsychotic use declined by 43 percent during this
period, decreasing across all racial and ethnic groups.

Order The Issue
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If you haven't already, join Health Affairs Unlimited to access our
current and past issues
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and our premium newsletters and virtual events.

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This month, join us for the following events:

* July 10: Lunch and Learn: Supreme Court Wrap Up
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* July 13: Lunch and Learn: Residential Segregation, Health, and Health
Equity
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View Full Event Schedule
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Health Affairs is proud to launch a new

**Forefront**series, "Private Sector Solutions for Health Equity
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featuring analysis, recommendations, and commentary that will inform
efforts to advance health equity.

The series includes articles exploring private sector efforts to
challenge injustices in health care, including public-private
partnerships and community initiatives.

The latest in three-already published articles comes from Adaeze
Enekwechi who argues that private capital is a key component to
improving health equity
<[link removed]>.

We are grateful to CVS Health <[link removed]> for
supporting this series.  

Read the Series
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New Policy Brief: Energy Insecurity and Health: America's Hidden
Hardship

Energy insecurity can have important implications for health and health
equity. Many long-standing programs to address energy insecurity need to
be refreshed in light of climate change, the recognition of unacceptable
disparities, and the impending transition to clean energy.

Robert Wood Johnson Foundation <[link removed]> provided support
for this brief.

Read the Brief
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mailto:[email protected]

About Health Affairs

Health Affairs is the leading peer-reviewed journal
<[link removed]> 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 <healthaffairs.org>, Health Affairs Today
<[link removed]>, and Health Affairs Sunday
Update <[link removed]>.  

Project HOPE <[link removed]> 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, 1220 19th Street, NW, Suite 800, Washington, DC 20036, United States

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