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 forHealth Policy and Services category.
The July issue of Health Affairs 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.
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, 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.
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 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.”
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 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.
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.”
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.
Health Affairs is proud to launch a new Forefront series, “Private Sector Solutions for Health Equity,” featuring analysis, recommendations, and commentary that will inform efforts to advancehealth equity.
The series includes articles exploring private sector efforts to challenge injustices in health care, including public-private partnerships and community initiatives.
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.
Health Affairs is the leading peer-reviewedjournalat 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.
