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A Weekly Health Policy Round Up From Health Affairs            

**February 16, 2020**

HEALTH AFFAIRS EVENTS-The Affordable Care Act Turns 10

Registration Now Open!
Tuesday, March 10, 2020
9:00 am - 1:00 pm Eastern
W Hotel Washington - 515 15th Street NW, Washington DC  20004
Register Today
 
 View Speaker List

The March 2020 issue of Health Affairs, "The Affordable Care Act Turns
10," offers must-read analyses of the ACA. Authors explain the law's
effects on coverage, cost, health status, and more. They also review the
political and legal issues that have shaped implementation and consider
what should come next. On March 10, Health Affairs will host a special
event to amplify the work.

Please join us for a special briefing when panels of authors and other
experts will present their work and participate in a robust discussion
of the topic including members of the audience.

Pre-order Issue

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delivered directly to your inbox.

THIS WEEK ON THE BLOG

FOLLOWING THE ACA

ACA Guidance Round-Up: Draft Letter To Issuers, QHP Compliance Report,
HRAs, And More

By Katie Keith (2/12/20)

On January 31, 2020, the Centers for Medicare and Medicaid Services
(CMS) released its proposed 2021 Notice of Benefit and Payment
Parameters rule. In conjunction with the proposed rule, CMS released
additional documents including the 2021 draft letter to issuers in the
federal marketplace. CMS also released guidance for states on the use of
excepted benefits health reimbursement arrangements, a summary report on
qualified health plan compliance, and new frequently asked questions on
the Summary of Benefits and Coverage. This post summarizes these
documents. Read More >>

New Lawsuits Challenge Abortion Policy, AHP Advisory Opinion

By Katie Keith (2/10/20)

Regular readers are familiar with the heaps of litigation over the
Affordable Care Act (ACA) and efforts by the Trump administration to
undermine the ACA. This post introduces two new lawsuits to the mix,
both related to recently finalized rules from the Trump administration.
Read More >>

COSTS & SPENDING

Prices Drove Spending Growth: Trends In Employer-Sponsored Insurance
Costs, 2014-2018

By Niall Brennan, Jean Fuglesten Biniek, and John Hargraves

The latest annual report from the Health Care Cost Institute shows that
average health care spending climbed to an all-time high in 2018 of
$5,892 per person for individuals with health insurance coverage through
an employer. That amounts to an average annual growth rate of 4.3
percent between 2014 and 2018.Read More >>

HEALTH INFORMATION TECHNOLOGY

ONC Should Not Delay The Release Of Its Rule

By Lucia C. Savage, Aaron Neinstein, Mark Savage, and Julia
Adler-Milstein (2/10/20)

Stakeholders such as electronic health record vendors, providers, and
app developers must do their part and act in the spirit of the new
regulations, not lobby against them, and give Americans what they
deserve: the ability to have their data move to where it is needed. Read
More >>

PAYMENT

The Center For Medicare And Medicaid Innovation Can Be A Powerful Force
To Accelerate Change, But Not Without Key Reforms

By Jeff Micklos, Clare Pierce-Wrobel, and Joshua Traylor (2/12/20)

Vanguard organizations that committed to the value-based payment mission
from the outset have learned much in their journeys. The Innovation
Center should focus new efforts on enticing those providers still
clutching onto fee-for-service for dear life to join the effort.
Read More >

BEHAVIORAL HEALTH CARE

Battling The Mental Health Crisis Among The Underserved Through State
Medicaid Reforms

By James Maxwell, Angel Bourgoin, and Zoe Lindenfeld (2/10/20)

State policy makers should use all available policy levers to advance
access and prevent the devastating and often tragic consequences that
these unmet mental health and substance use disorder needs can have on
the lives of individuals and families. Read More >>

MEDICARE

CMS Releases Advance Notice For Medicare Advantage And Part D Plans

By Billy Wynne and Josh LaRosa (2/10/20)

Last week, the Centers for Medicare and Medicaid Services released Part
II of its Advance Notice of Methodological Changes for Medicare
Advantage (MA) Capitation Rates and Part D Payment Policies for Calendar
Year (CY) 2021 and its proposed rule on policy and technical changes to
MA and Part D for CYs 2021 and 2022. This post focuses on summarizing
the Advance Notice component of this package of policies. Read More >>

QUALITY OF CARE

Cold Water Or Rocket Fuel? Lessons From The Camden "Hot-Spotting"
Randomized Controlled Trial

By Eric C. Schneider and Tanya B. Shah (2/11/20)

Built on the logic that a fairly small number of individuals have
disproportionately high health care costs because they use more
emergency and hospital care, the Camden Coalition designed and
implemented an intuitively appealing intervention: intensive case
management to achieve better coordination of care and remedy the unmet
social, medical, and emotional needs that can drive a revolving door of
emergency care visits. Read More >>

DETERMINANTS OF HEALTH

Don't Throw Cold Water On Health Care's Hot Spotters

By Shreya Kangovi and David Grande (2/11/20)

The Camden Coalition program was at the forefront of the modern movement
to link social interventions to health care delivery. Read More >>

GLOBAL HEALTH

Novel Coronavirus Should Prompt Examination Of Impact Of Outbreaks On
Health Care Workers

By Nakisa B. Sadeghi and Leana S. Wen (2/14/20)

Health care workers are on the front lines of epidemics, where they care
for patients affected by the disease in question. This blog will discuss
the impact of infectious disease outbreaks on health care workers and
strategies for building a robust health workforce that is equipped to
respond to health crises. Read More >>

MATERNAL & CHILD HEALTH

Revisiting CHIP Buy-In Programs For Children

By Megan McCarthy-Alfano, Janet Weiner, Amaya Diana, Elizabeth Hagan,
and Kristin Wikelius (2/14/20)

Properly designed, targeted, and marketed, buy-in programs could be a
cost-effective way of moving toward universal coverage for children.
Read More >>

COSTS & SPENDING

Prices Drove Spending Growth: Trends In Employer-Sponsored Insurance
Costs, 2014-2018

By Niall Brennan, Jean Fuglesten Biniek, and John Hargraves (2/13/20)

The latest annual report from the Health Care Cost Institute shows that
average health care spending climbed to an all-time high in 2018 of
$5,892 per person for individuals with health insurance coverage through
an employer. That amounts to an average annual growth rate of 4.3
percent between 2014 and 2018.Read More >>

PHARMACEUTICALS AND MEDICAL TECHNOLOGY

The Grass Is The Same Colour, Part II: Prescription Drug Woes On Both
Sides Of The US-Canada Border

By Oliver Kim (2/13/20)

There are many lessons-both in terms of politics and policy-that
Canadians can learn from mistakes and successes associated with
enactment of Medicare Part D, the ACA, and other federal programs in the
US. Read More >>

PUBLIC OPINION

FORESIGHT: How Good Could Our Health Be In The Future If We Start
Shaping It Differently Now?

By Raymond Baxter and Laura Landy (2/13/20)

The three-year FORESIGHT initiative, supported by 17 foundations, seeks
new ways to look at the future of health. It is combining information
about both current trends already having an impact and emerging issues,
with insights into what people and communities-in several localities
around the country-need and want. FORESIGHT leaders envision that the
initiative will point to new ways to create equitable and sustainable
systems for health. Read More >>

IN THE JOURNAL

NURSES

Implications Of The Rapid Growth Of The Nurse Practitioner Workforce In
The US

By David I. Auerbach, Peter I. Buerhaus, and Douglas O. Staiger

According to David Auerbach and coauthors, an important recent
development in the US nursing workforce is the dramatic increase in the
number of advanced practice registered nurses (RNs), particularly those
who are prepared as nurse practitioners (NPs), with higher earning
potential. The authors examined data from the Census Bureau's American
Community Survey for the period 2010-17 and found that during that
time the number of NPs in the US rose from approximately 91,000 to
190,000. Read More >>

POLITICS

Guns In Political Advertising Over Four US Election Cycles, 2012-18

By Colleen L. Barry, Sachini Bandara, Erika Franklin Fowler, Laura Baum,
Sarah E. Gollust, Jeff Niederdeppe, and Alene Kennedy Hendricks

Colleen Barry and coauthors analyzed data on more than fourteen million
candidate-related television advertisement airings for national and
state races for political office in the 2012, 2014, 2016, and 2018
election cycles. Read More >>

PHARMACEUTICALS & MEDICAL TECHNOLOGY

Non-Infection-Related And Non-Visit-Based Antibiotic Prescribing Is
Common Among Medicaid Patients

By Michael A. Fischer, Mufaddal Mahesri, Joyce Lii, and Jeffrey A.
Linder

Amid growing concern about antibiotic overuse, which can contribute to
resistance, Michael Fischer and colleagues use Medicaid claims data to
explore inappropriate prescribing behavior. They find that "28 percent
[of antibiotic prescriptions] were not associated with a recent
[clinician] visit, and another 17 percent were dispensed without
evidence of a visit that had an infection-related diagnosis." Read
More >>

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DETERMINANTS OF HEALTH

Renovating Subsidized Housing: The Impact On Tenants' Health

By Ingrid Gould Ellen, Kacie L. Dragan, and Sherry Glied

Many public and subsidized housing developments in the US are aging and
in need of significant repairs. Ingrid Gould Ellen and coauthors
evaluated a recent renovation of public housing that was undertaken
through the transfer of six housing developments from the New York City
Housing Authority to a public-private partnership to see whether the
renovation and transfer to private managers led to improvements in
tenants' health over three years, as measured by Medicaid claims. Read
More >>

MATERNAL & CHILD HEALTH

Five-Year Outcomes Among Medicaid-Enrolled Children With In Utero Opioid
Exposure

By Marian P. Jarlenski, Elizabeth E. Krans, Joo Yeon Kim, Julie M.
Donohue, A. Everette JamesIII, David Kelley, Bradley D. Stein, and Debra
L. Bogen

Marian Jarlenski and colleagues examine outcomes among Medicaid-enrolled
children in Pennsylvania exposed to opioids in utero, born in the period
2008-11 and followed up for five years. By age five, with the
exception of neonatal conditions, children exposed to either opioids or
tobacco or not exposed to either had similar rates of pediatric complex
chronic conditions, when maternal and child risk factors were controlled
for. 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

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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
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health care workers to save lives across the globe. Project HOPE has
published Health Affairs since 1981.

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