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A Weekly Health Policy Round Up From Health Affairs            

**August 4, 2019**

THIS WEEK ON THE BLOG

MEDICARE

Aligning Payment And Prevention To Drive Antibiotic Innovation For
Medicare Beneficiaries

By Seema Verma

****In this post, I will outline the agency's multi-pronged strategy
for stimulating access to antibiotic innovation through the Fiscal Year
2020 Inpatient Prospective Payment System rule, including changes to the
New Technology Add-On Payment and severity adjustments to ICD-10 codes
for AMR. I will also discuss CMS's interest in addressing AMR beyond
payment reform, such as investments in public health infrastructure like
stewardship programs. Read More >>

FOLLOWING THE ACA

CMS Approves Reinsurance Waivers In CO, ND; Issues RADV Report, New
Notices

By Katie Keith (8/2/19)

On July 31, 2019, the Centers for Medicare and Medicaid Services (CMS)
approved Colorado and North Dakota's requests to develop state-based
reinsurance programs under Section 1332 of the Affordable Care Act
(ACA). CMS also released its first summary report on the impact of risk
adjustment data validation and issued updated renewal and
discontinuation notices for 2020 coverage. Read More >>

PHARMACEUTICALS & MEDICAL TECHNOLOGY

The Use Of Vendors In Medicare Part B Drug Payment

By Paul B. Ginsburg, Caitlin Brandt, and Steven Lieberman (8/2/19)

A voluntary vendor approach for Medicare could diminish the incentives
of buy and bill and engage physicians in trading off cost and
effectiveness of Part B drugs within a class.
Read More >>

Trump Administration, In Shift, Announces Plan To Permit Drug
Importation

By Rachel Sachs (7/31/19)

This morning, the Trump administration announced a plan that, if
eventually finalized, would enable the importation of prescription
drugs, primarily from Canada. Like all of the administration's drug
pricing agenda, the importation plan faces a number of potential
roadblocks. Read More >>

Biologics Are Still Natural Monopolies

By Peter B. Bach, Jennifer A. Ohn, Preston Atteberry, and Mark Trusheim
(7/31/19)

The ideological preference for competition needs to be put aside for a
more effective, efficient, and economically justified approach of
regulating biologics as natural monopolies.
Read More >>

Is 'Competitive Licensing' Proposed In HR 1046 Practical For
Lowering Drug Prices?

By Rena M. Conti and Paul Kleutghen (7/29/19)

Other proposals aiming to empower the federal government to pursue lower
prescription drug prices may serve the needs of US consumers and payers
better.Read More >>

MEDICAID

"We Have All Seen This Movie Before": Once Again, A Federal Court
Vacates HHS Approval Of A Medicaid Work Experiment

By Sara Rosenbaum (8/2/19)

On July 29th-for the fourth time-Judge James Boasberg of the United
States District Court for the District of Columbia, in Philbrick v Azar,
vacated HHS approval of an 1115 Medicaid work experiment waiver. Read
More >>

PRIMARY CARE

Slowly Getting Serious: The New CMS Primary Care Models And Implications
For Serious Illness Care

By Mark Japinga, Mathew Alexander, David Casarett, William K. Bleser,
Mark B. McClellan, and Robert S. Saunders (7/31/19)

CMS must remain a committed partner to better integrate primary care and
the kind of innovation offered by serious illness and palliative care.
Read More >>

CHILDREN'S HEALTH

Screening For Social Needs: What Do Parents Think?

By Suzanne Brundage (7/31/19)

Public Agenda was commissioned by United Hospital Fund to conduct focus
groups on what parents of low-income children in the New York City metro
area think about screening for social determinants of health at their
pediatrician's office. Although parents had some reservations about
discussing sensitive topics, they were still enthusiastic about
discussing factors that shape their kids' health and well-being. Three
foundations fund this UHF initiative.
Read More >>

QUALITY OF CARE

What Do We Know About Prices And Hospital Quality?

By Michael E. Chernew and Richard G. Frank (7/29/19)

As policy proposals to reduce prices in the commercial sector march
ahead, the potential impact of lower prices for health care quality is
important to understand. Read More >>

ACCESS TO CARE

To Advance Well-Being In Indian Country, Limit The Health Harms of
Incarceration

By Rachel Simon, Leila Borowsky, Siobhan Wescott, and Matthew L. Tobey
(7/30/19)

Limiting the health harms of incarceration could represent a key
strategy to strengthen community health in rural American Indian and
Alaska Native communities. Read More >>

PAYMENT

Advancing Bundled Payments Through Radiation Oncology Episodes

By Amol S. Navathe, Justin E. Bekelman, and Joshua M. Liao (8/1/19)

The recently proposed RO Model emphasizes several new policy levers that
can drive health care value but have been partially or completely
unexplored in bundled payment programs to date. Read More >>

IN THE JOURNAL

MEDICAID

Association Of State Policies With Medicaid Disenrollment Among
Low-Income Medicare Beneficiaries

By Eric T. Roberts, Jacqueline Hayley Welsh, Julie M. Donohue, and
Lindsay M. Sabik

Eric Roberts and coauthors examine Medicaid disenrollment among
fee-for-service Medicare beneficiaries and the relationship between
disenrollment and state policies.Read More >>

ACCOUNTABLE CARE

ACO Contracts With Downside Financial Risk Growing, But Still In The
Minority

By Kristen A. Peck, Benjamin Usadi, Alexander J. Mainor, Elliott S.
Fisher, and Carrie H. Colla

Kristen Peck and coauthors explore ACO structure and contracts in
2012-18. Read More >>

BEHAVIORAL HEALTH CARE

Nonopioid Overdose Death Rates Rose Almost As Fast As Those Involving
Opioids, 1999-2016

By Christopher J. Ruhm

The number of Americans dying from drug overdoses has risen rapidly, but
the contribution of nonopioid drugs to this growth is not well
understood. Using vital statistics data, Christopher Ruhm calculates
levels of and increases in overall nonopioid fatal overdose rates.
Read More >>

MEDICARE

Impact Of Medicare Readmissions Penalties On Targeted Surgical
Conditions

By Karan R. Chhabra, Andrew M. Ibrahim, Jyothi R. Thumma, Andrew M.
Ryan, and Justin B. Dimick

Karan Chhabra and coathors evaluate the Medicare Hospital Readmissions
Penalty Program's announcements' effects on risk-adjusted
readmission rates, episode payments, lengths-of-stay, and observation
status use. Read More >>

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Call For Submissions: Narrative Matters Poetry Contest 2019

The Narrative Matters section of Health Affairs is seeking poetry
submissions for an upcoming issue of the journal.

We are holding a poetry contest, from July 1 to August 31, looking for
well-crafted poems that touch on topics related to health and health
policy. Three winning poems will be announced in September. Winning
poets will receive a monetary prize-$500 for first place, $300 for
second, and $100 for third-as well as publication in Health Affairs,
and two copies of the issue containing the winning poem.

All entries will be read and judged by Health Affairs staff.

* Limit 3 poems submitted per person. Each poem-in pdf or word doc
format-should be submitted as a separate entry through our submission
portal here .

* Poems must be no longer than a single-spaced page, with double spaces
between stanzas

* Font size no smaller than 11 point.

* Poems must be written in English.

* Poems must be previously unpublished.

* Poems themselves should contain no personal identifiers.

You can read some earlier poems published by

**Health Affairs**, including the winners of the 2015 Narrative Matters
poetry contest
,
poems by patients and consumers
,
poems on vulnerable populations
,
and poems on the cancer experience
.

We look forward to reading your submissions!

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About Health Affairs

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