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A Weekly Health Policy Round Up From Health Affairs
August 4, 2019
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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 >>
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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 2019The 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
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.
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