The Connection
A roundup of recent Fund publications, charts, multimedia, and other timely content.
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November 13, 2023
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Many on Medicare Struggle to Afford Health Care
Even with their coverage, many Medicare beneficiaries struggle to pay for expenses like premiums, copayments, coinsurance, and uncovered health services, according to national survey data from the Commonwealth Fund. Among the findings: one-third of Medicare beneficiaries said it was difficult to afford health care costs; and more than one in five said health care costs made it harder for them to afford food and utility bills. Download our chartpack to learn more.
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States Respond to the Youth Behavioral Health Crisis
As the nation’s largest health insurer for children and adolescents, Medicaid has a critical role to play in ensuring young people get the care they need. On To the Point, Manatt Health’s Jocelyn Guyer and colleagues review what is and isn’t working for young people living with complex behavioral health conditions. Some of the most effective strategies, they say, center on establishing a foundation of stable coverage and benefits; taking advantage of federal options to reach young people involved child welfare and the juvenile justice; and promoting mental health screening through Medicaid.
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How the Administration Can Support Family Caregivers
Unpaid family caregivers are gaining recognition for their crucial role in allowing older adults and people with disabilities to remain in their homes and communities. Barbara Lyons and Jane Andrews identify opportunities for the Biden administration to support family caregivers, including: increasing the availability of Medicare in-home benefits; ensuring caregivers have access to services like food, transportation, and respite care; updating Medicare payment codes so that caregivers can receive training; and providing payment options for caregivers.
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Helping Older Adults Age Well in Rural America
Rural communities in the United States struggle to care for aging adults: there are fewer health care providers, fewer professional caregivers, and fewer young people than in urban areas. With many services hours away, older adults are often forced to leave their homes or go without care. The newest feature article produced through the Commonwealth Fund’s partnership with the Bassett Research Institute showcases ways in which rural older adults can get the range of supports they need. Some approaches mobilize local assets, like health and human service organizations; others leverage telehealth, team-based care, and home visits to make it easier for older adults to access services.
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What We Need to Do to Improve Maternal Health Equity
The United States has the worst maternal health outcomes of any wealthy country, particularly for Black and Indigenous people. Two articles coauthored by the Commonwealth Fund’s Laurie Zephyrin, M.D., explore how we can get at the root causes of maternal health outcome disparities ([link removed] ) in the U.S. and other high-income countries, and how value-based payment in Medicaid could be reoriented to promote better, more culturally appropriate maternity care ([link removed] ) .
States Use Public Option Plans to Reduce Health Costs
Some states have been establishing new public option plans to push down health care prices, lower insurer administrative costs, and increase plan choices and access to coverage for consumers. Georgetown University’s Christine H. Monahan and colleagues discuss some of the first-generation public option–style plans, including those in Washington and Colorado, which are already showing progress. Requested rate increases for plans in the Colorado Option program, for example, are more than 30 percent lower than those for other private plans.
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Do Insurers Provide Fair Access to Prescription Drugs?
In an ideal world, people could easily determine whether their insurers cover their prescription drugs, and at what cost. But it’s often not that simple. As Matt Seidner and Sarah K. Emond explain on To the Point, while insurance policies — at least on paper — largely provide fair access to medications, it’s hard to say how this translates into real-world access and affordability for patients. According to a new study from the Institute for Clinical and Economic Review, most policies provide fair access in terms of clinical eligibility and prescriber restrictions, but fewer meet criteria for cost sharing and transparency.
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Is Private Equity Making Things Worse in Health Care?
Health care is a $4.3 trillion business in the United States, accounting for 18 percent of the nation’s economy. It should come as no surprise then that the industry has become attractive to private investors, who promise cost savings, expanded use of technology, and streamlined operations. In the latest episode of The Dose podcast, host Joel Bervell charts a wide-ranging discussion with Yale University’s Howard Forman, M.D., about private equity’s growing role in American health care.
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Funding Public Health: The Time to Act Is Now
The mismatch between public health needs and funding to support those needs persists, even after the COVID-19 pandemic. Though chronic underfunding of public health in the United States predates the pandemic, much is at risk in the fiscal 2024 federal budget negotiations. In Health Affairs, David Blumenthal, M.D., the former Commonwealth Fund president, joins the Fund’s Rachel Nuzum and J. Nadine Gracia of Trust for America’s Health to discuss the importance of building public health defenses through short- and long-term funding.
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Tackling Overtreatment, Overspending in U.S. Health Care
Overtreatment is a big problem in American health care. The proliferation of unnecessary medical tests and procedures not only harms patients but costs the United States billions of dollars every year. On The Dose podcast, host Joel Bervell talks to Vikas Saini, M.D., executive director of the Lown Institute, a think tank that examines overspending and overtreatment in the health care system. Dr. Saini unpacks how health care practices are misaligned with patient needs and discusses strategies for “rightsizing” U.S. health care.
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Webinar: Reducing Hospital Greenhouse Gas Emissions
The health care sector is responsible for 8.5 percent of national greenhouse gas (GHG) emissions, making the United States the foremost emitter of health care–related GHGs. Experts and policymakers increasingly recognize the necessity of cutting GHGs from the health system, beginning with our nation’s hospitals. On November 9, the Bipartisan Policy Center (BPC) and the Commonwealth Fund hosted a discussion about how hospitals can safely reduce GHG emissions while protecting and promoting patient health and safety. An archived video of the event, which was moderated by Joanne Kenen, Politico contributing editor and the Commonwealth Fund Journalist-in-Residence at Johns Hopkins Bloomberg School of Public Health, and featured Fund President Joseph R. Betancourt, M.D., can be viewed on the BPC website ([link removed] ) .
USC Health Equity Fellows Announced
The USC Center for Health Journalism has announced the second class of grantees in the Impact Fund for Reporting on Health Equity and Health Systems ([link removed] ) . These journalists will embark on projects expected to shine a light on the intricacies of health systems and their role in creating health equity. The grantees are: Suzette Brewer, freelance reporter; Jade Jackson, Indianapolis Recorder; Tasmiha Khan, Palabra; Kalynh Ngo, Nguoi Viet Daily News; Camille Alexandra Padilla Dalmau, 9 Millones; Bart Pfankuch, South Dakota News Watch; Shantal Riley, Harvard Public Health; Alana Semuels, TIME; and Allen Siegler, Mountain State Spotlight.
Betancourt Named to New York State Health Commission
On November 2, Governor Kathy Hochul announced the New York State Commission on the Future of Health Care ([link removed] ) , a new 13-member advisory body to provide ongoing strategic recommendations for transforming the state’s health care system. The commission is charged with helping to ensure that limited resources are optimized to enable the delivery of accessible, equitable, high-quality care for all New Yorkers. Commonwealth Fund President Joseph R. Betancourt, M.D., was named to the commission.
Ways to Alleviate Burnout Among Clinicians
This month, the Washington Post reported several large health systems are testing whether ChatGPT could be used to generate replies to patients’ email queries ([link removed] ) , which have more than doubled since early 2020. Each reply would be reviewed and edited by a physician before being sent. In a recent article, Commonwealth Fund researchers described a host of other ways health systems are working to alleviate clinician burnout ([link removed] ) .
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