The Connection

A roundup of recent Fund publications, charts, multimedia, and other timely content.

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March 11, 2024

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Is Value-Based Payment the Future for Federally Qualified Health Centers?

More than 31.5 million people rely on federally qualified health centers for primary care and preventive services. But the way these centers are funded can leave them financially vulnerable. On To the Point, Commonwealth Fund researchers examine the promise and challenges of value-based payment (VBP) as an alternative financing model for these critical safety-net providers. Many health center leaders believe that VBP could make funding more predictable for health centers while freeing up resources. According to some experts, it represents “the future of health care payment and a necessary shift to improve patient care.”

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How the IRA Can Lead to More Sustainable Health Care

The health care sector produces 8.5 percent of total U.S. greenhouse gas emissions. While many hospitals and health care systems are working to reduce their emissions, costs are standing in the way of rapid progress. On To the Point, the Commonwealth Fund’s Lovisa Gustafsson and Deloitte’s Elizabeth Baca and Christine Brynaert discuss how the Inflation Reduction Act (IRA) could make sustainability efforts more affordable. They say the IRA opens the door for tax benefits, including direct financial incentives for nonprofits, that could strengthen organizational resiliency, reduce financial risk, and support actions to cut carbon emissions.

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FEATURED CHART

CHCs Can Help Meet Demand for Behavioral Health Care

Community health centers (CHCs), which serve many low-income adults and Medicaid beneficiaries across the country, are seeing a steep rise in visits for behavioral health conditions, including substance use disorders and mental health needs. The Commonwealth Fund’s Celli Horstman reports on actions that CHCs are taking to meet this surge in demand, including ramping up behavioral health workforce training and recruitment, leveraging telehealth to ensure continuous access to behavioral health services, and expanding school-based health centers to meet rising mental health needs among youth.

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How Medicare Advantage Plans Are Paid

Privately run Medicare Advantage plans now enroll about half of all Medicare beneficiaries. As enrollment continues to grow, how they are paid — and how much — will be central to the debate over the efficiency and sustainability of Medicare spending. Our new explainer breaks down the federal government’s complex process for setting payment rates and helping to ensure plans can meet patients’ health needs while making efficient use of taxpayer dollars.

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VBP and Equitable Use of Prescription Drugs

A policy push to improve prescription drug affordability and access is unlikely to be truly successful if it isn’t integrated with efforts to improve care delivery, say Robert Saunders of the Duke-Margolis Center for Health Policy and colleagues in Health Affairs Forefront. Their research, supported by the Commonwealth Fund, suggests that leveraging value-based payment models may be a path to success.

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How Young Voices Can Shape Prescription Drug Policy

By teaching young adults how to use their voices to advance positive change in health care policy, we can empower them to be effective advocates for their health needs. Sneha Dave and colleagues write on To the Point that young adult patients can and should be involved in areas like pharmaceutical patent reform so they can advocate for lower-cost prescription drugs, regulation of social media ads targeting young adults, and clinical trial diversity.

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Effects of Georgia’s Reinsurance Waiver on Affordability

Reinsurance waivers obtained through the Affordable Care Act have allowed some states to reduce premiums for enrollees in unsubsidized marketplace plans. But little is known about how reinsurance affects costs and enrollment for the majority of marketplace enrollees who receive subsidies. In a recent Health Affairs article, the University of Pittsburgh’s Coleman Drake and colleagues reported that Georgia’s reinsurance waiver increased the minimum cost of enrolling in subsidized marketplace coverage by about 30 percent and decreased enrollment by roughly a third for marketplace enrollees with incomes between 251 percent and 400 percent of the federal poverty level.

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Providers Are Winning Big in NSA Dispute Resolution

The No Surprises Act (NSA) protects consumers against surprise medical bills from out-of-network providers and governs how insurers and providers come to agreement on fair payment through independent dispute resolution. On To the Point, Jack Hoadley and Kevin Lucia of Georgetown University look at the fewer than 7 percent of claims that have been resolved through dispute resolution since the NSA became law. Providers, they found, won about 77 percent of resolved cases in 2023, and those wins yielded nearly three times the usual in-network rates offered by payers.

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How Health Care Providers Can Respond to Gun Violence

The Ad Council, which has developed some of the country’s most iconic social impact campaigns, recently announced a new initiative focused on preventing firearm deaths and injuries ([link removed] ) . Health systems and hospitals affiliated with the National Health Care CEO Council on Gun Violence Prevention and Safety have contributed $10 million in seed funding. In January, Transforming Care reported on how some health care providers are developing a more comprehensive response to gun violence ([link removed] ) . Modeled on public health campaigns targeting cigarette smoking and car accidents, their efforts focus on screening and surveillance to identify people at risk and reveal patterns of injury.

Affordable, quality health care. For everyone.

The Commonwealth Fund, 1 East 75th Street, New York, NY 10021

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