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A Weekly Health Policy Round Up From Health Affairs            

**August 11, 2019**

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IN THE JOURNAL

NEW ISSUE: MILITARY HEALTH SYSTEMS

As the Military Health System (MHS) goes through a major restructuring,
it also faces pressures and opportunities similar to the civilian
sector. The August issue of Health Affairs examines the health systems
that serve 1.4 million active duty service members; provide insurance
coverage for another 8 million reservists, retirees, and family members;
and provide care for 9 million veterans.

This issue was supported by the Uniformed Services University of the
Health Sciences and the New York State Health Foundation.

Read the August 2019 table of contents
and listen to a
two-minute introduction to the issue from Editor-in-Chief Alan Weil.

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The US Military Health System: Promoting Readiness And Providing Health
Care
By Terri Tanielian and Carrie Farmer

Terri Tanielian and Carrie Farmer describe the evolution of coverage for
military service members and their families from the 1880s to the
current TRICARE program. Read More >>

A Military Health System For The Twenty-First Century

By Terry Adirim

Terry Adirim discusses the 2017 National Defense Authorization Act
requirement to consolidate the direct care system currently operated
separately by the Army, Navy, and Air Force, under a single authority.
Read More >> 

Readiness Of Medical Providers In The Military Health System: Overview
Of Operational And Policy Considerations

By Paul J. Hutter, Joachim Roski, Jonathan Woodson, Allen Middleton,
Robert Kneeland, Averston Worthy, Derik Zitelman, Thomas Trinh, Shaun
Dela Cruz, and Elaine Cooper

An essential component of the MHS is its ability to deploy medical
personnel on a moment's notice to remote, often austere, settings.
Paul Hutter and coauthors describe the challenge of gaining and
maintaining the skills necessary to treat battlefield wounds when most
training and medical practice occurs in traditional clinical settings,
where patients generally are treated for fairly routine conditions.Read
More >>

GOVERNMENT PROGRAMS & POLICIES

Veterans Health Administration Investments In Primary Care And Mental
Health Integration Improved Care Access

By Lucinda B. Leung, Lisa V. Rubenstein, Jean Yoon, Edward P. Post, Erin
Jaske, Kenneth B. Wells, and Ranak B. Trivedi

Lucinda Leung and coauthors report on results from the national Primary
Care-Mental Health Integration initiative of the Veterans Health
Administration, which embedded specialists, care managers, or both in
primary care clinics to care for veterans with psychiatric illness.
Read More >>

The Opioid Epidemic In Veterans Who Were Homeless Or Unstably Housed

By Amanda M. Midboe, Thomas Byrne, David Smelson, Guneet Jasuja, Keith
McInnes, and Lara K. Troszak

Amanda Midboe and coauthors report on a retrospective observational
study to examine opioid use disorder in a national sample of veterans
who accessed specialized homeless programs in the Veterans Health
Administration. Read More >>

DETERMINANTS OF HEALTH

Finding Shelter And Support Along The Road To Better Health

By Brian Rinker

In this month's Leading to Health, Brian Rinker reports on how
Sacramento is using California's Whole Person Care program to help its
homeless population. Read More >>

This article appears in

**Health Affairs'** series on Leading to Health
.

HEALTH AFFAIRS EVENTS

HEALTH SPENDING:  MOVING FROM THEORY TO ACTION

NEW SPEAKERS ANNOUNCED

Wednesday, September 11, 2019
9:00 am - 3:00 pm Eastern
National Press Club - Washington, DC
REGISTRATION OPEN

Eighteen months ago, Health Affairs teamed with the National
Pharmaceutical Council and Anthem, Inc. to launch a multi-year project
to promote an evidence-based conversation about health spending. To
continue the discussion, Health Affairs and the National Pharmaceutical
Council are hosting a forum with the following speakers:

* Mandy Cohen, Secretary, North Carolina Department of Health and Human
Services

* Patrick Conway, President and CEO, Blue Cross and Blue Shield of North
Carolina

* Robert W. Dubois, Executive Vice President and Chief Science Officer,
National Pharmaceutical Council

* Christopher F. Koller, President, Milbank Memorial Fund

* Reed Tuckson, Managing Director, Tuckson Health Connections, LLC

* NEW! Otis Brawley, Bloomberg Distinguished Professor, Johns Hopkins
University

* NEW! Dan Ollendorf, Director, Value Measurement and Global Health
Initiatives, Center for the Evaluation of Value and Risk in Health
(CEVR), Tufts University Medical Center

* NEW! Surya Singh, President, Singh Healthcare Advisors

* NEW! Adaeze Enekwechi, President, IMPAQ

* NEW! Ceci Connolly, President and CEO, Association of Community Health
Plans

Be part of the conversation on September 11.
                                    
Getevent-specific emails
delivered directly to your inbox.

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THIS WEEK ON THE BLOG

FOLLOWING THE ACA

ACA Litigation Round-Up: Contraceptive Mandate, Section 1557, And More

By Katie Keith (8/6/19)

This post provides a brief status update on litigation over the "take
care" case, Section 1557, the health insurance tax, and the provider
conscience rule. Read More >>

ACA Litigation Round-Up: AHPs, Short-Term Plans, CSRs, And Risk
Adjustment

By Katie Keith (8/5/19)

This post covers pending ACA litigation and provides a brief status
update on lawsuits over non-ACA plans, cost-sharing reductions, and the
risk adjustment program. Read More >>

PHARMACEUTICALS AND MEDICAL TECHNOLOGY

The Economics Of Biologic Drugs: A Further Response To Bach et al.

By Alex Brill and Benedic Ippolito (8/8/19)

We begin by commenting on expectations for biologic prices in a market
with biosimilar competition before responding to some of Bach et al.'s
new arguments and explaining why we remain steadfast that biologic drugs
as a group are not natural monopolies, that the early evidence from
biosimilar entry is encouraging, and that a host of policy options other
than price controls can be considered to lower costs within this market.
Read More >>

ACCESS TO CARE

Language Access Rights Under Threat

By Kathy Ko Chin (8/9/19)

If finalized after the comment period ends on August 13, this regulation
will turn back the clock and progress on civil rights and language
access. The Health Care Rights Law is clear: language should not be a
barrier to accessing health coverage or services. Read More >>

A Mapping Tool To Address Health And Education Disparities And Improve
Access To School-Based Health Care

By Hayley Love, John Schlitt, Nirmita Panchal, and Jené Grandmont
(8/9/19)

The tool is designed for diverse audiences who are interested in making
data-driven decisions to address health and education disparities and
improve access to care for children and adolescents. Read More >>

Who Will Be Our Moral Conscience Now? A Tribute To Uwe Reinhardt

By Janet Currie, Katherine Ho, B. Rose Kelly, and Ilyana Kuziemko
(8/8/19)

One thing that most people can agree on is that everyone, regardless of
income or socioeconomic status, should have access to necessary care. We
can honor Uwe's legacy by keeping this mantra forever at the forefront
of our work. Read More >>

PRIMARY CARE

The Importance Of Primary Care-And Of Measuring It

By Hoangmai Pham and Ann Greiner (8/6/19)

A standard, publicly reported measure of primary care for the US would
not only allow us to make comparisons among states, health plans, and
accountable care organization but would catalyze research quantifying
the value of primary care. Read More >>

WORKFORCE IN THE COMMUNITY

Leveraging Technology To Support-Not Supplant-The Home Care
Workforce

By Kezia Scales (8/7/19)

To mitigate potential risks when introducing new technologies in home
care, it is essential to involve consumers and workers in every stage of
the research and development process.
Read More >>

ADOLESCENTS

The Forgotten Billion In Universal Health Coverage And Three Ways To
Make Them A Priority

By Stefan Germann (8/7/19)

The CEO of Fondation Botnar, a funder based in Switzerland, cites
research showing that between 2003 and 2015, just 1.6 percent of global
health aid was targeted to specific health issues affecting young
people. If we are to truly realize universal coverage and achieve health
equity, we can no longer ignore this funding neglect. He urges all to
commit to three measures, including investment in new technologies, to
bring young people's health issues to the forefront. Read More >>

QUALITY OF CARE

Fixing Clinical Practice Guidelines

By Gilbert Benavidez and Austin Frakt (8/5/19)

Any guideline-promulgating body must use a universal methodology to
facilitate the job of holding guidelines to a rigorous standard. Read
More >>

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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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