Forefront: Is the IRA Reducing Inflation or Threatening Patient Access?
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Monday, May 6, 2024 | The Latest Research, Commentary, and News from Health Affairs
Dear John,
The May issue of Health Affairs covers a range of topics, including analysis of payment in the Medicare program, efforts to reduce the burden of the COVID-19 pandemic, access to money-saving biosimilars, and how restrictions on abortion providers relate to rates of intimate partner–related homicides.
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Medicare
Hannah James and coauthors examine the role that health risk assessments (HRAs) play in increasing the risk scores of Medicare Advantage enrollees ([link removed] ) .
Using 2019 data, they find that 44.4 percent of beneficiaries had at least one HRA, and one in five of those with an HRA had their risk score elevated as a result, yielding up to an aggregate $12.3 billion increase in risk payments to health plans.
Sukruth Shashikumar and coauthors examine the financial outcomes of physician group practices ([link removed] ) participating in the Bundled Payments for Care Improvement Advanced Model (BPCI-A), launched in 2018.
Total incentive payments during the first four performance periods (2018–20) were $421 million, with higher target prices almost universally leading to higher bonus payments.
As part of our Practice Of Medicine series, Carter Nakamoto and coauthors compare claims data for Medicare enrollees who receive care from health systems ([link removed] ) with high and low use of telemedicine.
Patients in high-use systems experienced small improvements in access and quality, with modest increases in costs, leading the authors to conclude that “it will be difficult to justify a return to restricting telemedicine payment in Medicare.”
Read More
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COVID-19
In an effort to reduce health disparities, California allocated COVID-19 vaccines with an emphasis on those communities rated lowest on an area-based socioeconomic measure ([link removed] ) .
Christopher Hoover and coauthors estimate that “vaccination rates increased by 28.4 percent, and more than 160,000 cases, 10,000 hospitalizations, and 670 deaths were averted because of the policy.”
However, they note, the policy did not eliminate disparities between more- and less-advantaged communities.
H. Joanna Jiang and coauthors compare changes in patient volume in rural and urban hospitals ([link removed] ) and find that “rural hospitals experienced more variability in patient volume, both up and down, than urban hospitals during the first two years of the COVID-19 pandemic.”
Yin Wang and coauthors explore the effects of a guaranteed payment to young adults ([link removed] ) in West Virginia for being fully vaccinated against COVID-19.
They find that young adults who were vaccinated as a result of the $100 incentive accounted for about 20 percent of all young adults who became vaccinated.
Examining Medicare pharmacy claims data ([link removed] ) , Katherine Wen and coauthors find that between January 2021 and April 2022, “urban counties [showed] greater use of Pfizer-BioNTech and rural counties less use of Pfizer-BioNTech for both first doses and booster doses.”
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Access To Care
Luca Bertuzzi and Luca Maini examine the effects of Medicare Part D benefit design ([link removed] ) on uptake of biosimilars.
They find that mandatory branded-drug discounts and subsidies during the catastrophic coverage phase contributed to reduced use of biosimilars, with statutory changes in more recent years mitigating these effects.
This is the first article published as part our new Eye On The IRA series ([link removed] ) , with support provided to Health Affairs by the National Pharmaceutical Council.
Maeve Wallace and colleagues examine the association between state laws that regulate abortion providers and intimate partner violence–related homicide ([link removed] ) .
Examining data from 2014–20, the authors find that each additional law adopted by a state is associated with a 3.4 percent increase in homicides of women and girls related to intimate partner violence.
Medication is a key component of effective opioid use disorder treatment, and requiring that treatment programs offer medication in order to obtain licensure is a mechanism for expanding its use.
Through interviews with policy officials and treatment providers in nine states, Alene Kennedy-Hendricks and coauthors identify facilitators of incorporating medication standards ([link removed] ) into treatment program licensure.
In a Policy Insight, Christopher Cai and Zirui Song offer an overview of the policy landscape of private equity acquisitions of health care providers ([link removed] ) and make recommendations to address the health and economic consequences of growing private equity acquisitions.
They call for increased transparency and oversight, as well as specific protections for patients and clinicians and limitations on excessively risky financial practices.
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Throughout May, join us for the following events:
- May 9: Lunch and Learn: The 20th Anniversary of the ONC ([link removed] ) (OPEN TO ALL)
- May 22: Journal Club: "California’s COVID-19 Vaccine Equity Policy: Cases, Hospitalizations, And Deaths Averted In Affected Communities" ([link removed] ) (Exclusive to Health Affairs Insiders--become one today ([link removed] ) !)
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Health Affairs is launching its second annual You’re A Health Policy Wonk If… contest!
The premise is simple. Finish the statement “You’re A Health Policy Wonk If…”
Besides honor, the first-place winner will receive a free online journal subscription for a year.
Submit by May 31.
Check out last year's submissions ([link removed] ) to get inspired before submitting your entry!
Submit
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For Dually Eligible Individuals, Medicare Brokers Are 'Broken' ([link removed] )
Michael Monson et al.
The IRA: Reducing Inflation Or Threatening Patient Access? ([link removed] )
Richard Hughes IV and Richard Kane
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About Health Affairs
Health Affairs is the leading peer-reviewed journal ([link removed] ) at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online.
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Project HOPE ([link removed] ) 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.
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