The Connection
A roundup of recent Fund publications, charts, multimedia, and other timely content.
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May 20, 2024
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Paying Physician Practices Upfront Can Improve Primary Care
To strengthen primary care, we need to change the way we pay for it, most experts say. On To the Point, Commonwealth Fund researchers review large-scale primary care payment models being tested by the Center for Medicare and Medicaid Innovation and suggest policy fixes for future iterations. Among their recommendations: ensuring at least two-thirds of a practice’s payments are paid prospectively, and helping practices learn to manage financial risk through a hybrid approach that maintains some fee-for-service payments.
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Betancourt’s Blueprint for an Equitable Health System
In Dr. Joseph Betancourt’s vision for the future of U.S. health care, “any patient who goes to any health care system around the country should get the highest quality of care, no matter who they are or where they’re from.” As the Commonwealth Fund’s president, he’s tackling some of the biggest challenges facing the U.S. health system while trying to ensure equity is embedded in health care policy, coverage, technology, and practice. Join host Joel Bervell for a wide-ranging conversation with Betancourt on The Dose podcast.
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FEATURED CHART
New Rule Will Help Dreamers Get Health Coverage
The Biden administration has just released a rule expanding health insurance access for about 100,000 “Dreamers” — young adults brought to the United States as children who are protected against deportation by the Deferred Action for Childhood Arrivals program. On To the Point, Commonwealth Fund experts examine the potential impact of the new rule on Dreamers and why immigrant coverage is an important policy priority.
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QUIZ
How many people have lost Medicaid coverage since the postpandemic “unwinding” began last year?
- 2.3 million
- 6.8 million
- 13.7 million
- 21.4 million
Scroll down to see if you got it right.
A New Day for Sickle Cell Patients
This month, a 12-year-old boy in Washington, D.C., became the first person in the world to undergo a grueling gene therapy treatment that could cure his sickle cell disease. It’s a game-changer for a disease whose history has been plagued by racism baked into our health care system. On The Dose podcast, host Joel Bervell talks with Dr. Cece Calhoun, a leading adolescent sickle cell specialist from Yale University. The two dive into what it means to be a young Black person in America with the disease and how health inequities continue to pose life-and-death challenges for sickle cell patients.
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An Unflinching Look at Caregiving in America
Roughly 42 million Americans provide unpaid care for a loved one, a number that will surely rise as the U.S. population continues to age. In season 2 of the podcast Uncared For, award-winning journalist SuChin Pak turns a spotlight on caregiving, from the medical and financial hurdles to the emotional highs and lows. The podcast, produced by Lemonada Media and the Commonwealth Fund, explores what it takes to ensure our loved ones can age with dignity through intimate conversations with family caregivers.
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Expanding Telehealth Access to Medication Abortion
Medication abortion now accounts for more than 60 percent of all abortions in the U.S. and is the preferred method for many patients. During a time of increasing restrictions, telehealth has been shown to ensure access to safe and effective medication abortions while also generating cost efficiencies. On To the Point, Dana Northcraft, director of the Reproductive Health Initiative for Telehealth Equity and Solutions, describes with her colleagues several actions that can expand access to medication abortion via telehealth.
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Health Coverage for All — Even Undocumented Migrants
Some 10.5 million undocumented migrants in the United States live without affordable health care, often delaying or skipping medical treatment as a result. Thailand, by contrast, offers undocumented migrants the same health benefits that citizens receive. Writing for International Insights, the Commonwealth Fund’s Munira Gunja reviews the Thai public health model, where inclusive health coverage has resulted in better outcomes for the entire population.
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Striking a Better Balance in Health Care
Complex, fragmented, and inefficient — health care in the U.S. needs a major reboot. How can we ensure that the care we pay for is not just accessible to all but also patient-centered, equitable, and affordable? In part 2 of “Rethinking Health Care from a Global Perspective,” science communicator and health services researcher Aaron Carroll, M.D., looks at how other countries strike a balance between the private and public sectors in care delivery. He also shows how those countries approach drivers of health, like housing, food security, and transportation.
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Meet the New Harkness Fellows
The 2024–25 class of Commonwealth Fund Harkness Fellows in Health Care Policy and Practice will begin its U.S. tenure this August. The new fellows represent nine countries and a wide range of professional experience in health care delivery, policymaking, health services research, and health technology innovation. Over the course of the year, fellows will conduct internationally comparative research and engage in a series of enriching leadership development experiences with U.S. policy, research, and care delivery experts and innovators. Learn more about them here ([link removed] ) .
New Policies Target Private Equity in Health Care
Evidence shows that hospitals, nursing homes, and physician practices controlled by private equity charge more and may even provide lower-quality care. In an opinion piece for the Milbank Quarterly, health economist Richard M. Scheffler and health policy expert David Blumenthal, M.D., offer their perspective on recent state and federal efforts to regulate private equity’s role in health care and whether these reforms can make an impact.
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Prescription Drugs and “Patent Thickets”
In a study of more than 1,400 patents and patent applications protecting the 10 highest-grossing brand-name drugs in the U.S., nearly three-quarters were filed after receiving approval from the U.S. Food and Drug Administration (FDA). In JAMA Internal Medicine, Commonwealth Fund grantee Aaron S. Kesselheim, M.D., and colleagues suggest that greater scrutiny of these overlapping patents is needed to promote timely generic and biosimilar competition.
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Cost Savings from Older Versions of Insulin
Each new generation of insulin products has come with a price increase. In a 2018 survey, nearly half of respondents managing diabetes reported going without insulin treatment for a time because of the financial burden it poses. Commonwealth Fund grantee Robin Feldman writes in STAT that giving diabetes patients access to the “trailing edge” of products — older and less expensive, but still effective, insulin that manufacturers have discontinued — would offer them more affordable options. “If consumers want a product that the original manufacturer no longer cares to produce, another manufacturer should be permitted to step in to meet the demand,” she says.
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Health Care Providers Can Respond to Gun Violence
According to the New York Times, the number of Americans living close to fatal gun violence ([link removed] ) — one in seven — rose sharply during the pandemic and remains elevated. A recent issue of Transforming Care described how health care organizations are developing a more comprehensive response ([link removed] ) to gun violence, one modeled on public health campaigns.
QUIZ: Answer
The answer is C, 13.7 million.
Procedural reasons have been mostly to blame for people losing their Medicaid coverage since the unwinding began in 2023. On To the Point, Kinda Serafi and Cindy Mann of Manatt Health examine provisions of a new federal rule ([link removed] ) that aims to help eligible adults and children enroll in Medicaid and the Children’s Health Insurance Program (CHIP) — and stay enrolled for as long as they remain eligible.
Affordable, quality health care. For everyone.
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