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A Weekly Health Policy Round Up From Health Affairs            

**April 12, 2020**

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IN THE JOURNAL

NEW ISSUE:

INTEGRATING SOCIAL SERVICES & HEALTH

The April issue of Health Affairs examines the integration of social
services and health. Despite growing understanding among health sector
professionals that social factors play a role in health, the programs
and systems that help people meet their social needs remain isolated
from those designed to meet their health care needs.

The April issue was supported by The Kresge Foundation.

Read the April 2020 table of contents.

Listen to a two-minute introduction of the issue from Editor-in-Chief
Alan Weil.

Read "From the Editor in Chief."

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FAST TRACK AHEAD OF PRINT

Self-Isolation Compliance In The COVID-19 Era Influenced By
Compensation: Findings From A Recent Survey In Israel

By Moran Bodas and Kobi Peleg

Moran Bodas and Kobi Peleg report the results of a poll of a randomized
sample of Israeli adults to ascertain their willingness to
self-quarantine. The survey was conducted during the last week of
February 2020, as COVID-19 cases began appearing around the globe. The
authors found that when survey respondents were told that compensation
for lost wages would be provided, 94 percent said they would comply with
a self-quarantine order. However, when lost-wage compensation was not
provided, the compliance rate dropped to less than 57 percent. Read More
>>

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INTEGRATING SOCIAL SERVICES & HEALTH

Health And Human Services Integration: Generating Sustained Health And
Equity Improvements

By Caroline Fichtenberg, Jorge Delva, Karen Minyard, and Laura M.
Gottlieb

In the April issue's overview paper, Caroline Fichtenberg and
coauthors "summarize the characteristics of current health and human
services integration efforts, synthesize key evidence on the
effectiveness of different integration activities, and highlight
associated gaps in the evidence and critical implementation
challenges." Read More >>

Linking Health And Social Services Through Area Agencies On Aging Is
Associated With Lower Health Care Use And Spending

By Amanda L. Brewster, Traci L. Wilson, Jennifer Frehn, Diane Berish,
and Suzanne R. Kunkel

Area Agencies on Aging (AAAs) have an almost fifty-year history of
providing access to social services for elderly Americans. As AAAs are
increasingly engaged in partnerships designed to improve health, Amanda
Brewster and coauthors analyze nationwide survey data on these
partnerships and find that "when AAAs established any type of
partnership with hospitals, counties covered by the AAAs experienced a
significant reduction of $135.50 per beneficiary per year in Medicare
spending."Read More >>

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Embedding Social Workers In Veterans Health Administration Primary Care
Teams Reduces Emergency Department Visits

By Portia Y. Cornell, Christopher W. Halladay, Joseph Ader, Jaime
Halaszynski, Melinda Hogue, Cristian E. McClain, Jennifer W. Silva,
Laura D. Taylor, and James L. Rudolph

Between 2016 and 2019 the Veterans Health Administration rapidly
increased the number of social workers included in Patient Aligned Care
Teams, its version of medical homes, which serve veterans in rural
areas. Portia Cornell and coauthors study this natural experiment and
find reductions in emergency department visits and hospital admissions
among high-risk veterans, leading the authors to conclude: "Hiring and
incorporating social workers in primary care is a worthwhile investment
of resources." Read More >>

THIS WEEK ON THE BLOG

COVID-19

Keeping Community Health Centers Strong During The Coronavirus Pandemic
Is Essential To Public Health

By Peter Shin, Rebecca Morris, Maria Velasquez, Sara Rosenbaum, and
Alexander Somodevilla (4/10/20)

Community health centers are very much at the front lines of severe
illness. They serve the poor, those with underlying health issues, and
the uninsured. Expanding eligibility for financial protections,
increasing funding amounts, and expediting health center payments are
all key to ensuring that health centers and other essential providers
survive and recover from the outbreak. Read More >>

Medicare Data Reveal Wide Variety Across Regions Of COVID-19 Fatality
Risk

By Nancy E. Morden, Jonathan Skinner, William B. Weeks, Stephanie C.
Tomlin, and James N. Weinstein (4/9/20)

In sum, we hope this novel measure of population risks arising from
COVID-19 can facilitate public health planning and help mitigate or
forestall potential serious adverse health effects arising from
SARS-CoV-2 infection.Read More >>

To Support Older Adults Amidst The COVID-19 Pandemic, Look To Area
Agencies On Aging

By Amanda L. Brewster, Traci L. Wilson, Suzanne R. Kunkel, Sandy
Markwood, and Tanya Shah (4/8/20)

Meeting the interrelated health and social needs of older adults over
this time will require intense and sustained effort on the part of many
health care and social care providers. For this reason, at the same time
that acute hospital capacity scales up to care for people who become
critically ill, capacity for the community-based services must also
scale up to help people stay safe at home. Read More >>

What Are Foundations Doing In The Fight Against COVID-19? Part II

By Lee-Lee Prina (4/8/20)

More and more foundations that fund in health are coming forward to help
people during this difficult time-sometimes with funding, sometimes
with useful information. Look for Part III of this series soon. Read
More >>

Widespread Home Testing Can Keep People Safe And Get Them Back To
Work-Here's How

By Ge Bai, Bruce Pyenson, and Gillian Woollett (4/7/20)

Testing should play a critical role in speeding our path to economic
recovery. We need rapid development and broad dissemination of home
tests and issuance of an immunization passport for those with presumed
immunity.Read More >>

Calling All States To Report Standardized Information On COVID-19
Hospitalizations

By Pinar Karaca-Mandic, Archelle Georgiou, and Soumya Sen (4/7/20)

Each state is navigating this crisis independently and desperately
seeking data to guide decision making. Shared data can unite states in
their efforts and help them help each other. Making these data publicly
available will become critical in the coming days as we experience a
surging demand for hospital beds, ICU capacity, ventilators, and other
hospital resources. Read More >>

Alternative Payment Models During A Pandemic: Suspending Down-Side Risk
During This Time Of National Crisis

By Basit Chaudhry and Lisa Tran (4/6/20)

Where possible by regulatory action, the Department of Health and Human
Services should suspend all down-side risk mechanisms in alternative
payment models given the current mass-scale disruption of the US health
care system caused by the novel coronavirus.
Read More >>

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FOLLOWING THE ACA

ACA Round-Up: Latest On Texas, Risk Adjustment, And More

By Katie Keith (4/6/20)

This post summarizes the latest action in California v. Texas, the
interim summary report on risk adjustment, final rate filing deadlines
for 2021, and the draft 2020 call letter on quality ratings. Read More
>>

CONSIDERING HEALTH SPENDING

COVID-19 Therapies As A Test Case For Coverage, Coding, And Payment
Reforms

By Kushal T. Kadakia (4/9/20)

Congress and policy makers must take action now on coverage, coding, and
payment to pave the way for accessible and affordable COVID-19
therapies. Read More >>

Competitive Bidding Reduced Medicare Spending On Diabetes Testing
Supplies Without Negatively Affecting Beneficiary Outcomes

By Brian O'Donnell, Eric Rollins, and James Mathews (4/8/20)

In the future, MedPAC could explore what role competitive bidding might
play in restraining the growth in Medicare spending in other sectors of
the program. Read More >>

The Importance Of The Medicaid Fiscal Accountability Rule

By Brian Blase (4/7/20)

If the proposals in the Medicaid fiscal accountability rule proposed by
the Centers for Medicare and Medicaid Services can overcome lobbyists'
interests, it would mark a significant step in improving program
integrity and preserving funds for Medicaid enrollees' health and
long-term care needs. Read More >>

These posts appear in the series Considering Health Spending
.

GLOBAL HEALTH POLICY

Toward Intercultural Health Care In Ecuador: A Roadmap For Equitable
Reform

By Alexandra Reichert (4/10/20)

Indigenous clinics should be officially recognized, medical schools must
improve their intercultural education programs, and the government
should invest in intercultural health education in rural areas. Read
More >>

AFFORDABLE CARE ACT

The ACA: Trillions? Yes. A Revolution? No.

By Joseph R. Antos and James C. Capretta (4/10/20)

A true revolution is needed if we are to address the real long-standing
problems of cost, quality, and access to appropriate care. Read More >>

ORGANIZATION OF CARE

From One-To-One To One-To-Many: Rethinking Health Care Relationships In
The Digital Age

By Shantanu Nundy, Joseph C. Kvedar, and Gina M. Cella (4/6/20)

With the right set of technologies, delivery models, and policy changes,
one-to-many care offers an opportunity for physicians to embrace their
dual roles as individual healers and public health-minded leaders.
Read More >>

HOSPITALS

The CMS Hospital Star Rating System: Fixing A Flawed Algorithm

By Daniel Adelman (4/8/20)

My proposal offers a more "explicit" way to compute hospital overall
scores. Read More >>

MEDICARE

Comparing Medicare Advantage And Fee-For-Service Medicare Suggests
Opportunities For Savings In Hospitalization, Postacute Care

By Jean Fuglesten Biniek, Aaron Bloschichak, Sally Rodriguez, Anne
Tumlinson, and Brian Fuller (4/9/20)

A variety of concurrent efforts could serve as mechanisms to reduce the
use of higher-cost postacute settings of care among fee-for-service
beneficiaries, and to a lesser extent among Medicare Advantage enrollees
as well. 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.

Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, United States

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