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A Weekly Health Policy Round Up From Health Affairs
April 12, 2020
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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. GottliebIn 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 >>
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THIS WEEK ON THE BLOGCOVID-19Keeping 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
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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.
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