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A Weekly Health Policy Round Up From Health Affairs            

**April 19, 2020**

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THIS WEEK ON THE BLOG

COVID-19

Despite The Families First Coronavirus Response Act, COVID-19 Evaluation
Is Not Necessarily Free

By Kao-Ping Chua and Rena M. Conti (4/19/20)

To remove barriers to the detection of COVID-19, it is crucial to expand
the protections in the  Families First Coronavirus Response Act and
eliminate patient financial liability for all forms of COVID-19
evaluation. Read More >>

How Should Health Care Systems Prioritize Communication Amidst COVID-19?

By Justin J. Sanders, Namita S. Mohta, and Joanna Paladino (4/19/20)

A systematic response can equip health care systems to ensure the
highest quality care to the most people, facilitate the most efficient
use of resources, and respond to the psychological needs of their
workforce. Read More >>

In The Age Of Coronavirus, Restrictive Immigration Policies Pose A
Serious Public Health Threat

By Wendy E. Parmet (4/18/20)

The pandemic is here, and restrictive immigration policies are impeding
efforts to flatten the curve. Still, small steps point to a growing
recognition, especially within the courts, that punitive immigration
policies can threaten the health of migrants and citizens alike. It
shouldn't take a pandemic to learn that lesson; we must retain it
before the next pandemic strikes. Read More >>

Serious Challenges And Potential Solutions For Immigrant Health During
COVID-19

By Whitney L. Duncan and Sarah B. Horton (4/18/20)

Health and immigration policies put in place long before the pandemic
reached the United States set the stage for inequalities and will
contribute to unnecessary suffering, sickness, and fear during this
crisis. It is essential to ensure that all community members, regardless
of immigration status, have the resources they need to weather this
storm.
Read More >>

The COVID-19 Tsunami: The Tide Goes Out Before It Comes In

By Robert L. Phillips, Andrew Bazemore, and Aaron Baum (4/17/20)

Many front-line primary care physicians are displaying tremendous
professionalism as xxxxxxs for their patients and the public at great
personal cost. Read More >>

COVID-19 Does Not Change The Right To Abortion

By Erica Turret, Sora Tannenbaum, Blake Shultz, and Katherine Kraschel
(4/17/20)

During this public health emergency, some states are illegally using the
legitimate need to preserve health care resources to stop people from
exercising their constitutional right to abortion. States that attempt
to use this pandemic as an opportunity to ban abortion detract from the
enormous challenges we all face and will be sued. Medical providers are
doing everything they can to provide comprehensive essential health care
during this emergency, and abortion should be no exception. Read More >>

Defunding WHO: Why The President's Decision Makes America Less Safe

By Ashish K. Jha (4/16/20)

The World Health Organization (WHO) is not perfect. But it is key to
ending this pandemic. To defeat COVID-19, end deaths around the globe,
and keep Americans healthy, it is essential that, contrary to President
Trump's recent decision. we fund and support WHO.
Read More >>

No Longer Invisible: The Critical Role Of Local Health Departments In
Responding To COVID-19

By Erika G. Martin and Jessica Kronstadt (4/16/20)

We need to ensure that local health departments do not slip back into
invisibility but instead receive the ongoing support necessary to
maintain their cornerstone role in protecting and promoting the health
of our communities. Read More >>

Health And Social Services Integration Is Mission-Critical In The
Coronavirus Response

By Caroline Fichtenberg and Laura M. Gottlieb (4/16/20)

Deepening our focus on social determinants in the health care sector
right now should be a cornerstone of the health care sector's response.
Here are four things a health care organization should do to lessen the
adverse impacts of the virus on vulnerable communities. Read More >>

Designating Certain Post-Acute Care Facilities As COVID-19 Skilled Care
Centers Can Increase Hospital Capacity And Keep Nursing Home Patients
Safer

By Leemore S. Dafny and Steven S. Lee (4/15/20)

Hospitals are bracing for an influx of patients that exceeds their
current capacity to care for them. We recommend designating specific
nursing facilities as "COVID-19 Skilled Care Centers." These facilities
should prepare for the influx by declining new uninfected patients
effective immediately, and, if uninfected longer-term residents cannot
be well-isolated, transferring them to other facilities. Read More >>

The Fierce Urgency Of Now: Closing Glaring Gaps In US Surveillance Data
On COVID-19

By Nancy Krieger, Gregg Gonsalves, Mary T. Bassett, William Hanage, and
Harlan M. Krumholz (4/14/20)

Where are the data on COVID-19 to understand who in the US population is
being tested, who is ill, and who is dying? The federal government
should mandate that all testing data from a new digital short form are
provided to the CDC, in real time, and that data are publicly reported,
in real time, in relation to total cases and stratified by
race/ethnicity, sex/gender, age, educational level, at the national,
state, county, and ZIP code levels. Read More >>

COVID-19 Makes Funding For Health And Social Services Integration Even
More Crucial

By Shauna Petchel (4/14/20)

As we look for solutions to the public health and economic challenges
ahead, policy makers and organizational leaders can leverage
cross-sector partnerships, social-needs screening, and sustainable
payment models for integrated care to ensure that the community response
to COVID-19 lays a foundation for a robust and coordinated recovery.
Read More >>

Accelerating Data Infrastructure For COVID-19 Surveillance And
Management

By Aaron Miri and Daniel P. O'Neill (4/14/20)

In this post, we outline key steps for a crash program to expand the
infrastructure needed to collect data and inform the phase triggers
proposed by Scott Gottlieb and colleagues. Broadly speaking, we argue
that this program can and should rely on technical standards and
data-sharing systems which already exist but will require a more
dirigiste approach than the US has embraced in the past, with firm
federal coordination, and in some cases, mandatory provider
participation. Read More >>

How Will We Care For Coronavirus Patients After They Leave The Hospital?
By Building Postacute Care Surge Capacity

By Vishal S. Arora and Jonathan E. Fried (4/13/20)

While the primary focus of policy makers has rightfully been on
providing hospital care, there is still more work necessary to help
patients actually recover from their illnesses.
Read More >>

How Can We Ramp Up Hospital Capacity To Handle The Surge Of COVID-19
Patients? Long-Term Acute Care Hospitals Can Play A Critical Role

By Anil N. Makam and David C. Grabowski (4/13/20)

Long-term acute care hospitals offer additional opportunities to prepare
for and manage the surge of COVID-19 patients experiencing respiratory
failure. Read More >>

Protecting Decarcerated Populations In The Era Of COVID-19: Priorities
For Emergency Discharge Planning

By Benjamin A. Howell, Haiyan Ramirez Batlle, Cyrus Ahalt, Shira Shavit,
Emily A. Wang, Nickolas D. Zaller, and Brie A. Williams (4/13/20)

Federal, state, and local criminal justice systems confronting COVID-19
outbreaks in correctional facilities should act swiftly and think
broadly to address the evolving risk.
Read More >>

New Guidance To Implement COVID-19 Coverage Requirements And More

By Katie Keith (4/13/20)

On April 11, 2020, the Departments of Health and Human Services,
Treasury, and Labor jointly issued guidance to implement the
COVID-19-related coverage provisions outlined in two recent pieces of
legislation: the Families First Coronavirus Response Act and the
Coronavirus Aid, Relief, and Economic Security (CARES) Act. This post
summarizes that guidance, highlights an analysis from the Congressional
Budget Office, and discusses the latest efforts to shield patients from
the cost of COVID-19 treatment. Read More >>

FOLLOWING THE ACA

Courts Rule On ACA Abortion Transaction Rule And Take Care Case

By Katie Keith (4/18/20)

Despite disruptions to the judicial branch in light of COVID-19, two
courts recently issued decisions on Affordable Care Act issues. A
district court in Washington set aside a recent federal rule over
abortion transactions. In a separate case, a district court in Maryland
ruled that a lawsuit over a range of Trump administration policies could
proceed under the Administrative Procedure Act but not the Take Care
Clause of the US Constitution.
Read More >>

CONSIDERING HEALTH SPENDING

Maintaining Progress Toward Accountable Care And Payment Reform In An
Unprecedented Pandemic: Part 1: Use And Financial Impact

By William K. Bleser, Elizabeth Singletary, Hannah L. Crook, Jonathan
Gonzalez-Smith, Robert S. Saunders, and Mark B. McClellan (4/14/20)

COVID-19 could have large financial impacts on accountable care
organizations (ACOs) and more strongly affect physician-led ACOs. Read
More >>

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Maintaining Progress Toward Accountable Care And Payment Reform In An
Unprecedented Pandemic: Part 2: Immediate Issues And Short-Term Actions

By William K. Bleser, Elizabeth Singletary, Hannah L. Crook, Jonathan
Gonzalez-Smith, Robert S. Saunders, and Mark B. McClellan (4/15/20)

In this post, we identify immediate issues and short-term actions that
private payers, Medicare, and Medicaid can take immediately to adjust
their accountable care organization programs to adapt to this crisis in
the coming weeks and months. Read More >>

These posts appear in the series Considering Health Spending
.

SUBSTANCE USE DISORDER

Can Churches Bring Addiction Treatment To Rural Areas?

By Alex Woodruff and Austin B. Frakt (4/16/20)

Due to the relatively high rates of religious participation in many
rural communities, faith-based community initiatives may be a respectful
and impactful approach to providing addiction treatment. Read More >>

Once The Coronavirus Pandemic Subsides, The Opioid Epidemic Will Rage

By Navdeep S. Kang (4/15/20)

If we take these steps now, when the next generation asks how we were
able to manage an epidemic amidst a pandemic, we'll be able to say
that we took meaningful action simultaneously on two fronts-and saved
countless lives in doing so. Read More >>

MARKETS
The Proposed Vertical Merger Guidelines And Health Care: Little Guidance
And Dubious Economics

By Thomas L. Greaney and Richard M. Scheffler

The health care sector is particularly vulnerable to anticompetitive
effects from vertical mergers because of several characteristics. Read
More >>

ELSEWHERE @HEALTH AFFAIRS

In Remembrance: Ted Agres, Senior Editor, Health Affairs (July 6, 1949
To April 14, 2020)

By Alan Weil, Donald E. Metz, and Jane Hiebert-White

It is with great sadness that we announce the death of Health Affairs
Senior Editor Ted Agres this week. Ted is remembered by his colleagues
as a beacon of calm amidst the storm of deadlines and for his swift
attention to articles across a wide range of topic areas. We will miss
his wry humor, creative insights, and caring conversation. Read More >>

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HEALTH POLICY BRIEF

Child Care Subsidies: Supporting Work And Child Development For Healthy
Families

By Gina Adams and Julia R. Henly

This Health Policy Brief provides background information about the Child
Care and Development Block Grant, which has the dual focus of supporting
parental employment and child development-both of which have important
implications for child and family health and well-being. Read More >>

IN THE JOURNAL

AHEAD OF PRINT-FROM OUR MAY ISSUE

Most Patients Undergoing Ground And Air Ambulance Transportation
Receive Sizable Out-Of-Network Bills

By Karan R. Chhabra, Keegan McGuire, Kyle H. Sheetz, John W. Scott,
Ushapoorna Nuliyalu, and Andrew M. Ryan

Karan R. Chhabra and coauthors sought to understand the impact of
surprise out-of-network bills in ground and air ambulance
transportation. They evaulated information from the Clinformatics
DataMart Database for the years 2013-17, which contains insurance
claims from all fifty states and the District of Columbia from a large
national insurance plan. According to the study, 71 percent of all
ground and air ambulance rides involved potential surprise bills. Read
More >>

Prevalence And Characteristics Of Surprise Out-Of-Network Bills
From Professionals In Ambulatory Surgery Centers

By Erin L. Duffy, Loren Adler, Paul B. Ginsburg, and Erin Trish

Erin Duffy and coauthors looked at the relatively unexplored prevalence
of surprise medical bills in ambulatory surgery centers (ASCs),
analyzing 4.2 million ASC-based episodes of care from around the US.
They found that in 10 percent of the episodes, patients were treated at
in-network ASCs but involuntarily received care from out-of-network
providers. Read More >>

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INTEGRATING SOCIAL SERVICES & HEALTH

The Organizational Risks Of Cross-Sector Partnerships: A Comparison Of
Health And Human Services Perspectives

By Shauna Petchel, Sherril Gelmon, and Bruce Goldberg

Shauna Petchel and coauthors study the perspectives of health and human
services leaders as Oregon created its Accountable Health Communities
initiative in 2019. Among the many differences in those perspectives:
Health system leaders view addressing social needs as population health
management that facilitates a move away from fee-for-service payment,
while human services leaders view contracts with health systems to
deliver services as a potentially more reliable source of
fee-for-service funding than grants and donations.
Read More >>

Cash Benchmarking For Integrated Health Care And Human Services
Interventions: Finding The Value Added

By Seth A. Berkowitz, Samuel T. Edwards, and Daniel Polsky

Health-related social problems, which include food insecurity, housing
instability, and lack of transportation, are strongly associated with
poor health outcomes, more health care use, and higher health care
spending. Integrating human services that address health-related social
needs into health care may address these issues. Seth Berkowitz and
coauthors propose an innovative methodological approach (borrowed from
developmental economics) called cash benchmarking, which can help
determine when health care and human services integration is most
useful. Read More >>

DETERMINANTS OF HEALTH

Interrupting Violence From Within The Trauma Unit And Well Beyond

By T. R. Goldman

Hoping to reduce the number of repeat visitors, one Washington, D.C.,
hospital is providing short- and long-term support to victims of
violence. Read More >>

This article appears in Health Affairs' series Leading To Health.

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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
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health care workers to save lives across the globe. Project HOPE has
published Health Affairs since 1981.

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