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