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A Weekly Health Policy Round Up From Health Affairs            

**April 26, 2020**

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FAST TRACK AHEAD OF PRINT

The Potential Health Care Costs And Resource Use Associated With
COVID-19 In The United States

By Sarah M. Bartsch, Marie C. Ferguson, James A. McKennell, Kelly J.
O'Shea, Patrick T. Wedlock, Sheryl S. Siegmund, and Bruce Y. Lee

Sarah Bartsch and coauthors developed a simulation model representing
the US population to estimate resource use and direct medical costs for
interventions and care specific to COVID-19. Read More >>

THIS WEEK ON THE BLOG

COVID-19

To Protect Palliative Care Patients During The COVID-19 Pandemic, Allow
More Flexibility To Prescribe Controlled Substances By Phone

By Patrice Villars, Eric Widera, and Chad D. Kollas (4/26/20)

We call on the DEA to waive the visual requirement for telemedicine
visits so that during the pandemic, palliative care providers can
prescribe controlled substances to patients who have not previously been
seen in person or via telemedicine in DEA facilities and who do not have
visual telemedicine options. Read More >>

Coverage Of COVID-19 Serology Testing Must Include The Uninsured

By Michael Liu and Joy Jin (4/26/20)

The federal government is not protecting individuals whose jobs create
an urgent need to know their immunity status yet who are least able to
afford serology testing on their own. Federal legislation is needed now
to cover the cost of COVID-19 serology testing for the uninsured. Read
More >>

In Allocating Scarce Health Care Resources During COVID-19, Don't
Forget Health Justice

By Elizabeth Tobin-Tyler (4/25/20)

Mapping the need for resources using not only reported cases in a given
area and current health care capacity, but also demographic data that
accounts for economic and social vulnerability, and surveillance data on
the prevalence of comorbidities within a community, will help to prevent
resources from going to the most privileged institutions and patient
populations. Read More >>

How To Conserve PPE And Protect Health Care Workers From COVID-19

By Miao Hua (4/25/20)

Health care workers and policy makers need to urgently consider how a
limited supply of PPE should be applied, allocated, and conserved. Read
More >>

States Should Act Now To Mitigate Commercial Insurance Costs Associated
With COVID-19

By Margot Thistle (4/25/20)

An examination of the impact that COVID-19-related health insurance
expenditures in 2020 will have in 2021, and how states can work with
health insurers to protect the individual and small group health
insurance markets during this turbulent time. Read More >>

Protecting Health Care's Family Caregivers Amidst The COVID-19
Pandemic

By Eli M. Cahan, Terry Fulmer, and Nirav R. Shah (4/24/20)

To the degree that COVID-19 produces intensified and extended caregiving
needs, while simultaneously leading to lost wages, benefits, and jobs
due to social distancing measures, the consequences for caregivers may
be stark.Read More >>

What If We Gave Hospitals Real Incentives To Prepare For The Next
Pandemic?

By Soleil Shah and Bob Kocher (4/24/20)

We need to rethink the way we incentivize hospitals to handle pandemic
response for ourselves and the future of our public health system. Read
More >>

Aggregating Counties To Hospital Referral Regions Shows That COVID-19 Is
Everywhere

By Elliott Fisher, Anoop Nanda, Sukdith Punjasthitkul, and Jonathon
Skinner (4/23/20)

Given the limited current state of testing for the coronavirus, it will
be important for state policy makers to have data to identify regions
where the virus is still active. Aggregating county-level data to larger
regions can help. Read More >>

Supporting Primary Care In Crisis: A Road Map For A Payer-Backed
COVID-19 Stimulus Package

By Nisarg Patel and Joseph Kwan-Ho Yun (4/23/20)

In the absence of dedicated financial relief from the federal
government, assistance from private payers will empower these practices
to survive through the COVID-19 pandemic and continue delivering
high-quality care for their patients well beyond it. Read More >>

Can Community Resource Referral Technologies Support Local COVID-19
Response?

By Yuri Cartier, Caroline Fichtenberg, and Laura M. Gottlieb (4/23/20)

To begin exploring this question, we turned back to ask the platform
vendors we included in our April 2020 Health Affairs article how they
had adapted their systems in light of COVID-19 and to ask our health
care early adopter interviewees how the platform they chose had helped
them respond to the crisis. Here is what we learned from seven vendors
and six informants. Read More >>

Prioritizing Public Health Resources For COVID-19 Investigations: How
Administrative Data Can Protect Vulnerable Populations

By Mark Krass, Peter Henderson, and Daniel E. Ho (4/22/20)

Our proof-of-concept shows the power of administrative data to augment
the capacities of health departments. Ensuring fairness in allocation
schemes is critically important, as is modernizing our public
infrastructure. As more data become available, more sophisticated
approaches based on machine learning and artificial intelligence can be
deployed to protect the vulnerable. Read More >>

In The Time Of COVID-19, We Should Move High-Intensity Postacute Care
Home

By Rachel M. Werner and Courtney Harold Van Houtven (4/22/20)

COVID-19 gives us the opportunity to reimagine what optimal
post-hospital care might look like after the pandemic is over, an
opportunity we shouldn't squander. There is a safe alternative to
nursing home-based post-acute care, one that is favored by many
patients and their families and might even cost us less. We can help
people recover at home.
Read More >>

COVID-19: It's Time For Foundations To Be The Life-Saving Difference

By Elizabeth Ripley (4/22/20)

The CEO of a foundation in Alaska discusses its essential roles in
supporting its grantees, and, in turn, the entire community, during the
COVID-19 pandemic. Because of this real "philanthropic emergency," the
foundation recognized that it needed to do some different things. For
example, it has been working with local mayors on unified strategic
communications to fill the COVID-19 information gap experienced by some
residents.
Read More >>

Health And Housing Consortia: Responding To COVID-19 Through
Cross-Sector Learning And Collaboration

By Bonnie Mohan, Amy L. Freeman, and Kelly M. Doran (4/21/20)

In our paper in the April 2020 issue of Health Affairs, we discuss how a
consortium of health, housing, and social service providers has worked
to bridge the divide between the health care and housing sectors to
improve care for the most vulnerable New Yorkers, starting in the Bronx
and expanding to Brooklyn. The challenges that already existed within
and between these systems have been exacerbated as the COVID-19 crisis
has hit New York City.
Read More >>

Housing As A Prescription For Health, Now And In The Future

By Allison Bovell-Ammon, Megan Sandel, and Thea James (4/21/20)

The COVID-19 pandemic and subsequent economic crisis highlight the
critical intersection between where you live and your health in myriad
ways. Solutions that respond to the complex nature of these interlocking
issues are needed more than ever and offer a way forward to reset our
future, post-pandemic. Read More >>

How Can We Protect The Health Of Justice-Involved Populations During The
COVID-19 Pandemic? Decarceration And Timely Access To Medicaid Are
Essential

By Jacqueline Lantsman and Mark Osler (4/21/20)

It is imperative that the president, governors, mayors, and others with
authority to reduce the populations of jails and prisons do so now. If
we are going to decarcerate-and we should-we must do it the right
way to protect the health and safety of all Americans. Read More >>

Good, A COVID-19 Vaccine Is In Development-Will It Be Accessible To
All Americans?

By Cecelia Thomas and Amy Pisani (4/20/20)

What measures should the administration and Congress take now to ensure
a smooth and equitable rollout of a COVID-19 vaccine throughout the
United States? Read More >>

Emerging Health Workforce Strategies To Address COVID-19

By Candice Chen, Patricia Pittman, Sara Westergaard, Edward Salsberg,
and Clese Erikson (4/20/20)

A number of emerging strategies from Washington State, New York,
California, and others stand as a potential road map for those that
follow.Read More >>

How To Read National Health Expenditure Projections In Light Of
COVID-19: Uncertain Long-Run Effects, But Challenges For All

By Michael E. Chernew (4/20/20)

The ultimate impact on national spending will depend largely on how much
of the ultimate COVID-19 costs, which are uncertain but potentially
substantial, are offset by a long-run decline in non-COVID-19 spending
and how other system reactions play out. Read More >>

Social Distancing And Challenges With Multidisciplinary, Integrated Care

By K. John McConnell (4/20/20)

Are social distancing and integrated care compatible? While the two are
not necessarily at odds, social distancing favors physical separation
and a certain type of siloing (even if temporary), activities that may
run counter to the conceptual model of co-located, multidisciplinary
teams practicing with warm hand-offs and high-touch care. Read More >>

FOLLOWING THE ACA

ACA Round-Up: Latest on SEPs, Pass-Through Funding, and RADV

By Katie Keith (4/21/20)

This post summarizes the latest information on special enrollment
periods, letters to thirteen states on federal pass-through funding for
2020, and a decision from the Centers for Medicare and Medicaid Services
(CMS) to postpone the risk-adjustment data validation process. CMS also
released its final unified rate review instructions for the 2021 plan
year. Read More >>

CONSIDERING HEALTH SPENDING

Cancer Deaths, Smoking, And Rodney Dangerfield

By Robert M. Kaplan

To paraphrase the words of Rodney Dangerfield, preventive efforts
don't get no respect. It is now time to redouble our efforts to
eliminate cigarette smoking worldwide. Read More >>

This post appears in the series Considering Health Spending
.

AFFORDABLE CARE ACT
Lessons From Covered California's First Five Years For Marketplaces
And The Employer Sector: Part 1

By Peter V. Lee, Elliott S. Fisher, and Kelly Green (4/20/20)

This first part highlights key areas of progress and outlines persistent
challenges that require more work. Read More >>

Lessons From Covered California's First Five Years For Marketplaces
And The Employer Sector: Part 2

By Peter V. Lee, Elliott S. Fisher, and Kelly Green (4/21/20)

In this second part of a two-part blog post, we are highlighting the
lessons learned from California's coverage expansion efforts and its
Marketplace, Covered California.
Read More >>

PUBLIC HEALTH

Risk And Reason: Australia, England, And The US E-Cigarette Crisis Of
2019

By Ronald Bayer, Amy Fairchild, Virginia Berridge, Wayne Hall, and Coral
Gartner (4/22/20)

Certainty about the cause of the acute lung injury outbreak did little
to influence the policy debate in the UK and Australia. Read More >>

ELSEWHERE @HEALTH AFFAIRS

Writing To Change Health Care: A New Narrative Matters Book

By Jessica Bylander (4/23/20)

The new book, Narrative Matters: Writing to Change the Health Care
System, comes more than a decade after the first Narrative Matters
collection was published (Narrative Matters: The Power of the Personal
Essay in Health Policy, Johns Hopkins University Press, 2006), and
features an entirely new lineup. Read More >>

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IN THE JOURNAL

INTEGRATING SOCIAL SERVICES & HEALTH

Project Nurture Integrates Care And Services To Improve Outcomes For
Opioid-Dependent Mothers And Their Children

By K. John McConnell, Menolly R. Kaufman, Jenny I. Grunditz, Helen
Bellanca, Amanda Risser, Maria I. Rodriguez, and Stephanie Renfro

K. John McConnell and coauthors report the effects of Project Nurture, a
program implemented in Oregon in 2015 that integrates maternity care and
substance use treatment and provides pregnant women with peer support,
clinical care, and links to social services. Among women covered by
Medicaid who had a hospital birth and an opioid use disorder diagnosis,
the authors find an 8.3-percentage-point reduction in the foster care
placement rate and a 7.2-percentage-point reduction in substantiated
reports of child maltreatment during a child's first twelve months of
life. Read More >>

Housing Intervention For Medically Complex Families Associated With
Improved Family Health: Pilot Randomized Trial

By Allison Bovell-Ammon, Cristina Mansilla, Ana Poblacion, Lindsey
Rateau, Timothy Heeren, John T. Cook, Tina Zhang, Stephanie Ettinger de
Cuba, and Megan T. Sandel

Allison Bovell-Ammon and coauthors report results from a pilot
randomized controlled trial of Housing Prescriptions as Health Care, a
supportive housing program in Boston serving families that have
experienced homelessness and housing instability. Read More >>

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Perspectives On Integrating Health Into The Low-Income Housing Tax
Credit: A Qualitative Study

By Marc Shi, Abigail Baum, and Craig E. Pollack

While there is increasing attention to the ways in which safe and
affordable housing may promote improved health, less work has focused on
the role of the Low-Income Housing Tax Credit (LIHTC) program. Marc Shi
and coauthors examined the perspectives of diverse stakeholders in the
housing sector on the opportunities and obstacles involved in including
health-related criteria in LIHTC funding decisions.Read More >>

The Development Of Health And Housing Consortia In New York City

By Amy L. Freeman, Bonnie Mohan, Henie Lustgarten, Deirdre Sekulic,
Laura Shepard, Megan Fogarty, Sue A. Kaplan, and Kelly M. Doran

Amy Freeman and coauthors describe the creation and replication of the
Bronx Consortium, "a collaborative network of health care, housing,
social services, and government organizations and agencies that share
the goal of strengthening and integrating health care and housing
systems at the policy, operational, and individual patient/client
levels." The consortium's success in providing a neutral space to
broker partnerships is due, in part, to the "focus on the priorities
and challenges of front-line staff." Read More >>

Financing The Infrastructure Of Accountable Communities For Health Is
Key To Long-Term Sustainability

By Dora L. Hughes and Cindy Mann

Accountable Communities for Health (ACHs) are collaborative partnerships
spanning health, public health, and social services that seek to improve
the health of individuals and communities by addressing social
determinants of health such as housing, food security, employment, and
transportation. Dora L. Hughes and Cindy Mann conducted a legal and
policy review to identify potential funding streams specifically for ACH
infrastructure activities. Read More >>

Implementing Community Resource Referral Technology: Facilitators And
Barriers Described By Early Adopters

By Yuri Cartier, Caroline Fichtenberg, and Laura M. Gottlieb

Health care organizations are increasingly implementing programs to
address patients' social conditions. New technology platforms have
emerged to facilitate referrals to community social services
organizations. To understand the functionalities of these platforms and
identify the lessons learned by their early adopters, Yuri Cartier and
coauthors reviewed nine platforms that were on the market in 2018 and
interviewed representatives from thirty-five early-adopter health care
organizations. Read More >>

Integrating Data To Advance Research, Operations, And Client-Centered
Services In California

By Emily Putnam-Hornstein, Mark Ghaly, and Michael Wilkening

In 2017 the California Health and Human Services Agency partnered with
the University of Southern California to link data across programs.
Emily Putnam-Hornstein and coauthors describe the value of this new
resource, which provides person-oriented data. Read More >>

COSTS & SPENDING

National Health Expenditure Projections, 2019-28: Expected Rebound In
Prices Drives Rising Spending Growth

By Sean P. Keehan, Gigi A. Cuckler, John A. Poisal, Andrea M. Sisko,
Sheila D. Smith, Andrew J. Madison, Kathryn E. Rennie, Jacqueline A.
Fiore, and James C. Hardesty

Estimates from the Office of the Actuary at the Centers for Medicare and
Medicaid Services project an average annual rate of national health
spending growth of 5.4 percent for 2019-28, outpacing average
projected growth in the gross domestic product (GDP) by 1.1 percentage
points. As a result, the health share of the economy is projected to
climb to 19.7 percent by 2028-up from 17.7 percent in 2018. (Given the
timing of publication and the uncertainty associated with the impacts of
the COVID-19 pandemic, those impacts are not reflected in the
estimates.)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.

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