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A Weekly Health Policy Round Up From Health Affairs
April 26, 2020
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THIS WEEK ON THE BLOGCOVID-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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