From Health Affairs Sunday Update <[email protected]>
Subject NEW ISSUE: Access To Care, Coverage, And More
Date September 8, 2024 12:13 PM
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NEW BRIEF: Voting To Impact Health Policy

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Sunday, September 8, 2024 | The Latest Research, Commentary, and News from Health Affairs

Dear John,

The September issue of Health Affairs ([link removed] ) includes articles addressing various aspects of access to and coverage of health care services.

Laura Tollen leads off the issue with the first report from the Eye On The IRA project, supported by the National Pharmaceutical Council, which examines how to judge the recently released results of the first round of Medicare drug price negotiations ([link removed] ) that were implemented as part of the IRA (Inflation Reduction Act) of 2022.

health-affairs-43-09-order-issue_eNewsletter-banner ([link removed] )

A C C E S S A N D C O V E R A G E

Megan Cole and coauthors analyze service use and quality metrics for pregnant enrollees ([link removed] ) in Medicaid accountable care organizations (ACOs) in Massachusetts.

Enrollment in the ACO program was associated both with improvement in three of six perinatal quality measures and with increases in the number of office visits during the perinatal period relative to those not enrolled in an ACO.

Noting that “miscarriage management and abortion management involve similar medications and procedures,” Jenna Nobles and coauthors estimate that nearly 400,000 miscarriages occur in states with current abortion bans ([link removed] ) .

Efforts to ban the use of mifepristone warrant “attention to the potential broader effects of these challenges on reproductive health.”

Kaylyn Swankoski and coauthors compare utilization by Medicare enrollees ([link removed] ) whose primary care is provided by “senior-focused” primary care organizations that receive capitation payments from a Medicare Advantage (MA) plan with that of MA enrollees who receive their care elsewhere.

The authors find greater use of primary care, fewer hospitalizations and emergency department visits, and higher quality, with the differences particularly pronounced for Black enrollees.

Jiani Yu and coauthors analyze telehealth use by physician and practice characteristics ([link removed] ) and find greater telehealth use among female physicians, psychiatrists, and primary care physicians, as well as among physicians in the Northeast and West.

Jonathan Cantor and coauthors estimate the relationship between ([link removed] ) in-person school closures during the COVID-19 pandemic and nurse labor supply.

They find a 12.5-percentage-point decline in employment among female nurses with young children, with no declines seen among female nurses with older children.

Eric Roberts and coauthors document increased enrollment in plans ([link removed] ) that integrate care for nursing home residents dually enrolled in Medicare and Medicaid, with the share enrolled in such plans increasing from 6.5 percent in 2013 to 16.9 percent in 2020.

Melissa Aldridge and coauthors document the growing number of hospices acquired by private equity firms ([link removed] ) .

In Narrative Matters, Jen Farnsworth describes the challenges of obtaining Medicaid coverage ([link removed] ) as a graduate student studying public health.

Read the Issue
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P H A R M A C E U T I C A L S

The complex system of drug rebates makes it difficult to calculate the actual cost of drugs ([link removed] ) .

Justine Mallatt and coauthors find that during the period 2007–20, annual list price increases were 9.1 percent, negotiated price increases were 4.3 percent, and out-of-pocket price increases were 5.8 percent, leading them to conclude:

“Concerns about price growth align more closely with the persistent increase in out-of-pocket prices than the recently stagnating growth in negotiated prices.”

Molly Beinfeld and coauthors examine commercial insurance coverage of biologics and biosimilars ([link removed] ) during the period 2017–22 and find sizable declines in preferred coverage only for a single product, along with rapid growth in copreferred coverage of multiple products.

Observing an average 63 percent drop in sales price four years after the introduction of the first biosimilar, the authors conclude:

“The impact of biosimilars on originator-biosimilar market pricing is encouraging and suggests a well-functioning market.”

Medicare’s coverage of new anti-obesity medicines is currently quite limited ([link removed] ) .

Benedic Ippolito and Joseph Levy model the costs of expanded coverage and find that “if 5 percent or 10 percent of newly eligible enrollees with obesity or overweight were prescribed a GLP-1…annual program costs would increase by $3.1 billion or $6.1 billion, respectively.”

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Jiani Yu on the Current Telehealth Landscape & Opportunities ([link removed] )

Health Affairs' Editor-in-Chief Alan Weil interviews Jiani Yu of Cornell University about her recent paper that explores how telehealth use and delivery differs significantly by physician and practice characteristics.

FTC's National Noncompete Ban is Down But Is It Out? ([link removed] )

Health Affairs' Jeff Byers welcomes Deputy Editor Chris Fleming to the program to discuss the latest hurdle to the FTC's attempt to ban noncompete agreements in employment contracts, and what the implications are for the health care industry.

health-affairs-brief-population-health-voting-lantz_eNewsletter ([link removed] )

In a Health Policy brief released this week, Paula Lantz and Emma Carter write about the role of direct democracy in state policy making ([link removed] ) as it relates to the drivers of population health and health disparities.

Read the Brief
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Interpreting The First Round Of Maximum Fair Prices Negotiated By Medicare For Drugs ([link removed] )

Inmaculada Hernandez et al.

Momentum Is Growing To Stabilize Coverage In Medicaid And CHIP For Young Children ([link removed] )

Alice Hm Chen

“A Hundred Small Steps”: Assessing The Effectiveness Of Perinatal Psychiatry Access Programs ([link removed] )

R. Christopher Sheldrick et al.

Out Of Balance: Fixing Our Health System’s Neglect Of Primary Care ([link removed] )

Christopher F. Koller et al.

The Failing Experiment Of Primary Care As A For-Profit Enterprise ([link removed] )

Kevin Grumbach et al.

Delays In Extending Enhanced Marketplace Subsidies Would Raise Premiums And Reduce Coverage ([link removed] )

Jason Levitis et al.

The Future of Telehealth and Its Impact on Primary Care ([link removed] )

Join Health Affairs Tuesday, September 24, for a virtual event examining the future of telehealth and its impact on primary care.

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About Health Affairs

Health Affairs is the leading peer-reviewed journal ([link removed] ) at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online.

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