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A Weekly Health Policy Round Up From Health Affairs
May 10, 2020
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NEW ISSUE:
SUBSTANCE USE, SURPRISE BILLING & MORE
The May issue of Health Affairs includes studies about substance use, surprise billing, maternal mortality, and other topics.
Read the May 2020 table of contents.
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OPIOID USE DISORDER
Self-Help Groups And Medication Use In Opioid Addiction Treatment: A National Analysis
By Hefei Wen, Benjamin G. Druss, and Brendan Saloner
People who receive treatment for opioid use disorder may participate in self-help programs, receive medication, or both. Analyzing discharge data from opioid treatment programs, Hefei Wen and coauthors find that for most patients, medication is not part of their treatment, and only one out of ten patients combine self-help programs and medication. Read More >>
Impact Of Long-Term Buprenorphine Treatment On Adverse Health Care Outcomes In Medicaid
By Hillary Samples, Arthur Robin Williams, Stephen Crystal, and Mark Olfson
Hillary Samples and coauthors examine the effects of longer-duration buprenorphine treatment among Medicaid enrollees. Comparing people who sustained treatment for at least 15 months with those treated for 6–9 months, the authors find that the former
have "significantly lower probability of all-cause inpatient use, all-cause emergency use, opioid-related hospital use, all overdose events, and prescription opioid use in the follow-up period than in the treatment period." Read More >>MATERNAL & CHILD HEALTH
Neighborhood Racial And Economic Polarization, Hospital Of Delivery, And Severe Maternal Morbidity
By Teresa Janevic, Jennifer Zeitlin, Natalia Egorova, Paul L. Hebert, Amy Balbierz, and Elizabeth A. Howell
Rates of severe maternal morbidity are growing and exhibiting shocking racial/ethnic disparities. Teresa Janevic and coauthors analyze birth records in New York City and, controlling for other factors, find that women who live in neighborhoods
with the highest concentrations of non-Hispanic black and low-income families face the highest excess risk of severe maternal morbidity. Read More >>
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THIS WEEK ON THE BLOGCOVID-19New Federal Rules Pave The Way For Patient-Driven Health Information Exchange And Real-World Evidence On COVID-19 Surveillance And Treatment
By Sanket S. Dhruva, Joseph S. Ross, Nilay D. Shah, Rachael Fleurence, and Harlan M. Krumholz (5/10/20)
New federal rules governing access to electronic health data could transform evidence generation and accelerate the discovery and delivery of novel drugs and medical devices, including for COVID-19. Read More >>
Here’s How States Can Deliver More Food Assistance To Low-Income Children During The COVID-19 Pandemic
By Ahmed Ahmed (5/10/20)
The harmful effects of food
insecurity are severe: it impacts children’s health, development, academic performance, and long-term well-being. We cannot sit idly by as students go hungry or miss meals due to state inaction. Pandemic Electronic Benefit Transfer can fill the void of lost school meals. It’s time more states apply for it. Read More >>
Three Workforce Strategies To Help COVID-19 Affected Communities
By Rishi Manchanda (5/9/20)
There are three ways state and federal leaders can ramp up a community-based workforce to protect vulnerable communities and augment the efforts of hospitals and public health leaders. They are inspired by the innovative solutions that we have mapped through discussions with leaders in health systems, community-based organizations, public health departments, and philanthropies. Read More >>
Ensuring The Growth Of Telehealth During COVID-19 Does Not Exacerbate Disparities In Care
By David Velasquez and Ateev Mehrotra (5/8/20)
Federal, state, and
local leaders, in addition to health and community systems, should push for health equity by addressing digital technology, literacy, and coverage. Their actions could ensure that the most vulnerable people are not left out during this critical time. Read More >>
Medicaid Retroactive Eligibility Waivers Will Leave Thousands Responsible For Coronavirus Treatment Costs
By Paul Shafer, Nicole Huberfeld, and Ezra Golberstein (5/8/20)
One of Medicaid’s key provisions has been weakened by recently approved section 1115 "demonstration projects," commonly referred to as waivers, that eliminate or reduce retroactive coverage. These waivers will diminish coverage for thousands of people seeking testing and treatment for COVID-19 and other medical care. Read More >>
Physicians Should Not Be Forced To Determine Resource Allocation: Triage Committees May Reduce Physician Trauma
By Susie A. Han and Valerie G. Koch (5/8/20)
Health care providers around the world are
confronting the real possibility of determining which patient receives a ventilator, adding to their emotional and physical exhaustion during the COVID-19 pandemic. Use of a triage officer or committee framework to make determinations regarding scarce resource allocation can ease the potential of physician trauma. Read More >>
The Need for "Exposure Registries" For Novel Coronavirus
By Bill Cassidy (5/7/20)
To save lives and reopen the economy as soon as possible, the United States should expand existing information systems, to make use of novel coronavirus (nCV) exposure history to aid in the public health response. We have both the technical capability and the privacy infrastructure necessary to create nCV "exposure registries" that are effective and in accordance with the rights of Americans. Read More >>
The COVID-19 Epidemic As A Catalyst For Health Care Fraud
By Michael Adelberg and Melissa Garrido (5/7/20)
There are compelling health policy arguments for
relaxing regulatory processes and requirements during a national emergency—strong action is necessary to address the COVID-19 crisis. Yet while leaders across the federal agencies are focused on consumer-facing COVID-19 scams, there is not yet corresponding concern on payer-facing fraud and waste. Read More >>
Getting The Most Out Of Self-Triage Websites: Experiences With COVID-19 And Principles For The Future
By Justin D. Schrager, Alexander P. Isakov, David W. Wright, and Annay Q. Yaffee (5/7/20)
We describe the steps that our group used to develop its self-triage website, and we examine what can be done in the short term to marry the data from the disparate self-triage systems to enhance and improve our nation’s response to COVID-19. We also discuss what can be done in the longer term so that we don’t engage in duplicative effort when the next pandemic inevitably comes. Read More >>
Child Care Investments Through The Lens Of The COVID-19 Pandemic
By Gina Adams and Julia Henly (5/6/20)
Rebuilding and strengthening the child care and early education sectors will be critical to the nation’s economic recovery from the COVID-19 pandemic. Read More >>
March-In Rights And Compulsory Licensing—Safety Nets For Access To A COVID-19 Vaccine
By Michael Liu, William B. Feldman, Jerry Avorn, and Aaron S. Kesselheim (5/6/20)
Given the state of the current pandemic, the US must be prepared to counteract measures that prevent optimal access to a COVID-19 vaccine. Read More
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To Strengthen The Public Health Response To COVID-19, We Need Community Health Workers
By Denise O. Smith and Ashley Wennerstrom (5/6/20)
The missed opportunity to leverage community health workers’ (CHWs’) potential is costing thousands of lives. Health systems, local governments, and state public health officials should immediately engage CHWs in
community-based strategies to protect vulnerable populations during the pandemic. Read More >>
Everyone Is Talking About Testing, But They’re Thinking About It All
Wrong
By Arthur L. Kellermann, Craig Goolsby, and Thomas D. Kirsch (5/5/20)
If testing is increased in an uncoordinated manner, it will boost counts of infected people but fail to generate the insights we need to tailor our countermeasures and start reopening our economy. Read More >>
Could Coronavirus Cause The Collapse Of Our Health Care Financing System?
By M. Gregg Bloche and Daniel Wikler (5/5/20)
When normal politics resumes, we can and should debate the question of whether COVID-19 has exposed flaws in our private coverage system so profound that we need to replace it, or back it up, with a public payment scheme. Meanwhile, let’s make sure that money doesn’t stand in the way of saving
lives. Read More >>
What CMS’s Response To COVID-19 Means For Front Line Clinicians
By Michael J. Lipp and Shari M. Ling (5/4/20)
To effectively respond to
the COVID-19 pandemic, we need all hands on deck to ensure that providers are mobilized and available to treat patients appropriate to the provider's level of training. This is why during this public health emergency, the Centers for Medicare and Medicaid Services (CMS) has enacted an unprecedented number of waivers and flexibilities to expand the capacity of facilities and providers. CMS has acted under Medicare rules that allow the provider workforce to adapt to meet the dynamic needs of patient care.
Read More >>
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FOLLOWING THE ACA
The 2021 Final Payment Notice, Part 1: Insurer Provisions
By Katie Keith (5/8/20)
Yesterday the Centers for Medicare and Medicaid Services released the 2021 Affordable Care Act final payment notice, containing policies and timelines for areas such as the marketplaces, the risk adjustment program, and the market reforms. Read the first installment of Katie Keith’s three-part unpacking of the payment notice, and check back for parts two and three, coming soon. Read More
>>
Supreme Court: No Clear Consensus On Contraceptive Mandate Rules
By Katie Keith (5/7/20)
On May 6, 2020, the Supreme Court heard one hour of oral argument over the validity of Trump-era rules to expand exemptions to the contraceptive mandate for religious or moral reasons. This post focuses on the questions asked by the justices and potential outcomes of the case. Read More >>
ACA Round-Up: COVID-19 Delays, New COBRA Guidance, And More
By Katie Keith (5/5/20)
In response to
the COVID-19 crisis, the Centers for Medicare and Medicaid Services (CMS) continues to delay enforcement of regulatory requirements and to issue guidance for insurers that offer Affordable Care Act plans. In a recent COVID-19 rule, CMS announced it would delay enforcement of parts of the program integrity rule and offer flexibility to states with the Basic Health Program. Read More >>
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MEDICAID
In The Middle Of A Pandemic, Oklahoma Pursues A Medicaid Funding Cap
By Sara Rosenbaum and Maria Velasquez (5/9/20)
Oklahoma’s proposed Healthy Adult Opportunity experiment is the latest evidence that some states are interested in fostering Medicaid policies that appear contrary to their populations’ health and economic well-being. From a legal perspective, it is unclear how a plan to test spending caps pursuant to a Section 1115 Medicaid waiver experiment could possibly be allowed to proceed. Read More >>
HEALTH EQUITY
A Foundation's Decision To Use A Different Kind Of Investment In Health Equity
By Nikki Highsmith Vernick (5/6/20)
A foundation's journey in racial health equity began with
looking at the data. Whether in chronic disease, mental health, or advance care planning, the staff saw glaring gaps and disparities affecting communities of color in its local area. The foundation's president and CEO says there is a need for strategies and solutions that include advocacy for policy change with a ripple effect on health and for an acknowledgment of the social determinants of health. 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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