View Message in Browser

[link removed]

 

[link removed]

 

[link removed]

 

[link removed]

 

mailto:[email protected]

[link removed]

A Weekly Health Policy Round Up From Health Affairs            

**May 17, 2020**

IN THE JOURNAL

[link removed]

FAST TRACK AHEAD OF PRINT

Strong Social Distancing Measures In The United States Reduced The
COVID-19 Growth Rate

By Charles Courtemanche, Joseph Garuccio, Anh Le, Joshua Pinkston, and
Aaron Yelowitz

To minimize the spread of COVID-19 during March and April, US state and
local governments joined worldwide efforts to impose social distancing
measures. They have included bans on large social gatherings, public
school closures, the shuttering of entertainment-related businesses, and
shelter-in-place orders. Charles Courtemanche and coauthors examined the
impact of these four measures, separately and collectively, and found
that these policies reduced the daily COVID-19 growth rate by 5.4
percentage points after 1-5 days, 6.8 percentage points after 6-10
days, 8.2 percentage points after 11-15 days, and 9.1 percentage
points after 16-20 days. Read More >>

EYE ON HEALTH REFORM

Risk Corridors, COVID-19, And The ACA

By Katie Keith

Affordable Care Act (ACA) litigation and implementation continue even
amid the coronavirus crisis. The Supreme Court has ruled that insurers
should receive more than $12.2 billion in owed risk corridors payments.
Other ACA litigation continues as well. The Department of Health and
Human Services released final Marketplace enrollment data for 2020,
interoperability standards, guidance on coronavirus, and more.Read More
>>

MEDICARE

Switching Between Medicare Advantage And Traditional Medicare Before And
After The Onset Of Functional Disability

By Claire K. Ankuda, Katherine A. Ornstein, Kenneth E. Covinsky, Evan
Bollens-Lund, Diane E. Meier, and Amy S. Kelley

Medicare Advantage (MA) plans have increasing flexibility to provide
nonmedical services to support older adults aging in place in the
community. However, prior research has suggested that enrollees with
functional disability were more likely than those without disability to
leave MA plans. Claire Ankuda and coauthors used data from the National
Health and Aging Trends Study linked to Medicare claims to measure and
characterize switches in either direction between MA and traditional
Medicare in the twelve months before and after onset of disability. Read
More >>

CONSIDERING HEALTH SPENDING

Wide State-Level Variation In Commercial Health Care Prices Suggests
Uneven Impact Of Price Regulation

By Michael E. Chernew, Andrew L. Hicks, and Shivani A. Shah

Michael Chernew and coauthors find that "prices charged for health care
services in the commercial market are well above those paid by
Medicare." Using IBM MarketScan data, they report overall
commercial-to-Medicare payment ratios of 2.16 for outpatient facility
services, 2.06 for inpatient hospital services, and 1.63 for
professional services. These ratios varied significantly across states,
implying that using Medicare payment rates as a benchmark would have
differential effects in different markets. Read More >>

Physician Prices And The Cost And Quality Of Care For Commercially
Insured Patients

By Mark A. Unruh, Yongkang Zhang, Hye-Young Jung, Manyao Zhang, Jing Li,
Eloise O'Donnell, Fabrizio Toscano, and Lawrence P. Casalino

Using data from the Health Care Cost Institute, Mark Unruh and coauthors
analyze the relationship between physician prices and the cost and
quality of care for commercially insured patients. Read More >>

These articles appear in the series Considering Health Spending.

BEHAVIORAL HEALTH CARE

The Impact Of Medicare's Mental Health Cost-Sharing Parity On Use Of
Mental Health Care Services

By Benjamin Lê Cook, Michael Flores, Samuel H. Zuvekas, Joseph P.
Newhouse, John Hsu, Rajan Sonik, Esther Lee, and Vicki Fung

The Medicare Improvements for Patients and Providers Act of 2008 phased
in cost-sharing reductions in Medicare for outpatient mental health
services in the period 2010-14. Benjamin Lê Cook and coauthors
assessed whether this reduction in mental health cost sharing was
associated with changes in specialty and primary care outpatient mental
health visits and psychotropic medication fills. Read More >>

PRIMARY CARE

Medicare's Care Management Codes Might Not Support Primary Care As
Expected

By Sumit D. Agarwal, Michael L. Barnett, Jeffrey Souza, and Bruce E.
Landon

To compensate physicians and their practices for activities that occur
outside of traditional face-to-face visits, the Centers for Medicare and
Medicaid Services introduced two new payment codes to the Medicare
Physician Fee Schedule for services related to transitional care
management (TCM) and chronic care management (CCM). Rates of adoption of
these codes have been low. To understand the patterns of adoption, Sumit
D. Agarwal and coauthors compared characteristics of the practices that
billed for these services to those of the practices that did not and
determined the extent to which a practice other than the beneficiary's
usual primary care practice billed for the services. Read More >>

[link removed]

[link removed]

THIS WEEK ON THE BLOG

COVID-19

The Role Of Hospital Infection Control In Flattening The COVID-19 Curve:
Lessons From South Korea

By Ron C. Li and Doo Ryeon Chung (5/15/20)

The role of hospitals in the fight against COVID-19 must be expanded
from treating sick patients to also serving the public health mission of
preventing future disease outbreaks. These efforts need to be
coordinated at scale to not just flatten the curve but also to keep it
flat. Read More >>

COVID-19 And State Medical Liability Immunity

By Benjamin J. McMichael, John R. Lowry, William H. Frist, and R.
Lawrence Van Horn (5/14/20)

COVID-19 has created a health care environment that is unprecedented and
ripe for litigation. To provide physicians with some protection in the
face of this emergency, states have begun taking action to address
medical liability.Read More >>

A Model For Avoiding Unequal Treatment During The COVID-19 Pandemic

By Somnath Saha and Mary Catherine Beach (5/14/20)

COVID-19 has imposed on hospitals and health systems the threat of
having to ration scarce resources. As health systems grapple with how to
ensure truly fair resource allocation, Oregon's experience with health
care prioritization offers lessons. Read More >>

How To Maintain Momentum On Other Public Health Initiatives Even As
COVID-19 Rages: Lessons From Pakistan

By Hina Khalid and Erika G. Martin (5/13/20)

As low- and middle-income countries (LIMCs) respond to the COVID-19
pandemic, it is imperative to ensure that other public health priorities
continue to receive necessary support to maintain progress. Ongoing
investments in more general health system strengthening can help LIMCs
be more prepared to respond to future public health crises. Read More >>

COVID-19 Testing: Lessons From The HIV Testing Experience

By Ronald O. Valdiserri, Gary R. West, and David R. Holtgrave (5/13/20)

Policy makers and legislators must embrace a broad vision that extends
beyond diagnostic testing when developing and funding strategies in
response to the COVID-19 pandemic. There is benefit in considering how
the cumulative experience of implementing public health HIV testing
programs might inform the direction of future programs to test for
SARS-CoV-2, especially in terms of the systems and structures necessary
to support widespread testing for prevention purposes.Read More >>

In The Fight Against COVID-19, It's Not Too Late To Fix America's
Public Health System

By Oxiris Barbot (5/12/20)

It shouldn't take mass casualties for the federal government to commit
to safeguarding the public's health. The cost of inaction is so clear.
When public health systems are willing but unable to address developing
threats, families, communities, and the economy suffer unimaginable
losses. Read More >>

The Importance Of Nursing Home Transparency And Oversight, Even In The
Midst Of A Pandemic

By David G. Stevenson and Alice Bonner (5/12/20)

During the COVID-19 crisis, nursing home oversight agencies must
emphasize transparency while ensuring that residents and staff are
connected to the resources and social supports they desperately need.
Read More >>

Flu Masks Failed In 1918, But We Need Them Now

By E. Thomas Ewing (5/12/20)

We need to learn the right lessons from the failure of flu masks in
1918. Masks can work if we wear them correctly, modify behavior
appropriately, and apply all available tools to control the spread of
infectious disease. Read More >>

Federal Funding For State And Local Contact Tracing Efforts Is An Urgent
Priority, And A Bargain

By Joshua A. Salomon and Arthur L. Reingold (5/11/20)

The investment that will help us reopen the United States will cost less
than 1 percent of COVID-19 relief funding to date. Read More >>

FOLLOWING THE ACA

Opening Briefs Filed In Texas Challenge To ACA

By Katie Keith (5/17/20)

Opening briefs in California v. Texas were due on May 6. This post
summarizes the opening briefs from a California-led coalition of 21
attorneys general and governors and the US House of Representatives;
provides the latest on the Trump administration's position in the
lawsuit; and describes what happens next.Read More >>

Wide Range Of Amici Support California, House In Texas Litigation

By Katie Keith (5/17/20)

Briefing continues in California v. Texas. Amicus briefs in support of
the parties defending the Affordable Care Act (ACA), due May 13, were
filed by every major health care stakeholder group. Amici warn of
massive disruption if all or parts of the ACA are deemed invalid. Many
also emphasize the importance of the ACA to the nation's COVID-19
response.
Read More >>

Risk Corridors Litigation: The Gift That Keeps On Giving

By Katie Keith (5/15/20)

On April 27, the Supreme Court ruled 8-1 that insurers were entitled to
more than $12 billion in unpaid risk corridors payments. One might think
that such a resounding decision would close this chapter in Affordable
Care Act litigation. But things are rarely so simple with the ACA. Read
More >>

MEDICAID

Overlap Plans Could Become An Important Option To Promote Continuity Of
Care And Contain Health Care Costs During A Recession

By Katherine Hempstead and Joanna Seirup (5/15/20)

As Medicaid enrollment grows during the COVD-19 pandemic, overlap plans
(plans offering both Marketplace and Medicaid managed care coverage) may
play an increasingly important role in advancing continuity of care and
containing growth in premium costs in many counties across the country.
Read More >>

Finding The Sweet Spot: When It Comes To Medicaid MCOs And Payment
Reform, One Size Does Not Fit All

By Julianne McGarry and Suzanne F. Delbanco (5/11/20)

Model Medicaid managed care organization contracts from states that have
begun to plot a journey toward payment reform provide an abundance of
forward-thinking and creative program design. Read More >>

HEALTH EQUITY

Inequity: Society's Most Important Pre-Existing Condition

By Bob Hughes (5/11/20)

COVID-19 just underscores the oppression that has been embedded in our
systems for years, says the president and CEO of a large health
foundation in the Midwest. Historic racism is front and center during
this time when all of us have various needs. But amidst all of the
tragedy and upheaval, we also can chart a unified course for a
healthier, more equitable future, he says. Read More >>

MEDICARE

Adapting Medicare Advantage Bidding For COVID-19-Related Uncertainty
On Claims: A Proposal

By Steven M. Lieberman (5/15/20)

Establishing temporary high-cost reinsurance and risk corridors-now
available to stand-alone prescription drug plans but not Medicare
Advantage (MA) plans-would significantly mitigate risk and limit
disruption in the MA market until the impacts of COVID-19 become better
understood. Read More >>

Medicare's Reliance On Acute Hospitalization Rates Could Undercut The
Impact Of Its Primary Care First Program

By Leah M. Marcotte, Amol S. Navathe, Jonathan Staloff, and Joshua M.
Liao (5/13/20)

Given the potential for primary care reform to improve outcomes, it is
critical that policy and practice leaders avoid unintended consequences
of program participation, engagement, and success.Read More >>

[link removed]

[link removed]

 

[link removed]

 

[link removed]

 

[link removed]

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.

Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, United States

Privacy Policy

To unsubscribe from this email, click here
.                 
                                               
                        I