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A Weekly Health Policy Round Up From Health Affairs            

**May 31, 2020**

THIS WEEK ON THE BLOG

COVID-19

The Risks of Remaining in the Medicare Shared Savings Program During the
COVID-19 Pandemic

By Robert Mechanic (5/30/20)

Accountable care organizations (ACOs) with substantial downside risk
need to evaluate their own circumstances carefully, but on balance, the
recent policy changes should give many ACOs confidence that the Medicare
Shared Savings Program remains viable in the current year. Read More >>

Inequities Amplified By COVID-19: Opportunities For Medicaid To Address
Health Disparities

By Shilpa Patel and Tricia McGinnis (5/29/20)

COVID-19 has laid bare and will likely exacerbate the glaring inequity
faced by communities of color due to a "constellation" of factors. By
leveraging the clarity and urgency that the pandemic has brought to
these issues, Medicaid agencies can create substantial and sustainable
impact in advancing health equity in both the near- and long-term. Read
More >>

Structural Discrimination In COVID-19 Workplace Protections

By Ruqaiijah Yearby and Seema Mohapatra (5/29/20)

To achieve true health justice for all, including essential workers,
interventions to address the root causes of inequity-including all
community conditions among them, such as environmental and educational
factors-are necessary. Read More >>

Leveraging Payment Reforms For COVID-19 And Beyond: Recommendations For
Medicare ACOs And CMS's Interim Final Rule

By Hannah L. Crook, Robert S. Saunders, William K. Bleser, Travis
Broome, David Muhlestein, and Mark B. McClellan (5/29/20)

The health care delivery organizations that have best been able to work
through the pandemic have been those participating in more advanced
alternative payment models. Recognizing the challenges clinicians and
delivery systems are facing, the Centers for Medicare and Medicaid
Services on April 30 announced multiple regulatory changes to payment
models. This post analyzes the proposed rule and recommends ways to
improve it. Read More >>

What Have Foundations Been Doing In The Fight Against COVID-19? Part III

By Lee-Lee Prina (5/28/20)

During this difficult time, foundations around the country have come
forward to help-with funding for a variety of purposes, including
useful surveys and publications. In this small sampling, read about the
varied ways foundations are aiding people around the world, the US,
their state, or their region. This is Part III of a GrantWatch series.
Read More >>

What's Driving The COVID-19 Blame Game? Anxiety And Confusion About
Wet Markets, China⁠-And The Entire Global Economy

By Ashley Andreou (5/28/20)

As we look ahead as a global community, we must enter into culturally
competent strategies to combat the spread of zoonotic disease. Read More
>>

COVID-19 Pandemic Provides Opportunity To Realign Self-Help Groups With
Medications For People With Opioid Use Disorder

By Nicolas K. Trad, Hefei Wen, and Brendan Saloner (5/28/20)

In this month's issue of Health Affairs, Hefei Wen and coauthors
analyze national data on opioid addiction treatment. In response to
world events, we asked the authors to put their work in the context of
the current COVID-19 crisis.

The COVID-19 pandemic has negatively affected individuals with opioid
use disorder. It has increased drivers of relapse such as social
isolation, loneliness, anxiety, and joblessness. COVID-19 also threatens
two sources of stability for people with opioid use disorder: access to
self-help groups and access to treatment programs offering highly
effective medications.
Read More >>

Reducing COVID-19 Deaths In Nursing Homes: Call To Action

By Michael D. Cantor, Christine K. Liu, Monera Wong, Jenny S. Chiang,
David F. Polakoff, and Jatin Dave (5/27/20)

Success in reducing COVID-19-related morbidity and mortality in
nursing homes requires urgent action in three areas: 1) enhancing
infection control; 2) ensuring necessary resources for staff, training,
PPE, onsite ancillary services, and so forth; and 3) establishing
state-level task forces on pandemic response in nursing homes.Read More
>>

Ending The COVID-19 Pandemic Requires Effective Multilateralism

By Marco Schäferhoff and Gavin Yamey (5/27/20)

Is multilateralism alive and well in the midst of the COVID-19 pandemic?
There are certainly some promising signs that it is. Substantial
additional investments will be needed to close the funding gaps for
emergency and disaster risk management in low- and middle-income
countries, to respond to the COVID-19 outbreak, and to strengthen
preparedness for future epidemics and pandemics. Read More >>

Centering The Needs Of Birthing People During The COVID-19 Pandemic

By Erin Miller and Samantha Espinoza (5/26/20)

During the COVID-19 pandemic, states must address safety concerns of
birthing people, their communities, and their health care providers.
Read More >>

To Stem The Spread of COVID-19, Address The Challenges Of Crowded
Housing

By Duncan Maru, Sheela Maru, Elizabeth Bass, and Joseph Masci (5/26/20)

For neighborhoods like ours to experience post-COVID-war recovery, we
need to address the short- and long-term housing crisis that made us
tragically vulnerable to COVID-19 in the first place. We will require a
large-scale effort of solidarity, imagination, and commitment to rebuild
our communities and, ultimately, eradicate the scourge of COVID-19. Read
More >>

FOLLOWING THE ACA

Latest Coverage Proposals In Congress

By Katie Keith (5/26/20)

Congressional Democrats have released several recent proposals related
to health insurance coverage and the COVID-19 crisis. On May 15, 2020,
the House passed the Health and Economic Recovery Omnibus Emergency
Solutions (Heroes) Act. And on May 22, 2020, a coalition of 33
Democratic senators issued a new proposal to expand health care coverage
and affordability during the pandemic. Read More >>

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IN THE JOURNAL

MEDICAID

Iowa's Medicaid Healthy Behaviors Program Associated With Reduced
Hospital-Based Care But Higher Spending, 2012-17

By Brad Wright, Youn Soo Jung, Natoshia M. Askelson, Elizabeth T.
Momany, and Peter Damiano

Iowa's Healthy Behaviors Program (HBP) requires Medicaid expansion
enrollees to complete an annual wellness exam and health risk assessment
or pay monthly premiums to avoid disenrollment. Using data for 2012-17
from Medicaid and for 2014-17 from HBP, Brad Wright and coauthors
evaluated changes in use of hospital-based care and spending associated
with HBP participation. Read More >>

Implementation Matters: Lessons From Iowa Medicaid's Healthy Behaviors
Program

By Natoshia M. Askelson, Brad Wright, Patrick J. Brady, Youn Soo Jung,
Elizabeth T. Momany, Brooke McInroy, and Peter Damiano

Natoshia Askelson and coauthors used claims data and interviews to
document the first year (2014) of Iowa's Healthy Behaviors Program
implementation. Read More >>

COSTS & SPENDING

Most Patients Undergoing Ground And Air Ambulance Transportation Receive
Sizable Out-Of-Network Bills

By Karan R. Chhabra, Keegan McGuire, Kyle H. Sheetz, John W. Scott,
Ushapoorna Nuliyalu, and Andrew M. Ryan

Karan Chhabra and coauthors sought to understand the impact of surprise
out-of-network bills in ground and air ambulance transportation. They
evaluated information from the Clinformatics DataMart Database for the
years 2013-17, which contains insurance claims from all fifty states
and the District of Columbia from a large national insurance plan.
According to the study, 71 percent of all ground and air ambulance rides
involved potential surprise bills.Read More >>

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Prevalence And Characteristics Of Surprise Out-Of-Network Bills From
Professionals In Ambulatory Surgery Centers

By Erin L. Duffy, Loren Adler, Paul B. Ginsburg, and Erin Trish

Erin Duffy and coauthors analyzed surprise billing in 4.2 million
ambulatory surgery center (ASC) episodes of care in 2014-17. They
found that in 10 percent of the episodes, patients were treated at
in-network ASCs but involuntarily received care from out-of-network
providers. Read More >>

GLOBAL HEALTH POLICY

The Case Against Labor-Tax-Financed Social Health Insurance For Low- And
Low-Middle-Income Countries

By Abdo S. Yazbeck, William D. Savedoff, William C. Hsiao, Joe Kutzin,
Agnès Soucat, Ajay Tandon, Adam Wagstaff, and Winnie Chi-Man Yip

An increasing interest in initiating and expanding social health
insurance through labor taxes in low- and low-middle-income countries
goes against available empirical evidence. This article builds on
existing recommendations by leading health financing experts and
summarizes recent research that makes the case against labor-tax
financing of health care in low- and low-middle-income countries. 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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