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 >>

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 >>

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 >>

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.

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