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A Weekly Health Policy Round Up From Health Affairs            

**June 7, 2020**

IN THE JOURNAL

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NEW ISSUE:
RURAL HEALTH, BEHAVIORAL HEALTH & MORE

The June issue of Health Affairs includes studies on rural health,
surprise out-of-network bills for mental health care, private equity in
some physician practices, and other topics. Also in the issue: final
published versions of two Fast Track COVID-19 studies.

Read the June 2020 table of contents
.

L
isten
to an introduction of the issue from Editor-in-Chief Alan Weil.

Read "From the Editor-in-Chief."

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FAST TRACK AHEAD OF PRINT

Incarceration And Its Disseminations: COVID-19 Pandemic Lessons From
Chicago's Cook County Jail

By Eric Reinhart and Daniel Chen

In the United States, jails and penitentiaries are severely overcrowded,
making infection control difficult. Eric Reinhart and Daniel Chen
evaluated booking, release, and COVID-19 data from the state of Illinois
and Chicago's Cook County Jail between February 1 and April 19, 2020.
They found that cycling through Cook County Jail is associated with 15.9
percent of all documented COVID-19 cases in Chicago and 15.7 percent of
cases in Illinois.
Read More >>

RURAL HEALTH

Varying Trends In The Financial Viability Of US Rural Hospitals,
2011-17

By Ge Bai, Farah Yehia, Wei Chen, and Gerard F. Anderson

Ge Bai and colleagues examine financial trends for approximately 1,000
rural US hospitals that collectively serve about sixty million people.
Between 2011 and 2017 overall profit margins declined for all hospital
types except nonprofit critical access hospitals, which saw their
margins increase, on average, from 2.5 percent to 3.2 percent. Read More
>>

BEHAVIORAL HEALTH CARE

Incorrect Provider Directories Associated With Out-Of-Network Mental
Health Care And Outpatient Surprise Bills

By Susan H. Busch and Kelly A. Kyanko

The high rate of mental health providers declining to participate in
health insurance networks leads to out-of-network expenses for many
patients. Using a survey of patients, Susan Busch and Kelly Kyanko find
that half of patients using mental health services encountered provider
directory inaccuracies. Those who encountered inaccuracies were more
likely to be treated by an out-of-network provider and four times more
likely to receive a surprise outpatient out-of-network bill. Read More
>>

THE PRACTICE OF MEDICINE

The Growth Of Private Equity Investment In Health Care: Perspectives
From Ophthalmology

By Eloise May O'Donnell, Gary Joseph Lelli, Sami Bhidya, and Lawrence
P. Casalino

The growth of private equity (PE) investment in health care has
dramatically changed the landscape of health care delivery over the past
decade. To examine how one specialty has been altered by this trend,
Eloise May O'Donnell and coauthors conducted thirty-five
semi-structured interviews with experts in PE acquisition of physician
practices, focusing on the field of ophthalmology. Read More >>

The Practice Of Medicine
series is
supported by the Physicians Foundation.

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THIS WEEK ON THE BLOG

ONCE IN A WEIL

The Social Determinants Of Death

By Alan Weil

It is not enough for health care institutions to stand against racism or
with those who protest it. The test of the day is whether those
institutions will use their power to fight racism.
Read More >>

COVID-19

To Protect Public Health During And After The Pandemic, We Need A New
Approach To Financing Community Health Workers

By Shreya Kangovi (6/5/20)

Community health workers are the test kits and the masks that will
protect public health during and after the pandemic. We need new short-
and long-term financing solutions to scale up this resource and make it
available for years to come. Read More >>

Why Do Some Recover From COVID-19 Quickly, While Others Seem Likely To
Face Long-Term Disability?

By Mady Hornig and David Tuller (6/5/20)

Now is the time to implement prospective research and start documenting
the biological pathways from initial illness to chronic neurological
dysfunctions and other disorders.
Read More >>

Beyond PPE: Protecting Health Care Workers To Prevent A Behavioral
Health Disaster

By Andrew B. Meshnick, Lilian Ryan, and Theresa Cullen

We need to mitigate the immediate behavioral health impact of COVID-19
on health care workers while also planning for the future. A
comprehensive, three-part strategy would strengthen the resilience of
the health care workforce during the pandemic and give workers the tools
to navigate public health emergencies in the years to come. Read More >>

New CMS Payment Model Flexibilities For COVID-19

By Seema Verma (6/3/20)

We know that we'll eventually beat COVID-19, and we want all our
partners to know that our commitment to value-based care will remain as
strong as ever, to support our health care system as our country
reopens-and far beyond.Read More >>

How The Rapid Shift To Telehealth Leaves Many Community Health Centers
Behind During The COVID-19 Pandemic

By June-Ho Kim, Eesha Desai, and Megan B. Cole (6/2/20)

By reorienting the goals for implementing telehealth, policy makers,
payers, and providers can empower health centers to thrive in the future
and meet the nation's underserved patients where they are, even during
the COVID-19 pandemic. In the long run, telehealth can increase access
and equity, but only if the right investments are made now to fill the
gaps laid bare by the pandemic.Read More >>

MEDICAID

As A Civil Rights Matter, CMS Can And Should Allow States To Make
Medicaid Retainer Payments

By Sara Rosenbaum and Morgan Handley (6/3/20)

The most affected providers during the COVID-19 pandemic are those whose
services are essential to Medicaid programs and minority communities and
patients. Yet despite having ample legal power to do so, the Centers for
Medicare and Medicaid Services continues to block states from using
Medicaid retainer payments, similar to those under Medicare, to help
stabilize critical providers. Read More >>

HEALTH EQUITY

The Movement Toward Equity: One Philanthropy's Shifting Role In
Catalyzing Change

By Kristy Klein Davis (6/3/20)

The Missouri Foundation for Health is carving out a unique niche for
itself as a "changemaker" in that state. It is working "collaboratively
to build communities where inequities in health and well-being are
nonexistent," says its chief strategy officer. For example, the
foundation has been working to eliminate "the root causes of infant
mortality, including dismantling structural racism embedded in our
health care systems." Read More >>

FOLLOWING THE ACA

New Proposed Rule On Risk Adjustment Data Validation

By Katie Keith (6/1/20)

On May 29, the Department of Health and Human Services (HHS) proposed
adjustments to the Affordable Care Act's risk adjustment data
validation (RADV) program. First, HHS proposes three changes to its
methodology for error rate calculations. Second, HHS would change the
way that it applies the RADV results to risk adjustment transfers.
Comments are due on July 2. Read More >>

CONSIDERING HEALTH SPENDING

Why Isn't Innovation Helping Reduce Health Care Costs?

By Eli M. Cahan, Robert Kocher, and Roger Bohn

Funding and research incentives have created a health care innovation
ecosystem that fails to advance net productivity. Redesigned incentives
that support process-based, frugal innovations can reduce costs while
maintaining high-quality patient care. Read More >>

Out-of-Network Spending: Why Growing Attention Is Focused On A Small
Share Of Medical Spending

By William C. Johnson, Kevin Kennedy, Jean Fuglesten Biniek, Zirui Song,
and Jacob Wallace (6/2/20)

The decreases in the share of spending on out-of-network services are
attributable to a decline in the utilization of out-of-network care. In
contrast, out-of-network charges per service have grown rapidly, and
have exposed patients to potentially larger balance bills in recent
years. Read More >>

These posts appear in the series Considering Health Spending
.

QUALITY OF CARE

In Remembrance Of Paul O'Neill

By Karen Wolk Feinstein (6/1/20)

Many obituaries have commemorated the exceptional life of an unusual
leader, Paul O'Neill. The listings of his positions and
accomplishments, however, hardly capture the aura of a man who changed
the way we think about safety and quality in a sector-health
care-where he never worked. Read More >>

PHARMACEUTICALS & MEDICAL TECHNOLOGY

Traditional Cost-Effectiveness Formulas And Precision Medicines

By Jaime Rubin Cahill (6/1/20)

Current approaches to evaluating cost-effectiveness often fail to
capture unique attributes and circumstances of precision medicines,
especially when applied to rare, chronic diseases. 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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