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.
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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.

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.
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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.
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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 >>

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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