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A Weekly Health Policy Round Up From Health Affairs            

**June 14, 2020**

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FAST TRACK AHEAD OF PRINT

COVID-19 FEATURE TOPIC-NYC Health + Hospitals

Critical Care And Emergency Department Response At The Epicenter Of The
COVID-19 Pandemic

By Amit Uppal, David M. Silvestri, Matthew Siegler, Shaw Natsui, Leon
Boudourakis, R. James Salway, Manish Parikh, Konstantinos Agoritsas,
Hyung J. Cho, Rajneesh Gulati, Milton Nunez, Anjali Hulbanni, Christine
Flaherty, Laura Iavicoli, Natalia Cineas, Marc Kanter, Stuart Kessler,
Karin V. Rhodes, Michael Bouton, and Eric K. Wei

As cases rose in New York City, NYC Health + Hospitals (NYC H+H) carried
out plans to greatly expand critical care capacity. Primary ICU spaces
were identified and upgraded as needed, while new ICU spaces were
created in emergency departments, procedural areas, and other inpatient
units. Read More >>

A Phone Call Away: New York's Hotline And Public Health In The Rapidly
Changing COVID-19 Pandemic

By Ross Kristal, Madden Rowell, Marielle Kress, Chris Keeley, Hannah
Jackson, Katherine Piwnica-Worms, Lisa Hendricks, Theodore G. Long, and
Andrew B. Wallach

In early March 2020, an outbreak of COVID-19 in New York City exerted
sudden and extreme pressures on emergency medical services and quickly
changed public health policy and clinical guidance. Recognizing this,
NYC H+H established a clinician-staffed COVID-19 hotline for all New
Yorkers. Read More >>

Staying Connected In The COVID-19 Pandemic: Telehealth At The Largest
Safety-Net System In The United States

By Jen Lau, Janine Knudsen, Hannah Jackson, Andrew B. Wallach, Michael
Bouton, Shaw Natsui, Christopher Philippou, Erfan Karim, David M.
Silvestri, Lynsey Avalone, Milana Zaurova, Daniel Schatz, Vivian Sun,
and Dave A. Chokshi

Starting in March 2020 NYC H+H was able to transform the system using
virtual care platforms through which it conducted almost 83,000 billable
televisits in one month and more than 30,000 behavioral health
encounters via telephone and video. Telehealth also enabled us to
support patient-family communication, post-discharge follow-up, and
palliative care for COVID-19 patients. Read More >>

Staffing Up For The Surge: Expanding The New York City Public Hospital
Workforce During The COVID-19 Pandemic

By Chris Keeley, Theodore G. Long, Natalia Cineas, Yvette Villanueva,
Donnie Bell, Andrew B. Wallach, Ivelesse Mendez-Justiniano, Hannah
Jackson, Donna Boyle Schwartz, Jonathan Jimenez, R. James Salway, and
Leon Boudourakis

To meet the unprecedented demand for patient care, NYC H+H redeployed
staff to the areas of greatest need and redesigned recruiting,
onboarding, and training processes. The hospital system engaged private
staffing agencies, partnered with the US Department of Defense, and
recruited volunteers throughout the country. Read More >>

IN THE JOURNAL

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LEADING TO HEALTH: CULTURE OF HEALTH

For Healthier Native Youth, Look To Their Strengths

By Jessica Bylander

The Zuni Youth Enrichment Project provides a model for improving the
health of American Indian youth by focusing on their culture and
strengths. Read More >>

This article appears in Health Affairs' series on Leading To Health
.

HEALTH INFORMATION TECHNOLOGY

Electronic Health Information Exchange At Discharge From Inpatient
Psychiatric Care In Acute Care Hospitals

By Morgan C. Shields, Grant Ritter, and Alisa B. Busch

Timely sharing of medical information is essential for care continuity
when people transition from inpatient psychiatric care to lower levels
of care. Morgan Shields and coauthors find that in contrast to the 88
percent of acute care hospitals that employ electronic data exchange
when patients are discharged, only 56.3 percent of inpatient psychiatric
units exchange data electronically upon discharge. Read More >>

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RURAL HEALTH

The Impact Of Medicare's Rural Add-On Payments On Supply Of Home
Health Agencies Serving Rural Counties

By Tracy M. Mroz, Davis G. Patterson, and Bianca K. Frogner

With the goal of increasing rural access to home health services, the
Medicare program has periodically provided add-on payments to agencies
serving rural communities. Tracy Mroz and coauthors analyze payments
over more than fifteen years and find that only when add-on payments
exceed 5 percent is there a positive effect on the supply of home health
agencies in rural counties. Read More >>

BEHAVIORAL HEALTH CARE

Fewer Than Half Of US Mental Health Treatment Facilities Provide
Services For Children With Autism Spectrum Disorder

By Jonathan Cantor, Ryan K. McBain, Aaron Kofner, Bradley D. Stein, and
Hao Yu

Nationally, 29.5 percent of children diagnosed with autism spectrum
disorder (ASD) have not received behavioral health care or medication
treatment. Jonathan Cantor and coauthors study the availability of
behavioral health care services for children with ASD at almost 10,000
mental health treatment facilities throughout the US. Read More >>

THIS WEEK ON THE BLOG

COVID-19

Clinical Trials For COVID-19: Populations Most Vulnerable To COVID-19
Must Be Included

By Aisha T. Langford and Alison Bateman-House (6/12/20)

For COVID-19 clinical trials, we advise researchers to give careful
thought to trials' inclusion and exclusion criteria, make sure people
are aware of and invited to participate in trials when eligible, ensure
that those eligible to participate have access to studies where they
live or get their care, and minimize participation burden. Read More >>

Reimagining COVID-19 Quarantine In The US To Be Effective, Ethical, And
Equitable

By Nana A. Y. Twum-Danso (6/12/20)

As the US looks to balance reopening communities and avoiding further
COVID-19 spread, identifying and quickly isolating positive cases is
becoming a more pressing concern. A national response should take into
account active management of individuals who have tested positive but
are not sick enough for hospitalization, and those who have been exposed
but have not yet had their infection status confirmed. Read More >>

NYC Health + Hospitals' Rapid Responses To COVID-19 Were Built On A
Foundation Of Emergency Management, Incident Command, and Analytics

By Syra Madad, Nicholas V. Cagliuso, Sr., Dave A. Chokshi, Machelle
Allen, Remle Newton-Dame, and Jesse Singer (6/11/20)

This post serves as the introduction to a series of articles describing
how our system grappled with the unprecedented COVID-19 crisis. Our hope
is that our early experiences may offer useful lessons for those facing
the pandemic's ongoing and future threats-health system leaders,
policy makers, elected officials, researchers, patients, caregivers, and
clinicians, among many others. Read More >>

Strengthening The Medicare Trust Fund In The Era Of COVID-19

By David M. Cutler, Richard G. Frank, Jonathan Gruber, and Joseph P.
Newhouse (6/10/20)

Key financial and programmatic changes to the Medicare Trust Fund would
improve the financial situation of the fund by at least $51 billion per
year. These changes would put new obligations on the Part B program,
which could be offset by savings from reduced payments for prescription
drugs and home health services. Read More >>

Beyond Lip Service: Taking A Genuine Approach To Tackling COVID-19 (And
All) Black-White Health Disparities In The United States

By LaShawn Marie Glasgow (6/9/20)

A genuine approach to addressing black-white health disparities that
includes confronting hard truths about systemic ills and injustice;
honoring black Americans as a diverse group of people; and meaningfully
engaging black citizens, communities, and experts will help deepen our
understanding of this complex problem and lead us to better solutions.
Read More >>

COVID-19: Substance Use Disorder, Privacy, And The CARES Act

By Nicolas P. Terry, Melissa M. Goldstein, and Kirk J. Nahra (6/8/20)

Congress surprisingly took the opportunity to settle-without public
debate and in a "must-pass" piece of legislation otherwise focused on
COVID-19-a longstanding dispute about the value of special protections
for the privacy of substance use disorder patients in the context of
existing health care industry practice. Read More >>

COVID-19 Reveals An Urgent Need To Reimagine What A System Of Health
Should Be

By David D. Fukuzawa (6/8/20)

We need to rethink and reimagine what a health system-or perhaps
better yet, a system of health-should be. The COVID-19 crisis has
shown us all too clearly that this is the time to move beyond a health
system centered on delivering medical services to one that is truly
centered on health at both an individual and population level. Read More
>>

FOLLOWING THE ACA

New Proposed Rule On Health Care Sharing Ministries And Direct Primary
Care

By Katie Keith (6/12/20)

On June 8, the IRS issued a proposed rule that would allow employers to
reimburse employees for fees for direct primary care and health care
sharing ministries through a health reimbursement arrangement (HRA). The
proposed rule defines these fees or "shares" as payments for medical
care or medical insurance, which makes them eligible for a tax deduction
as qualified medical expenses.Read More >>

SUBSTANCE USE DISORDER

Expanding Access To Treatment For Opioid Use Disorder: The Pandemic
Presents A Learning Opportunity

By Karen Scott (6/12/20)

A national funder that launched in 2018 decided that its first priority
should be making it easier for people with opioid use disorder to access
evidence-based treatment services. The foundation wanted to focus on
groups with the highest risks of overdose deaths, including people
leaving correctional facilities, postpartum women, and residents of
remote, rural, and inner-city areas. Then COVID-19 hit. The foundation
has adapted to the pandemic and aims to learn from it. 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 .  

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health care workers to save lives across the globe. Project HOPE has
published Health Affairs since 1981.

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