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A Weekly Health Policy Round Up From Health Affairs            

**July 5, 2020**

Racism & COVID-19

COVID-19 has affected an estimated 10.7 million people, resulting in an
estimated half a million deaths globally, including more than 128,000
deaths in the US. As the COVID-19 pandemic unfolds, stark disparities in
infection and mortality risk along racial lines have emerged.

**Understanding and addressing racial disparities in COVID-19 requires
attention to the root causes of health disparities-and, in particular,
to the health impacts of racism.** Racism, be it overt, structural, or
environmental, is an undeniable part of the United States' history and
present.

**Writing on Health Affairs Blog, researchers and providers explore the
intersections of racism, health disparities, and COVID-19.**

* Dismantling health care inequities will require addressing the
structural racism at the root
of
both COVID-19 disparities and the murders of George Floyd and other
Black Americans, Alexander Bryan and coauthors write.

* Sandra Soo-Jin Lee and coauthors say the COVID-19 recovery phase
presents "a rare and critical opportunity" to pursue audacious
policies

that dismantle structural inequities and address structural racism,
including redirecting state spending on prisons to public health.

* Despite racism's alarming impacts on health and health care,
preeminent scholars and the journals that publish them, including

**Health Affairs**, routinely fail to interrogate racism
as
a critical driver of racial health inequities, Rhea Boyd and coauthors
write.

* Drawing lessons from Critical Race Theory, Michelle Morse and
colleagues argue that the COVID-19 crisis offers a unique opportunity to
mobilize US physicians
to
advocate for progressive social policies that dismantle structural
racism and structure our society more equitably.

* Acknowledging the urgency of both health and racial justice in this
moment, Sheila Foster and coauthors set forth a legal agenda to fight
the health effects of racism
in
housing, policing, the environment, and other areas.

As

**Health Affairs** Editor-In-Chief Alan Weil wrote recently
,
the legacy of racism "is baked into our institutions, our thinking,
and our policies."

**Racism must be explored as a key driver of health outcomes and health
disparities.**

Follow the conversation on Twitter
@Health_Affairs.

THIS WEEK ON THE BLOG

COVID-19

Expand COVID-19 Testing With Real-Time Processing Through Community
Pharmacies

By S. Lawrence Kocot (7/1/20)

The Emergency Prescription Assistance Program was designed to be
flexible. It could be expanded and leveraged by states to increase the
current capacity for local community diagnosis testing for COVID-19 and
to facilitate the eventual distribution of COVID-19 vaccines. Read More
>>

COVID-19 And The Financial Viability Of US Rural Hospitals

By Ge Bai and Gerard F. Anderson (7/1/20)

COVID-19 imposes financial challenges on rural hospitals that were
already struggling prior to the pandemic. Structural changes, notably
paying for standby services, are needed to fundamentally improve rural
hospital financial viability. Read More >>

Is It Fair? How To Approach Professional Scope-Of-Practice Policy After
The COVID-19 Pandemic

By Alden Yuanhong Lai, Susan M. Skillman, and Bianca K. Frogner
(6/29/20)

Swift relaxation of scope-of-practice policies was necessary to build
health care workforce capacity during the pandemic. To avoid detrimental
effects on health care professionals, decisions on whether to roll back
these changes should not be equally swift. Read More >>

Medicaid Managed Care Plans Have An Opportunity To Play A Key Role In
Recovery

By Jeremy Cantor, Rachel Tobey, Nicole Giron, and Tracey Kirui (6/29/20)

States should encourage Medicaid managed care plans to act now to
address social needs related to COVID-19; the alternative is to wait for
social and economic despair to manifest as health conditions and provide
clinical treatment then. Read More >>

FOLLOWING THE ACA

Access To ACA Coverage In The COVID-19 Crisis

By Katie Keith (7/1/20)

The Centers for Medicare and Medicaid Services reports increased
marketplace enrollment during the pandemic through existing special
enrollment periods (SEPs), but many believe a broad SEP that would allow
any uninsured person to enroll is necessary to meet the enormous need.
Read More >>

PUBLIC HEALTH

Police Transparency Is A Public Health Issue, Too

By Evan L. Eschliman, Brie A. Garner, Tiffany Le, Priyanka Srinivasan,
and Robert E. Fullilove (6/30/20)

When facing police misconduct and brutality, public health does not have
everything that it needs to analyze trends, design and promote
interventions, and inform policy around this issue to improve population
health. Read More >>

MEDICARE

Bipartisan Tax-Free Solution To Health Care Financing: Coupling HRAs
With A Public Option

By Regina E. Herzlinger, Richard J. Boxer, and James Wallace (6/30/20)

A combination of health insurance initiatives by the presumptive 2020
Democratic and Republican presidential nominees could expand health care
coverage and significantly reduce costs, without raising taxes. Along
the way, the combination could revitalize private plans. Read More >>

HEALTH CARE FINANCE

Why States' 'Netflix Model' Prescription Drug Arrangements Are No
Silver Bullet

By Harry Liu and Andrew Mulcahy (6/30/20)

Despite the buzz and catchy notion, it's hard to come up with a
theoretical case that supports subscription models over traditional
price negotiation between payers and manufacturers over a per-dose or
per-unit price.Read More >>

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IN THE JOURNAL

HEALTH EQUITY

Avoidable Hospitalizations And Observation Stays: Shifts In Racial
Disparities

By José F. Figueroa, Laura G. Burke, Kathryn E. Horneffer, Jie Zheng,
E. John Orav, and Ashish K. Jha

Racial disparities in hospitalization rates for ambulatory
care-sensitive conditions are concerning and may signal differential
access to high-quality ambulatory care. Whether racial disparities are
improving as a result of better ambulatory care versus artificially
narrowing because of increased use of observation status is unclear.
Using Medicare data for 2011-15, José Figueroa and coauthors sought
to determine whether black-white disparities in avoidable
hospitalizations were improving and evaluated the degree to which
changes in observations for ambulatory care-sensitive conditions may
be contributing to changes in these gaps. Read More >>

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HOME HEALTH

Home Health Use In Medicare Advantage Compared To Use In Traditional
Medicare

By Laura Skopec, Stephen Zuckerman, Joshua Aarons, Douglas Wissoker,
Peter J. Huckfeldt, Judith Feder, Robert A. Berenson, Judith Dey, and
Iara Oliveira

Medicare covers home health benefits for homebound beneficiaries who
need intermittent skilled care. While home health care can help prevent
costlier institutional care, some studies have suggested that
traditional Medicare beneficiaries may overuse home health care. Laura
Skopec and coauthors compared home health use in Medicare Advantage and
traditional Medicare, as well as within Medicare Advantage by
beneficiary cost sharing, prior authorization requirement, and plan
type. Read More >>

ACCOUNTABLE CARE

Accountable Care Organizations' Increase In Nonphysician Practitioners
May Signal Shift For Health Care Workforce

By David J. Nyweide, Woolton Lee, and Carrie H. Colla

Both the number and the size of accountable care organizations (ACOs) in
the Medicare Shared Savings Program have been increasing. The number of
ACOs rose from 220 in 2013 to 548 in 2018, while the average number of
participating clinicians in ACOs increased from 263 to 653. Although
increases occurred for primary care physicians (from an average of 141
to 251) and medical specialists (from an average of 76 to 157), the
increase for nonphysician practitioners (from an average of 47 to 245)
was the largest. Read More >>

GRANTWATCH

Funders' Efforts: Aging And Health, COVID-19

By Lee L. Prina

The June 2020 GrantWatch column offers a sampling of how foundations are
helping older people. The John A. Hartford Foundation, for example,
awarded a large grant aiming "to improve the quality of care and
outcomes for older adults in retail clinic settings." You can also read
about the SCAN Foundation's work related to California's Master Plan for
Aging. (Gov. Gavin Newsom announced that plan in June 2019.) Content on
falls prevention, as well as COVID-19, is also included. In the Key
Personnel Changes section, read about Bruce Chernof's upcoming
retirement from the SCAN Foundation, and more in the column.
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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