Preview

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 >>

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 >>

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 >>

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.
Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, United States

Privacy Policy

To unsubscribe from this email, click here. I