FAST TRACK AHEAD OF PRINT

COVID-19

Designing Pull Funding For A COVID-19 Vaccine
By Christopher M. Snyder, Kendall Hoyt, Dimitrios Gouglas, Thomas Johnston,
and James Robinson

Christopher Snyder and coauthors propose a "pull" program that incentivizes late-stage development for COVID-19 vaccines by awarding advance purchase commitments to bidding firms. According to the authors’ model, the optimal pull program should spend more than $100 billion to induce virtually all serious vaccine candidates to participate, scaling up capacity at risk to provide an average of 2.2 billion doses in 2021 across simulations, generating net social benefits of $2.8 trillion. Read More >>

EYE ON HEALTH REFORM

Contraceptive Mandate, ACA Final Rules, And COVID-19
By Katie Keith

Katie Keith reviews several key Supreme Court decisions pertaining to the Affordable Care Act (ACA). These include the court’s 7–2 decision in Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania, upholding two Trump-era rules that broadly exempt employers from complying with the contraceptive mandate of the ACA when they object for religious or moral reasons. In addition, Keith notes new federal guidance on the ACA, identifying ACA requirements that are now being delayed as a result of COVID-19.
Read More >>

CONSIDERING HEALTH SPENDING

Lessons From The Impact Of Price Regulation On The Pricing Of Anticancer Drugs In Germany
By Victoria D. Lauenroth, Aaron S. Kesselheim, Ameet Sarpatwari, and Ariel D. Stern

Under the 2011 German Pharmaceutical Market Restructuring Act, manufacturers set the prices of newly authorized drugs during their first year on the market. Benefit assessments are carried out during this year and then used in price negotiations between manufacturers and representatives of the country’s statutory health insurers. Using data on fifty-seven anticancer drugs launched in Germany from 2002 to 2017, Victoria Lauenroth and coauthors found that implementation of the act was associated with drug prices being more closely aligned with clinical benefit. Read More >>

See our Considering Health Spending page for more on this series topic.

DISPARITIES

EMS Access Constraints And Response Time Delays For Deprived Critically Ill Patients Near Paris, France
By Matthieu Heidet, Thierry Da Cunha, Elise Brami, Eric Mermet, Michel Dru, Béatrice Simonnard, Eric Lecarpentier, Charlotte Chollet-Xémard, Corinne Bergeron, Mohamed Khalid, Brian Grunau, Jean Marty, and Etienne Audureau

Increased emergency medical services (EMS) response times and areas of low socioeconomic status are both associated with poorer outcomes for several time-sensitive medical conditions attended to by medical personnel before a patient is hospitalized. We evaluated the association between EMS response times, area deprivation level, and on-scene access constraints encountered by EMS in a large urban area in France.
Read More >>

MEDICAID

A Medicaid Alternative Payment Model Program In Oregon Led To Reduced Volume Of Imaging Services
By Stephan Lindner, Menolly R. Kaufman, Miguel Marino, Jean O’Malley, Heather Angier, Erika K. Cottrell, K. John McConnell, Jennifer E. DeVoe, and John R. Heintzman

In 2013 Oregon’s Medicaid program changed its reimbursement of traditional primary care services for selected community health centers (CHCs) from a per visit to a per patient rate. Using Oregon claims data, Stephan Lindner and coauthors analyzed the price-weighted volume of care for five service areas: traditional primary care services, including imaging, tests, and procedures; other services provided by CHCs that were carved out from the payment reform; emergency department visits; inpatient services; and other services of non-CHC providers. Read More >>

PHARMACEUTICALS & MEDICAL TECHNOLOGY

Abandoning List Prices In Medicaid Drug Reimbursement Did Not Affect Spending
By Benedic Ippolito, Joseph F. Levy, and Gerard F. Anderson

State fee-for-service Medicaid programs have traditionally based payments to pharmacies for drugs on a percentage of the drugs’ list price. Because list prices have increased more quickly than the prices actually paid by pharmacies, estimating appropriate reimbursements has become challenging. In recent years most states have switched to models where payments were based instead on results from a survey of pharmacy invoices. Benedic Ippolito and coauthors examined how this changed fee-for-service Medicaid drug spending. Read More >>

In 1999, at the urging of President Clinton’s Advisory Commission on Consumer Protection and Quality in the Healthcare Industry, the National Quality Forum was formed to promote health care quality through measurement and public reporting.

Twenty years later, with America in the grips of COVID 19, the work of NQF continues and is more important than ever. A new report from the National Quality Task Force, entitled, "The Care We Need: Driving Better Health Outcomes for People and Communities" provides a roadmap to consistent and predictable high quality care for every person by 2030. The Task Force consists of nearly 100 leaders and diverse stakeholders from across the health care system.

At an online forum on July 30, Health Affairs Editor-in-Chief Alan Weil (who was a member of the Advisory Commission) will host leaders of the quality movement for a discussion of the report and its recommendations for improving the health and safety of all Americans.

Date: Thursday, July 30, 2020
Time: 2:00 p.m. – 3:15 p.m. (Eastern)
Place: Online details to come after you’ve registered

Speakers to include:

Shantanu Agrawal, President and CEO, National Quality Forum
Carolyn Clancy, Deputy Under Secretary for Discovery, Education and Affiliate Networks, Veterans Health Administration, US Department of Veteran’s Affairs; Former Director, Agency for Healthcare Research and Quality
Kenneth W. Kizer, Chief Healthcare Transformation Officer and Senior Executive Vice President, Atlas Research; Founding President and CEO, National Quality Forum
Mary Wakefield, Visiting Distinguished Professor, Practice of Health Care, Georgetown University; Member, President Clinton's Advisory Commission on Consumer Protection and Quality in the Health Care Industry
Alan Weil, Editor in Chief, Health Affairs

THIS WEEK ON THE BLOG

COVID-19

The Day After Tomorrow Must Include Independent Primary Care
By Azalea Kim, Scott Heiser, Leslie McKinney, Robert Overman, and Rahul Rajkumar (7/23/20)

We now have a unique opportunity to revisit how we value and pay for health care. The choices we make today in responding to the crisis faced by independent primary care providers during the pandemic will shape the delivery system we have the day after tomorrow, when COVID-19 is behind us. Read More >>

The Pharmacist’s Role In COVID-19 Response Efforts
By Richard Hughes IV, Daniel Nam, Nick Diamond, Colleen Hopkins, Neil Rosacker, and Manuel Aviña (7/23/20)

Direct patient care by pharmacists has been shown to potentially improve various patient outcomes during a public health emergency. As pharmacists play a larger role in COVID-19 response efforts, the question remains whether states and the federal government will expand legal scope of practice and reimbursement beyond this public health emergency. Read More >>

Ten Actions For Better Post-Pandemic Health Care In The United States
By David Beier, Robert Kocher, and Avik Roy (7/23/20)

The 1918 influenza pandemic—the worst viral pandemic of the twentieth century—led to few meaningful health care reforms. Let’s not make the same mistake again. Here are ten actions that will lead to better health care after the current pandemic. Read More >>

Paying Their Fair Share: States Should Require Increased Medicaid Health Plan Payments To Support Safety-Net Providers In The Age Of COVID-19
By Jacob Wallace, Julia E. Smith, and Timothy J. Layton (7/22/20)

States must act quickly and leverage the options available to prevent catastrophic losses for safety-net providers while ensuring that Medicaid managed care plans pay their fair share.
Read More >>

A Regionalized Public Health Model To Combat COVID-19: Lessons From Japan
By Ryoko Hamaguchi, Kay Negishi, Masaya Higuchi, Masafumi Funato, June-Ho Kim, and Asaf Bitton (7/22/20)

With public health centers as its crux, Japan’s unique regionalized public health model appears to have been one of the drivers of Japan’s success in weathering the COVID-19 crisis. Japan provides an example for countries looking to employ locally responsive public health centers to lead regional coordination, surveillance, and triage during a pandemic.
Read More >>

Caring For Kids In The COVID-19 Era: Addressing Social Drivers And Paying For Health
By R. Lawrence Moss, Charlene A. Wong, Daniella Gratale, and Mark B. McClellan (7/21/20)

The road to recovery from COVID-19 is through transforming our health care and social service systems to address underlying social factors impacting the health of children and families, with a goal of promoting health equity. Read More >>

Addressing Racial Health Disparities In The COVID-19 Pandemic: Immediate And Long-Term Policy Solutions
By Leana S. Wen and Nakisa B. Sadeghi (7/20/20)

As states begin to reopen, and we look ahead to the next stage of the COVID-19 pandemic, policy makers, health systems, and public health authorities should turn attention to concrete steps that can be taken to ensure that recurring patterns of health disparities do not repeat themselves. It is not sufficient to advance policy or strategy without an explicit focus on equity. Read More >>

FOLLOWING THE ACA

ACA Litigation Round-Up: Part I
By Katie Keith (7/20/20)

This post summarizes the recent Affordable Care Act (ACA)–related Supreme Court decisions and the latest in California v. Texas. A second post will discuss the status of long-standing ACA-related lawsuits and highlight newer lawsuits over ACA implementation. A third post will focus on the resolution of lawsuits over unpaid risk corridors payments.
Read More >>

ACA Litigation Round-Up: Part II
By Katie Keith (7/21/20)

This post discusses the status of long-standing ACA-related lawsuits and highlights newer lawsuits over ACA implementation. A prior post summarized the implications of recent Supreme Court decisions and California v. Texas. A third post will focus on the resolution of lawsuits over the risk corridors program. Read More >>

ACA Litigation Round-Up: Part III
By Katie Keith (7/22/20)

In April 2020, the Supreme Court ruled that insurers were entitled to more than $12.2 billion in unpaid risk corridors payments. This post summarizes the latest on risk corridors litigation in the wake of that ruling. Two prior posts focused on other recent ACA-related Supreme Court decisions and ACA lawsuits in the lower courts. Read More >>

PHARMACEUTICALS & MEDICAL TECHNOLOGY

Who Is Sowing Seeds Of Confusion About The QALY?
By Jennifer C. Chen and Anna Kaltenboeck (7/24/20)

Industry-sponsored patient advocacy groups say that they find fault in the quality-adjusted life year (QALY) for technical reasons. But their stance also benefits pharmaceutical manufacturers that fund them and have an interest in disrupting efforts at value assessment. 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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