THIS WEEK ON THE BLOG

COVID-19

Building The Long-Term Care System Of The Future: Will The COVID-19 Nursing Home Tragedies Lead To Real Reform?
By Bruce Allen Chernof and Cindy Mann (7/31/20)

This is neither a sustainable system nor one prepared for future outbreaks, particularly in light of a rapidly aging population. Read More >>

A Digital Bridge To Real-Time COVID-19 Data
By John R. Lumpkin and Andrew Wiesenthal (7/31/20)

The need for accurate COVID-19 surveillance is immediate. The Digital Bridge is a production solution that is already meeting that need in some places. Its use should be mandated to encompass all reportable conditions of public health interest going forward. Read More >>

Addressing Barriers To Care For Patients With Limited English Proficiency During The COVID-19 Pandemic
By Lala Tanmoy Das, Eric J. Kutscher, and Christopher J. Gonzalez (7/29/20)

Language barriers to COVID-19 care, exacerbated by HHS relaxing language access regulations, illustrate how much more work is necessary in this domain. Implementing changes in medical education, as well as adopting language accessibility-focused technology solutions, may help to lessen these disparities in the long term. Read More >>

Imposing The Costs Of Workplace Coronavirus Testing On Group Plan Coverage Would Place An Excessive Burden On Essential Workers
By Linda J. Blumberg, Sabrina Corlette, and Michael Simpson (7/28/20)

Although testing is one of the most important tools we have for reopening businesses and schools, there is no comprehensive federal strategy for identifying which workers should be tested, how often, or how testing should be financed. Direct federal government funding for COVID-19 testing for workers in essential industries would spread these public health–associated costs broadly across all taxpayers. Read More >>

Maximizing Food Security For Unauthorized Immigrants During COVID-19
By David Velasquez, Jordan Kondo, Sarah Downer, and Emily Broad Leib (7/28/20)

The US should take steps to meet the basic food needs of unauthorized immigrants in the US to protect them from the harms of COVID-19. Read More >>

Village Versus Virus: Rural Ethos Protects Where Public Health Fails
By Anne N. Sosin and Elizabeth A. Carpenter-Song (7/27/20)

Despite the many challenges that these systems face, rural health systems and communities were able to mount an effective response to the COVID-19 pandemic that helped to stem the spread of the disease, created capacity to respond to a surge, and protected their most vulnerable populations. Read More >>

Data-Driven Solutions For COVID-19 In Skilled Nursing Facilities: MDS ‘Section Y’
By Barry S. Fogel (7/27/20)

In the present SARS-CoV-2 pandemic, decisions about health policy and clinical care for skilled nursing facility (SNF) residents are being made daily despite a lack of comprehensive data to inform them. I propose a feasible, cost-efficient, and rapidly implementable solution to the data gap: the addition of a new section to the Minimum Data Set for SNF residents comprising data specific to COVID-19. Read More >>

FOLLOWING THE ACA

ACA Round-Up: Pennsylvania Waiver Approved, DE Guidance, And More
By Katie Keith (7/29/20)

On July 24, Pennsylvania became the thirteenth state to be approved for a state-based reinsurance program under Section 1332 of the Affordable Care Act (ACA). This post also summarizes a recent Centers for Medicare and Medicaid Services (CMS) report on state-based reinsurance programs, the newest waiver proposal in Georgia, and other recent federal guidance on direct enrollment (DE), COVID-19, and more. Read More >>

Marketplace Effectuated Enrollment Data Stable; Report Shows Slight Increase In Risk Scores
By Katie Keith (7/27/20)

The Centers for Medicare and Medicaid Services recently released two new reports. The first includes a full year of Marketplace enrollment data for the 2019 plan year and preliminary effectuated Marketplace enrollment data for the 2020 plan year. The second report is the summary risk adjustment report for 2019 detailing about $10.8 billion in transfers.
Read More >>

QUALITY OF CARE

High-Value Care Every Time: Recommendations From The National Quality Task Force
By Ayesha D’Avena, Shantanu Agrawal, and Kenneth W. Kizer

While much remains to be achieved, the historical progression of the quality movement is encouraging. Building on the foundation of Crossing the Quality Chasm, the National Quality Task Force has identified five strategic objectives to normalize high-value, person-centered care for every person, everywhere, every time. Read More >>

The Care We Need: Getting From Here To There
By Carolyn Clancy (7/30/20)

While we have made much progress in improving the safety of care that we provide patients, especially in reducing health care–acquired infections and medication errors, there is still much more to learn and implement. Read More >>

ADOLESCENT HEALTH

It's Time To Invest In Better Health And Well-Being For Teens
By Benjamin F. Miller and Denise Dougherty (7/30/20)

Teens today are facing a myriad of challenges—many unique to their generation—and we are not doing enough to help them, says this post by Ben Miller of Well Being Trust and Denise Dougherty of AcademyHealth. They discuss a recent foundation-funded report, Advancing Teen Flourishing: Moving Policy Upstream, which contains ideas and strategies. One suggestion is for schools to focus on not only teens' academic achievement but also their social, emotional, and psychological well-being. Read More >>

DISPARITIES

Focusing Beyond Disparities In Patient Outcomes
By Jacqueline M. Chiofalo (7/28/20)

When discussing health disparities, much attention is focused on disparities in health outcomes. However, these are the final culminations of systems stacked against minority groups. Greater research focus needs to be placed on structural and process measures of health to allow for comparisons within and between institutions. Read More >>

SOCIAL DETERMINANTS OF HEALTH

Comparison of SDOH-Related Investments By Texas And California Medicaid Health Plans
By Shao-Chee Sim, Jeremy Cantor, Nicole Giron, Carolyn Wang Kong, Kay Ghahremani, and Jamie Dudensing (7/27/20)

Given the important role of Medicaid health plans in California and Texas in addressing the health and social needs of large enrollee populations and the plans' interest in advancing the social determinants of health (SDOH) agenda in both states, two foundations sought to better understand the plans' investments in improving SDOHs. The authors compare results from surveys in California and Texas—the two most populous states in the US. Read More >>

WOMEN'S HEALTH

Pharmacist-Prescribed And Over-The-Counter Hormonal Contraception In Los Angeles County Retail Pharmacies
By Dima Mazen Qato, G. Caleb Alexander, Jenny S. Guadamuz, Sun Choi, Rebecca Trotzky-Sirr, and Stacy Tessler Lindau

Dima Qato and coauthors use a census of retail pharmacies in Los Angeles County to evaluate contraception availability a year after California implemented a statewide order granting pharmacies prescriptive authority for preventive contraceptives, and four years after federal law eliminated age restrictions on obtaining emergency contraception. Read More >>

BEHAVIORAL HEALTH CARE

Prices And Cost Sharing For Psychotherapy In Network Versus Out Of Network In The United States
By Nicole M. Benson and Zirui Song

Patients in the US are more likely to receive out-of-network behavioral health care, including treatment for mental health or substance use disorders, than they are to receive other medical and surgical services out of network. Nicole Benson and Zirui Song compare levels and growth of insurer-negotiated prices, patient cost sharing, and use of psychotherapy services in network and out of network in a large, commercially insured US population during 2007–17. Read More >>

COVID-19

Estimating The Infection Fatality Rate Among Symptomatic COVID-19 Cases
In The United States
By Anirban Basu

Ascertaining the infection fatality rate (IFR) of COVID-19 infections is essential in combating this pandemic. Anirban Basu selected 116 counties, spanning 33 states, with a total of 40,835 confirmed cases and 1,620 confirmed deaths through April 20, 2020, to calculate that the IFR in the US is 1.3 percent, with significant variations across counties. Read More >>

Thousands Of Lives Could Be Saved In The US During The COVID-19 Pandemic If States Exchanged Ventilators
By Daniel Adelman

During the current COVID-19 pandemic, concerns have been raised about a nationwide shortage of mechanical ventilators, a necessary element in saving lives. With the peak number of COVID-19 cases varying by state, there have already been voluntary exchange efforts to make ventilators available when and where they are needed most. Daniel Adelman assesses the benefits of a potential nationwide logistical operation, to be organized and administered by the US military. Read More >>

Disparities In Outcomes Among COVID-19 Patients In A Large Health Care System In California
By Kristen M. J. Azar, Zijun Shen, Robert J. Romanelli, Stephen H. Lockhart, Kelly Smits, Sarah Robinson, Stephanie Brown, and Alice R. Pressman

As the COVID-19 pandemic spreads throughout the United States, there is growing evidence that racial and ethnic minorities and socioeconomically disadvantaged groups bear a disproportionate burden of illness and death. Kristen Azar and coauthors analyzed the medical records of COVID-19 patients at Sutter Health, a large integrated health network in Northern California, to measure potential disparities. After analyzing 1,052 confirmed COVID-19 cases from January 1 to April 8, 2020, the authors observed that, compared with non-Hispanic white patients, African Americans had 2.7 times the odds of hospitalization, after adjusting for age, gender, comorbidities, and income. Read More >>

Strong Social Distancing Measures In The United States Reduced The COVID-19 Growth Rate
By Charles Courtemanche, Joseph Garuccio, Anh Le, Joshua Pinkston, and Aaron Yelowitz

To minimize the spread of COVID-19 during March and April 2020, US state and local governments joined worldwide efforts to impose social distancing measures. They have included bans on large social gatherings, public school closures, the shuttering of entertainment-related businesses, and shelter-in-place orders. Charles Courtemanche and coauthors examined the impact of these four measures, separately and collectively, and found that these policies reduced the daily COVID-19 growth rate by 5.4 percentage points after 1–5 days, 6.8 percentage points after 6–10 days, 8.2 percentage points after 11–15 days, and 9.1 percentage points after 16–20 days. Read More >>

GRANTWATCH

Funders Support Mental Health Care: COVID-19 And Before
By Lee L. Prina

The July 2020 GrantWatch column focuses on foundation activities related to mental health—including a few related to COVID-19. Here are some examples. The Ethel and James Flinn Foundation is funding free virtual behavior therapy and counseling for Detroit, Michigan, residents affected by COVID-19. The Bipartisan Policy Center has launched a Behavioral Health Integration Task Force funded by three foundations. And the California Health Care Foundation announced an online training program to "nearly double" the pipeline of psychiatric mental health nurse practitioners in that state. In the column's Key Personnel Changes section, read about the Robert Wood Johnson Foundation's new vice president for policy.
Read More >>

About Health Affairs

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