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A Weekly Health Policy Round-Up From Health Affairs            

**August 16, 2020**

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THIS WEEK ON THE BLOG

COVID-19
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Moving On From Telehealth-By-Desperation: What Will Make Telehealth
Stick

By Lori Uscher-Pines (8/14/20)

While many providers have found telehealth ideal for improving access to
care during the pandemic, telehealth visits are already declining and
may continue to decline. Without permanent policy changes, it is unclear
if telehealth services will represent a significant proportion of US
health care visits in the long run. Read More >>

Collaborative Approach To Public Goods Investments (CAPGI): Lessons
Learned From A Feasibility Study

By Len M. Nichols, Lauren A. Taylor, Paul Hughes-Cromwick, George
Miller, Ani Turner, Corey Rhyan, and Richard M. Hamrick (8/13/20)

This post briefly describes the results of a one-year feasibility
project (June 2019-May 2020) to establish whether our "Collaborative
Approach to Public Goods Investments" would be interesting and feasible
enough for real communities to implement and test. The simple answer is
yes, but most communities need more technical assistance and time than
we could provide in the spring of COVID-19. Read More >>

Community Resilience For COVID-19 And Beyond: Leveraging A System For
Health Care And Social Services Integration

By Amanda L. Brewster, Mark Fleming, Margae Knox, and Anna Roth
(8/12/20)

Following statewide shelter-in-place orders, California's Contra Costa
County leveraged cross-sector partnerships to reach out to vulnerable
Medicaid enrollees to identify and help manage their social and medical
needs. This experience shows that health care and social service
integration can promote resilience in the face of emerging public health
threats.
Read More >>

After COVID-19, A Payment Policy Reboot: Three Lessons From The Pandemic
On How To Improve Value-Based Payment

By Amol S. Navathe and Joshua M. Liao (8/11/20)

Prior to COVID-19, payment policy had largely involved incremental
changes. While positive, this approach has been insufficient on its own
to move Medicare off its unsustainable course toward insolvency.
COVID-19 provides a powerful wake-up call to address these issues. Read
More >>

How To Ensure COVID-19 Doesn't Delay Value-Based Care

By Soleil Shah and Bob Kocher (8/11/20)

The longer we proceed under pure fee-for-service models, the longer
health care costs will spiral with limited improvements in quality. We
suggest supporting the adoption and existence of accountable care
organizations; creating opportunities for new value-based payments; and
preventing the loss of value-based opportunities via private equity or
large hospital network acquisitions. Read More >>

How Lessons From Global Health Can Improve Health And The Response To
COVID-19 In The US

By Charles B. Holmes and Eric P. Goosby (8/10/20)

Drawing from our experiences, we put forth seven lessons learned from
efforts to protect global health that, if applied here at home, will
help to reduce inequities and improve the health of all Americans. Read
More >>

FOLLOWING THE ACA

CMS Approves NH 1332 Waiver, States Adopt Own Health Insurance Taxes

By Katie Keith (8/10/20)

On August 5, the Centers for Medicare and Medicaid Services and the
Treasury Department approved New Hampshire's waiver application to
operate a state-based reinsurance program. This post also summarizes
recent legislation enacted in Colorado and New Jersey to adopt
state-level health insurance assessments. Read More >>

POLITICS

Democrats Will Adopt Their Health Care Platform Next Week-Here's
What It Says

By Billy Wynne (8/14/20)

The platform reiterates some hallmarks of Democratic philosophy while
addressing current challenges like the COVID-19 pandemic and adding new
details to long-sought policy goals, such as a public option. Read More
>>

BEHAVIORAL HEALTH

How We Are Integrating Behavioral Health Into Primary Care

By Jennifer Zimmerman, Jill Miller, and Julie Geiler (8/12/20)

A Cincinnati, Ohio-based funder reports lessons learned from its grant
to develop a patient-centered approach to integrating behavioral health
into primary care practices. For example, the grantee, an integrated
health care delivery system, gained physician buy-in and adoption, even
though such integration is an enormous culture change. The grantee also
identified a shortage of behavioral health consultants in the area and
is working to develop a pipeline of potential candidates. Read More >>

PAYMENT

Getting It Done: Consensus On Surprise Billing Protections

By Jack Hoadley, Kevin Lucia, and Katie Keith (8-12-20)

Action to address surprise medical billing should transcend traditional
bipartisan division. Failure to do so would be a true loss for consumers
in the midst of a global pandemic.
Read More >>

MEDICAID

Medicaid Work Experiments Redux: The Administration's Petition For US
Supreme Court Review Of Gresham v Azar

By Sara Rosenbaum, Morgan Handley, and Maria Velasquez (8/13/20)

On February 14 a three-judge panel of the DC Circuit unanimously
affirmed a lower court's decision to vacate the federal government's
approval of Arkansas's Medicaid work experiment. We analyze the
Department of Justice's request that the US Supreme Court review the
DC Circuit's decision. Read More >>

FOOD

A Different Approach To The FSMA Laboratory Accreditation Rule

By Robin E. Stombler (8/10/20)

Eight years after the passage of the Food Safety Modernization Act
(FSMA) of 2011, a rule was proposed by the Food and Drug Administration
outlining how the agency would establish a program for the testing of
food by accredited laboratories. The proposed rule provides a narrow
interpretation of the FSMA. This post examines what the law says and
what is proposed, and suggests a new approach. Read More >>

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IN THE JOURNAL

HOME HEALTH

Informal And Formal Home Care For Older Adults With Disabilities
Increased, 2004-16

By Courtney H. Van Houtven, R. Tamara Konetzka, Elizabeth Taggert, and
Norma B. Coe

Older adults and people with disabilities rely on a combination of
formal (paid) and informal care-with the latter often provided by
family members-to support them in their activities of daily living.
Courtney Van Houtven and coauthors examine trends in care from 2004 to
2016 in this DataWatch. Read More >>

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ORGANIZATION OF CARE

Financial Integration's Impact On Care Delivery And Payment Reforms: A
Survey Of Hospitals And Physician Practices

By Elliott S. Fisher, Stephen M. Shortell, A. James O'Malley, Taressa
K. Fraze, Andrew Wood, Marisha Palm, Carrie H. Colla, Meredith B.
Rosenthal, Hector P. Rodriguez, Valerie A. Lewis, Steven Woloshin, Nilay
Shah, and Ellen Meara

Elliott Fisher and coauthors write that national data on what different
types of health care organizations are actually doing to improve care
are "largely missing from the existing literature." This article aims to
address this knowledge gap to determine the relationship between
financial integration of hospitals and physician practices and better
quality, as measured by higher levels of adoption of care delivery and
payment reforms.Read More >>

PHARMACEUTICALS & MEDICAL TECHNOLOGY

Medicare Part D Plans Rarely Cover Brand-Name Drugs When Generics Are
Available

By Stacie B. Dusetzina, Juliette Cubanski, Leonce Nshuti, Sarah True,
Jack Hoadley, Drew Roberts, and Tricia Neuman

Stacie Dusetzina and coauthors write: "Recent press reports and other
evidence suggest that Medicare Part D plans may be encouraging the use
of brand-name drugs instead of generics. However, the scope of such
practices is unclear." To explore this question, the authors examine
brand-name and generic drug placements in Medicare formularies. Read
More >>

NURSING HOMES

Trends In Hospitals And Skilled Nursing Facilities Sharing Medical
Providers, 2008-16

By Elizabeth M. White, Cyrus M. Kosar, Momotazur Rahman, and Vincent Mor

Elizabeth White and coauthors examine the growing phenomenon of
clinicians focusing exclusively on caring for nursing home patients and
becoming "SNFists." This specialization can reduce the coordination that
naturally occurs when a clinician provides care in both hospital and
skilled nursing facility (SNF) settings. Read More >>

WOMEN'S HEALTH

Compared With Other Countries, Women In The US Are More Likely Than Men
To Forgo Medicines Because Of Cost

By Jamie R. Daw and Michael R. Law  

Nonadherence to prescription medicines because of cost is associated
with adverse clinical outcomes. Jamie Daw and Michael Law find that in
eleven high-income countries, the largest disparities in nonadherence
for women compared with men occur in the US, Canada, and Australia,
which are among the countries in which out-of-pocket spending for
pharmaceuticals is the highest. 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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