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A Weekly Health Policy Round Up From Health Affairs            

**August 23, 2020**

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FAST TRACK AHEAD OF PRINT

COVID-19

Severe Staffing And Personal Protective Equipment Shortages Faced By
Nursing Homes During The COVID-19 Pandemic

By Brian E. McGarry, David C. Grabowski, and Michael L. Barnett

Brian McGarry and coauthors evaluated public data about staffing and
personal protective equipment (PPE) shortages between May and July 2020
from a new national database covering 98 percent of US nursing homes.
The authors found that more than one in five nursing homes reported a
severe shortage of PPE-with one week or less of available supply-or
a staffing shortage.Read More >>

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IN THE JOURNAL

PATIENT-CENTERED CARE
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Veterans' Experiences With Outpatient Care: Comparing The Veterans
Affairs System With Community-Based Care

By Megan E. Vanneman, Todd H. Wagner, Michael Shwartz, Mark Meterko,
Joseph Francis, Clinton L. Greenstone, and Amy K. Rosen  

Timely access to outpatient care was a primary driver behind the
Department of Veterans Affairs' (VA's) increased purchase of
community-based care under the Veterans Access, Choice, and
Accountability Act of 2014, known as the Choice Act. Megan Vanneman and
coauthors compare veterans' experiences in VA-delivered and
community-based outpatient care after implementation of the act. Read
More >>

COVID-19

Community Use Of Face Masks And COVID-19: Evidence From A Natural
Experiment Of State Mandates In The US

By Wei Lyu and George L. Wehby

This landmark paper finds that face mask use possibly averted
230,000-450,000 cases of COVID-19 by May 22, 2020. Cited in more than
350 news stories and tweeted by thousands, it has been used by policy
makers in many US states as well as countries around the world in
support of face mask mandates. The peer-reviewed, unedited version of
the paper was released online as a Health Affairs Fast Track
Ahead-of-Print paper.
Read More >>

GLOBAL HEALTH POLICY

Return On Investment From Immunization Against 10 Pathogens In 94 Low-
And Middle-Income Countries, 2011-30

By So Yoon Sim, Elizabeth Watts, Dagna Constenla, Logan Brenzel, and
Bryan N. Patenaude
 
So Yoon Sim and coauthors estimate the return on investment (ROI) of
immunization programs for ten pathogens in ninety-four low- and
middle-income countries for the period 2011-30. Read More >>

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NARRATIVE MATTERS: COVID-19

An Understaffed Hospital Battles COVID-19

By David Scales

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In the first of three Narrative Matters essays in this issue, David
Scales, a hospitalist physician, describes the harrowing reality of
caring for patients with COVID-19 in an overwhelmed community hospital.
Read More >>

Listen to the podcast here.

THIS WEEK ON THE BLOG

COVID-19

The Food and Drug Administration (FDA) outlines the regulatory landscape
and major policy considerations for the three key components of the
COVID-19
response-testing, therapeutics, and vaccines-in a four-part series
today on Health Affairs Blog.

And for more on COVID-19 vaccines and treatment, RSVP now
for a
Health Affairs symposium on August 24.

The FDA Response To COVID-19 At Six Months: Regulatory Innovation In The
Face Of A Pandemic

By Anand Shah and Stephen M. Hahn (8/18/20)

We hope that chronicling and communicating FDA's actions to date will
spur conversation from stakeholders about what lessons the agency can
draw from the pandemic experience to support short- and long-term steps
to modernize regulatory policies, processes, and programs. Read More >>

FDA Support For Expedited Access To COVID-19 Diagnostics

By Anand Shah, Jeffrey Shuren, and Stephen Hahn (8/18/20)

The agency is committed to providing interactive regulatory support for
test design and collaborating with partners to share data for
performance validation to help expand access to accurate tests for
COVID-19. Read More >>

FDA Initiatives To Accelerate The Development Of COVID-19 Therapeutics

By Anand Shah, Kushal T. Kadakia, Peter W. Marks, Patrizia Cavazzoni,
and Stephen M. Hahn (8/18/20)

As the medical and scientific community works to broaden the therapeutic
toolkit for COVID-19, FDA is committed to reviewing investigational
programs, policies, and partnerships with the aim of providing a clear
path forward for the rigorous development of new therapies for the
pandemic and possibly beyond. Read More >>

Ensuring The Safety And Efficacy Of A COVID-19 Vaccine

By Anand Shah, Peter W. Marks, and Stephen M. Hahn (8/18/20)

Access to a safe and effective vaccine will be a critical component of
the public health response to the COVID-19 pandemic. The FDA is hopeful
that its proactive guidance on key issues such as trial design and
statistical considerations will provide regulatory clarity to sponsors
that are currently in the process of planning clinical trials. Read More
>>

POLITICS

Taking Stock Of Republican Health Policy In The Trump Era

By Katie Keith (8/21/20)

Health care will continue to be a hot topic as we near the 2020
election. Next week, the Republican party takes its turn laying out a
vision for the next four years under a second term for the Trump
administration. This post identifies several of the Republican party's
health policy priorities since 2017 and takes stock of President
Trump's record on health care.
Read More >>

FOLLOWING THE ACA

ACA Round-Up: Texas Oral Argument, RADV Report, And More

By Katie Keith (8/20/20)

The August recess has not slowed Affordable Care Act activity. Among
other developments, this post discusses the latest in California v.
Texas, which the Supreme Court will hear on November 10-one week after
the 2020 election-including the last round of briefs in the case. Read
More >>

CMS Finalizes BHP Methodology For 2021

By Katie Keith (8/19/20)

The Centers for Medicare and Medicaid Services maintains its position
that it cannot provide states with the cost-sharing reduction (CSR)
component of their Basic Health Plan payment in the absence of a
congressional appropriation for CSR funding. Thus, as it did in prior
years, the methodology incorporates a premium adjustment factor of 1.188
for 2021 to account for unpaid CSRs. Read More >>

Court Vacates New 1557 Rule That Would Roll Back Antidiscrimination
Protections For LGBT Individuals

By Katie Keith (8/18/20)

In the first of several coming rulings on the Trump administration's
new rule implementing the Affordable Care Act's primary
antidiscrimination provision, the court said that the government had
acted arbitrarily and capriciously in not revisiting its definition of
discrimination "on the basis of sex" after the Supreme Court rejected
that interpretation. Read More >>

Federal Circuit: Insurers Owed Unpaid Cost-Sharing Reductions, Reduced
By Higher Premium Tax Credits From Silver Loading

By Katie Keith (8/17/20)

The Federal Circuit panel agreed with the lower courts that the
government has an "unambiguous obligation" to make cost-sharing
reductions (CSR) payments to insurers, and that this obligation is
enforceable for damages in court. However, the panel limited the amount
of unpaid CSRs that insurers can recover based on premium loading,
necessitating complex calculations of damages by the lower courts. Read
More >>

PHARMACEUTICALS & MEDICAL TECHNOLOGY

Unraveling A Composite Measure To Drive Immunization Uptake In Adults: A
Critical Compromise

By Angela K. Shen and Elizabeth A. Sobczyk (8/20/20)

The current pandemic has heightened awareness of the utility of vaccines
to prevent disease and save on medical, economic, and social costs. With
more experience and comfort in electronic reporting of immunizations for
adults, increasing data capture of adults in immunization information
systems, and with increased provider recommendation, administration, and
referral of vaccinations, perhaps the existing composite measures can be
reassembled with less specious concern.Read More >>

AFFORDABLE CARE ACT

Choice, Competition, And Flexibility, Part I: Post-ACA Consumer
Challenges

By Brian J. Miller and Robert E. Moffit (8/19/20)

This is the first part of a two-part post discussing the current state
of health reform and where we should go from here. Part I examines the
effects of the ACA and progressive reform initiatives. Part II will
outline a market-driven path forward. Read More >>

Choice, Competition, And Flexibility, Part II: Market-Driven
Alternatives To Single Payer

By Brian J. Miller and Robert E. Moffit (8/20/20)

This is the second part of a two-part post discussing the current state
of health reform and where we should go from here. Part I examined the
effects of the ACA and progressive reform initiatives. Part II outlines
a market-driven path forward. Read More >>

DISPARITIES

No Longer An Elective Pursuit: The Importance Of Physician Advocacy In
Everyday Medicine

By Ayotomiwa Ojo, Raquel Sofia Sandoval, Derek Soled, and Amanda Stewart
(8/19/20)

As the nation reckons with structural racism's establishment in all
aspects of society, physicians and medical students are mobilizing in an
unprecedented manner. Current events exemplify why we cannot return to
the traditional practice model in which most physicians prioritize
patient care while advocacy becomes elective. Read More >>

MARKETS

The Value Of Short-Term Health Plans: Rebutting The Energy And Commerce
Democratic Staff Report

By Brian Blase and Doug Badger (8/17/20)

Short-term plans represent an important option for millions of Americans
harmed by federal policy over the past decade that has resulted in
reduced choice of health insurance plans and skyrocketing premiums and
deductibles. Eliminating this option would force those enrolled in
short-term plans to choose between paying much higher premiums for
ACA-compliant coverage and becoming uninsured. Read More >>

ACCESS TO CARE

How To Boost Health Insurance Enrollment: Three Practical Steps That
Merit Bipartisan Support

By Christen Linke Young, James C. Capretta, Stan Dorn, David Kendall,
and Joseph Antos (8/17/20)

The US has a complex, enrollment-based health insurance system. It is
not easy to navigate in the best of times; in a pandemic, the challenge
is compounded. The practical steps recommended here would allow more
Americans to get and keep health insurance as they cope with difficult
transitions. 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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