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A Weekly Health Policy Round Up From Health Affairs
August 23, 2020
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PATIENT-CENTERED CARE
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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By David Scales
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.
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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 >>
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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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