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A Weekly Health Policy Round Up From Health Affairs            

**September 1, 2019**

THIS WEEK ON THE BLOG

FOLLOWING THE ACA

CMS Rejects Idaho Waiver As Incomplete

By Katie Keith (8/30/19)

Idaho failed to include sufficient analysis for CMS to assess the
effects of the proposed waiver. Read More >>

HHS Walks Back New Policy On Drug Coupons

By Katie Keith (8/28/19)

Until the 2021 payment rule is issued and effective, the Departments of
Labor, Health and Human Services (HHS), and Treasury will not take
enforcement action against an insurer or plan that excludes the value of
drug manufacturers' coupons from the annual limitation on cost
sharing, including when no medically appropriate generic equivalent is
available.
Read More >>

CMS Approves Reinsurance Waivers in DE, RI

By Katie Keith (8/27/19)

Delaware and Rhode Island were the final two states awaiting approval of
a Section 1332 waiver for the 2020 plan year. In addition to summarizing
the programs in Delaware and Rhode Island, this post highlights some of
the variation among the twelve states with an approved state-based
reinsurance program. Read More >>

CONSIDERING HEALTH SPENDING

The New Hospital Price Disclosure Rule Is Important, But Only A First
Step

By James C. Capretta (8/26/19)

Prices need to be based on standardized, episode-based services that are
defined in ways that are meaningful to consumers. Read More >>

WORKFORCE IN THE COMMUNITY

Developing The Workforce The Country Needs Through Geriatric Workforce
Enhancement Programs

By Jennifer Jurado Severance and Janice Knebl (8/30/19)

Funding for current and additional GWEPs is necessary for a sustained
commitment to geriatrics education and better care for a growing
population of older adults. Read More >>

PHARMACEUTICALS AND MEDICAL TECHNOLOGY

Prescription 2020: Democratic Candidates And Drug Pricing

By Rohan Chalasani, Julie M. Donohue, and Walid F. Gellad (8/29/19)

Most revealing of the issue's salience in the approaching presidential
race is that every Democratic presidential hopeful from the Senate has
sponsored legislation centered on lowering prescription drug costs, and
the remaining candidates have pushed their own proposals on the campaign
trail. Read More >>

HIV/AIDS

PrEP School: A Field Manual For The Battle Over HIV Prevention Drug
Pricing

By Rochelle P. Walensky and A. David Paltiel

Donations, US Preventive Services Task Force endorsements, and generic
equivalents may each result in modest near-term incremental benefits but
they will certainly serve as no substitute for a good old-fashioned
price cut. Read More >>

SYSTEMS OF CARE

An International Perspective On The Paradoxes Of US Health Care

By Angèle Malâtre-Lansac (8/28/19)

What are the most surprising aspects of the US system through the lenses
of ten observers from Australia, France, Germany, the Netherlands, New
Zealand, Norway, and England?
Read More >>

ACCESS TO CARE

Applying Sutton's Law To Alternative Payment Models For The Seriously
Ill
By Joan M. Teno, Jennifer Bunker, and Pedro Gozalo (8/27/19)

There is a sizable population with both high needs and the potential for
cost avoidance that would benefit from enhanced continuity of care and
expanded access to palliative care as proposed in this new alternative
payment model. Read More >>

HEALTH PHILANTHROPY

People Post: Foundation Staffers' Goings and Comings; Job Openings

By Lee-Lee Prina (8/29/19)

Who has a new job or has received a promotion in health philanthropy?
Read news from foundations around the country. Also, read about job
openings at foundations in Maine and New Jersey. Read More >>

HEALTH AFFAIRS EVENTS

AGING AND HEALTH:  IMPROVING CARE FOR OLDER ADULTS

New Event!
September 24, 2019
10:00 am - 12:00 pm Eastern
National Press Club - Washington, DC
Registration Now Open

Join Health Affairs and The John A. Hartford Foundation for a robust
policy conversation featuring authors from the journal's Aging &
Health series, as well as other experts in the field, to discuss topics
including:
* Moving Serious Illness Care from Hospital to Home

* Disparities in Home- and Community-Based Care

* Impact of Caregiving on Spouses and Need for Support

In addition to Terry Fulmer, President of The John A. Hartford
Foundation, speakers include:
* Timothy G. Ferris, CEO, Massachusetts General Physicians Organization

* Ann Hwang, Director, Center for Consumer Engagement in Health
Innovation, Community Catalyst

* R. Tamara Konetzka, Professor of Health Services Research, Department
of Public Health Sciences and Department of Medicine, The University of
Chicago Biological Sciences, on "A National Examination of Long-term
Care Setting, Outcomes, and Disparities among Elderly Dual-Eligibles"
(July 2019)

* Bruce Leff, Professor of Medicine and Director, Center for
Transformative Geriatric Research, Division of Geriatric Medicine, Johns
Hopkins University School of Medicine

* Katherine A. Ornstein, Assistant Professor, Geriatrics and Palliative
Medicine, Icahn School of Medicine at Mount Sinai @IcahnMountSinai, on
"Spousal Caregivers Are Caregiving Alone In The Last Years Of Life"
(June 2019)

* Brad Stuart, Chief Medical Officer, Coalition to Transform Advanced
Care, on "A Large-Scale Advanced Illness Intervention Informs
Medicare's New Serious Illness Payment Model" (June 2019)

* Jennifer Wolff, Eugene and Mildred Lipitz Professor and Director of
the Roger C. Lipitz Center for Integrated Health Care, Johns Hopkins
School of Public Health

Getevent-specific emails
delivered directly to your inbox.

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IN THE JOURNAL

MILITARY HEALTH SYSTEM

Families With TRICARE Report Lower Health Care Quality And Access
Compared To Other Insured And Uninsured Families

By Roopa Seshadri, Douglas Strane, Meredith Matone, Karen Ruedisueli,
and David M. Rubin

Roopa Seshadri and coauthors analyze access and quality for children
covered by TRICARE. Overall, children on TRICARE are more likely to have
complex medical or mental health needs than children covered by other
public or private insurance programs.Read More >>

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Assessing Low-Value Health Care Services In The Military Health System

By Tracey Pérez Koehlmoos, Cathaleen King Madsen, Amanda Banaag, Adil
H. Haider, Andrew J. Schoenfeld, and Joel S. Weissman

Tracy Pérez Koehlmoos and colleagues examined the provision of
low-value care in the Military Health System, comparing care delivered
in civilian health care facilities (purchased care) to care delivered in
Department of Defense-controlled health care facilities (direct care).
Read More >>

Post-Deployment Screening In The Military Health System: An Opportunity
To Intervene For Possible Alcohol Use Disorder

By Rachel Sayko Adams, Erich J. Dietrich, Joshua C. Gray, Charles S.
Milliken, Natalie Moresco, and Mary Jo Larson

Army active duty soldiers are routinely screened for possible alcohol
use disorder in pre- and post-deployment health surveillance surveys.
Rachel Adams and coauthors examined the likelihood of having a follow-up
behavioral health visit or receiving an alcohol use disorder diagnosis
among soldiers returning from deployments associated with the
Afghanistan or Iraq operations in fiscal years 2008-13, based on their
post-deployment screening results.
Read More >>

ENTRY POINT

Back At Home, A New Purpose For Battlefield Skills

By T. R. Goldman

A pilot program will allow returning military medics and corpsmen,
guided by an algorithm, to expand access to care. Read More >>

Listen to the author describe the program in a WTOP interview here
.

GRANTWATCH

Foundations' Work To Help Military And Veterans

By Lee L. Prina

The August 2019 GrantWatch column provides examples of foundations that
fund in the area of veterans' and military health. These include the
New York State Health Foundation, United Health Foundation, and others.
In the Key Personnel Changes section, read about a physician and combat
veteran who will become the new leader of the Advancing a Healthier
Wisconsin Endowment in September and about a new role for John R.
Lumpkin, formerly of the Robert Wood Johnson Foundation. Read More >>

BOOK REVIEW

Reinhardt's Final Work

By Jeff Goldsmith

Jeff Goldsmith reviews

**Priced Out**, Uwe Reinhardt's final book, calling it "an unsparing and
sobering analysis of the United States' unfinished health policy
agenda." Read More >>

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