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A Weekly Health Policy Round Up From Health Affairs            

**August 30, 2020**

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FAST TRACK AHEAD OF PRINT

COVID-19

Community-Level Factors Associated With Racial And Ethnic Disparities

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**In COVID-19 Rates In Massachusetts**

By José F. Figueroa, Rishi K. Wadhera, Dennis Lee, Robert W. Yeh, and
Benjamin D. Sommers

This past spring, Massachusetts had one of the highest incidence rates
of COVID-19 cases in the US. Early reports suggested that Black and
Latino residents were disproportionately affected. However, evidence on
whether specific demographic, economic, and occupational factors were
associated with a higher risk for COVID-19 among minority communities
remains sparse. José Figueroa and coauthors examined the association
between community-level factors and COVID-19 case rates across 351
cities and towns in Massachusetts between January 1 and May 6, 2020.
Read More >>

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IN THE JOURNAL

AFFORDABLE CARE ACT
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Are Higher For Marketplace Members Who Enroll During Special Enrollment
Periods Compared With Open Enrollment

By Laura F. Garabedian, Robert LeCates, Alison Galbraith, Dennis
Ross-Degnan, and J. Frank Wharam

Adverse selection, the phenomenon in which people are more likely to
enroll in a health insurance plan when they have a medical need, has the
potential to threaten the stability of the Affordable Care Act (ACA)
exchanges, or Marketplaces. This study examines the trends among those
who enrolled during a special enrollment period in a Marketplace of a
large national insurer. Read More >>

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DETERMINANTS OF HEALTH

Food Insecurity Is Associated With Higher Health Care Use And Costs
Among Canadian Adults

By Fei Men, Craig Gundersen, Marcelo L. Urquia, and Valerie Tarasuk  

This study marks an important step toward understanding the relationship
of household food insecurity to individual health, health care use, and
public health expenditure. Fei Men and coauthors note: "The study was
situated in the Canadian context, where the costs of acute care
hospitalization and same-day surgery were fully covered by universal
health insurance, thus minimizing the selection bias introduced by
affordability." Read More >>

SNAP Participants Improved Food Security And Diet After A Full-Service
Supermarket Opened In An Urban Food Desert

By Jonathan Cantor, Robin Beckman, Rebecca L. Collins, Madhumita Ghosh
Dastidar, Andrea S. Richardson, and Tamara Dubowitz  

Jonathan Cantor and coauthors explore the intersection of two US
government efforts to improve access to food-the Supplemental
Nutrition Assistance Program (SNAP) and the Healthy Food Financing
Initiative (HFFI). They test the impact of a new, HFFI-financed,
full-service supermarket on SNAP participants in an urban food desert.
Read More >>

GRANTWATCH

Foundations Help Fight Effects And Roots Of COVID-19

By Lee L. Prina

The August 2020 GrantWatch column is a three-page sampling of how
foundations from California to Massachusetts have been participating in
the fight against the coronavirus. They have awarded grants, held
webinars, commissioned a poll, funded an online "COVID-19 Resources for
States," and published instructive blog posts and opinion pieces. In Key
Personnel Changes, read about the recently named leader of Arcora
Foundation, an oral health funder, as well as news of Sheldon Weisgrau,
Katherine Fritz, and Harvard's David R. Williams. Read More >>

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NARRATIVE MATTERS: COVID-19

A Patient With COVID-19 Is Left Behind As Care Goes Virtual

By Kumara R. Sundar

Primary care physician Kumara Sundar reflects on his institution's
equity initiatives and how they left certain patients behind in the
rapid shift to telemedicine.
Read More>>

Listen to the podcast here.

THIS WEEK ON THE BLOG

COVID-19

Engaging Primary Care In The Community Management Of COVID-19: Global
Lessons From A Small Town In Alberta, Canada

By Saugata Chakraborty, Adam Vyse, and Annalee Coakley (8/28/20)

The outbreak at the High River meat packing plant in early April 2020 is
a case study on how socioeconomic factors can contribute to the spread
of COVID-19. Read More >>

Understanding The FDA's Controversial Convalescent Plasma
Authorization

By Rachel Sachs (8/27/20)

In the longer term, the damage done to the Food and Drug
Administration's independent image may translate into a loss of public
trust, which could lead to increased levels of vaccine
hesitancy-potentially disastrous when a vaccine may be critical to
fighting COVID-19.
Read More >>

Count Native Hawaiian And Pacific Islanders In COVID-19 Data-It's An
OMB Mandate

By Richard Calvin Chang, Corina Penaia, and Karla Thomas (8/27/20)

Identifying particularly susceptible populations will be critical for
effectively allocating health and economic resources that will help
mitigate COVID-19's impact. State and county agencies should not have
to miss opportunities for additional resources, and Native Hawaiians and
Pacific Islanders should not be hidden in the data when strong
justification exists for counting them. Read More >>

COVID-19 Underscores The Need For Digital Quality Measurement

By Benjamin Hamlin, Margaret E. O'Kane, Michael Barr, and Paul Cotton
(8/26/20)

Digital quality measures shorten the time required to advance more
clinically relevant measures that reduce burden, enhance accuracy, and
drive quality improvement. To fully implement them, policies must be in
place to help reshape the quality ecosystem, just as was done for
learning measurement systems and computable evidence synthesis. Read
More >>

Expanding Community-Based Immunization To Meet Today's Vaccine
Challenges

By Purva Rawal, Jennifer Rak, Elizabeth Docteur, and Lu Zawistowich
(8/24/20)

To ensure timely and equitable access to vaccines during the COVID-19
pandemic, the health care delivery system must reconfigure resources and
make additional investments in three existing community-based sites that
policy makers and stakeholders should build on through additional
support and partnership. Read More >>

FOLLOWING THE ACA

Temporary Premium Credits: New Rule Clarifies Risk Adjustment And
Medical Loss Ratio Standards

By Katie Keith (8/26/20)

On August 25, the Centers for Medicare and Medicaid Services released a
sweeping interim final rule providing additional guidance on the
recently announced temporary premium credits policy. The policy,
announced on August 4, allows insurers in the individual and small group
markets to temporarily reduce monthly premiums for 2020 coverage.Read
More >>

Trump Administration Deems Georgia's 1332 Waiver Application, With
Individual Market Restructuring, Complete

By Katie Keith (8/25/20)

While not as dramatic as Georgia's initial application, the revised
Georgia Access Model would still-if approved-make marked changes to
the state's individual market and would be the broadest waiver ever
approved under Section 1332 of the Affordable Care Act.
Read More >>

CULTURE OF HEALTH

Making Anti-Racism A Core Value In Academic Medicine

By J. Nwando Olayiwola, Joshua J. Joseph, Autumn R. Glover, Harold L.
Paz, and Darrell M. Gray, II (8/25/20)

Academic medical centers and health care organizations that are not
acting to eliminate racism are perpetuating its proliferation. The Ohio
State University's Anti-Racism Action Plan provides a model for
actively working against racism, by evaluating curricula, practices,
training models, behaviors, and actions through a lens of anti-racism.
Read More >>

HOSPITALS

The Hospital Industry Is In A Financial Mess: We Have A Unique
Opportunity To Fix It

By Bruce Stuart (8/27/20)

The COVID-19 pandemic has revealed a hospital system woefully unprepared
to deal with a financial crisis. We must fix the system and design
policy solutions to mitigate the effects of hospital market power. Read
More >>

MATERNAL HEALTH

Bringing Community-Based Doula Care To New Jersey

By Aron Lesser, Renée Nogales, and Atiya Weiss (8/27/20)

Community doulas can help pregnant and postpartum women by providing
physical, educational, and social support through individualized
services. Evidence shows that doula care can improve maternal and child
health outcomes, especially in low-income areas and communities of
color. Members of a group advising New Jersey Medicaid on equitable
policy development for, and implementation of, doula care learned the
importance of community members' direct participation in health policy
development. 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
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health care workers to save lives across the globe. Project HOPE has
published Health Affairs since 1981.

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