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A Weekly Health Policy Round-Up From Health Affairs            

**September 6, 2020**

THIS WEEK ON THE BLOG

COVID-19

A Population Health Segmentation Framework For Balancing Medical Need
And COVID-19 Risk During And After The Pandemic

By Hadi Kharrazi, Kimberly A. Gudzune, and Jonathan P. Weiner (9/4/20)

Over the next year or longer, clinicians will need to simultaneously
work to mitigate the impact of COVID-19 on those at highest risk while
also responding to the growing backlog of unmet general medical needs.
We suggest how existing medical and public health data can be collated
and curated to create a population-health analytic framework to manage
and inform the care processes of the current COVID-19 era. Read More >>

FOLLOWING THE ACA

Another Court Vacates LGBTQ-Specific Rollbacks From New 1557 Rule

By Katie Keith (9/4/20)

On September 2, a second federal court preliminarily blocked portions of
a new federal rule that would strip protections from LGBTQ people by
eliminating protections under Section 1557 of the Affordable Care Act
against discrimination based on sex stereotyping.
Read More >>

ACA Round-Up: Navigator Grantees, EHB Changes, And More

By Katie Keith (9/1/20)

On August 28, the Centers for Medicare and Medicaid Services (CMS)
announced $10 million in grants to 30 organizations to serve as
navigator entities in 28 states that use the federal Marketplace. CMS
separately announced that three states-Michigan, New Mexico, and
Oregon-have updated their essential health benefits (EHB) benchmark
for 2022.
Read More >>

PHARMACEUTICALS AND MEDICAL TECHNOLOGY

Challenging Patents To Promote Timely Generic Drug Entry: The Second
Look Act And Other Options

By Liam Bendicksen, Jonathan Darrow, and Aaron Kesselheim (8/31/20)

One important means of addressing rising prescription drug expenditures
is to facilitate the market entry of generic drugs after reasonable
exclusivity periods for brand-name drugs. The latest proposal to
encourage timely generic entry is a bill in Congress intended to help
efficiently screen out improperly issued drug patents. Read More >>

PUBLIC HEALTH

The Flint Settlement: The Exception That Proved The Rule

By Wendy E. Parmet (9/2/20)

As Michigan Governor Whitmer suggested, compensation alone cannot undo
all of the harms caused by government's failure to protect the people
of Flint. Compensation cannot restore lives, health, or trust in the
government. Read More >>

MEDICAID

How Foundational Moments In Medicaid's History Reinforced Rather Than
Eliminated Racial Health Disparities

By LaShyra T. Nolen, Adam L. Beckman, and Emma Sandoe (9/1/20)

While Medicaid serves as an essential safety net and has contributed to
improved health outcomes for minority populations, foundational moments
in the program's history led to inequities in health care access, and
the racial disparities and disparate health outcomes that followed. Read
More >>

DISPARITIES

Value-Based Health Care Must Value Black Lives

By Ayotomiwa Ojo, Parsa Erfani, and Neel Shah (9/3/20)

Value-based health care has had limited impact on reducing racial health
disparities, and alternative payment models do not explicitly name
disparities reduction as a performance measure. To achieve health
equity, hospital systems and payers must reorient value-based care
around racial and health justice. Read More >>

SOCIAL DETERMINANTS

A Small Foundation Gives Generously To Support Civic Engagement,
Pre-Election 2020

By Faith Mitchell (9/2/20)

A national health funder has invested $20 million to support civic
participation in the run-up to the 2020 election. That amount is more
than 20 percent of its endowment. What reasoning led to this decision?
The foundation, which defines health broadly, aims to ensure that all
eligible voters, especially those in Black, Latinx, and indigenous
communities, voice their opinions through democratic processes that also
protect their health during a pandemic. Read More >>

IN THE JOURNAL

COMMENTARY: THE PRACTICE OF MEDICINE

Practice And Policy Reset Post-COVID-19: Reversion, Transition, Or
Transformation?

By Christine Sinsky and Mark Linzer  

Christine Sinsky and Mark Linzer describe three areas-clinical
workflows, measurement and monitoring, and technology-where the
response to COVID-19 reduced administrative burdens associated with
practicing medicine. This paper appears in an ongoing Health Affairs
article series, The Practice of Medicine
, which is
supported by The Physicians Foundation. Read More >>

RESEARCH ARTICLE: OPIOID USE DISORDER

Primary Care Providers And Specialists Deliver Comparable Buprenorphine
Treatment Quality

By Alex K. Gertner, Allison G. Robertson, Byron J. Powell, Hendree
Jones, Pam Silberman, and Marisa Elena Domino  

To help stem the rising numbers of opioid overdose deaths, primary care
providers have stepped in to help deliver buprenorphine treatment. Alex
Gertner and coauthors note, however, that "policy makers and providers
have raised concerns that expanding treatment access may reduce
treatment quality and that primary care providers are not well equipped
to deliver buprenorphine treatment." To unpack this policy concern, the
authors investigated buprenorphine treatment use and quality change in
North Carolina Medicaid, and looked at how treatment quality differed
between primary care providers and specialists.
Read More >>

DATAWATCH: ORGANIZATION OF CARE

Consolidation Of Providers Into Health Systems Increased Substantially,
2016-18

By Michael F. Furukawa, Laura Kimmey, David J. Jones, Rachel M. Machta,
Jing Guo, and Eugene C. Rich

The consolidation of hospitals and physicians has been changing the
landscape of health care delivery in the United States. Using national
data, Michael Furukawa and coauthors examine this consolidation from
2016 to 2018. They also explore how the number of systems and system
size changed, and how the landscape of health systems varied by
ownership type in 2018. Read More >>

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COVID-19

When the COVID-19 pandemic arrived in the United States, the place
hardest hit was New York City. New York City Health + Hospitals, the
city's safety net system-and the largest such system in the
country-became "the epicenter of the epicenter." Four commentary
articles published in this issue describe how that system expanded its
physical and professional capacity and then connected that capacity to
the diverse population it serves.

Staffing Up For The Surge: Expanding The New York City Public Hospital
Workforce During The COVID-19 Pandemic

By Chris Keeley, Jonathan Jimenez, Hannah Jackson, Leon Boudourakis, R.
James Salway, Natalia Cineas, Yvette Villanueva, Donnie Bell, Andrew B.
Wallach, Donna Boyle Schwartz, Ivelesse Mendez-Justiniano, and Theodore
G. Long  

A Phone Call Away: New York's Hotline And Public Health In The Rapidly
Changing COVID-19 Pandemic

By Ross Kristal, Madden Rowell, Marielle Kress, Chris Keeley, Hannah
Jackson, Katherine Piwnica-Worms, Lisa Hendricks, Theodore G. Long, and
Andrew B. Wallach  

Staying Connected In The COVID-19 Pandemic: Telehealth At The Largest
Safety-Net System In The United States

By Jen Lau, Janine Knudsen, Hannah Jackson, Andrew B. Wallach, Michael
Bouton, Shaw Natsui, Christopher Philippou, Erfan Karim, David M.
Silvestri, Lynsey Avalone, Milana Zaurova, Daniel Schatz, Vivian Sun,
and Dave A. Chokshi  

Critical Care And Emergency Department Response At The Epicenter Of The
COVID-19 Pandemic

By Amit Uppal, David M. Silvestri, Matthew Siegler, Shaw Natsui, Leon
Boudourakis, R. James Salway, Manish Parikh, Konstantinos Agoritsas,
Hyung J. Cho, Rajneesh Gulati, Milton Nunez, Anjali Hulbanni, Christine
Flaherty, Laura Iavicoli, Natalia Cineas, Marc Kanter, Stuart Kessler,
Karin V. Rhodes, Michael Bouton, and Eric K. Wei  

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NARRATIVE MATTERS: COVID-19

Protecting Access To Abortion During The COVID-19 Pandemic

By Maryl G. Sackeim  

Maryl Sackeim, an obstetrician/gynecologist, shares the stories of two
patients in need of abortion care during COVID-19.
Read More >>

Listen to the podcast here.

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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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