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A Weekly Health Policy Round-Up From Health Affairs
September 6, 2020
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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 >>
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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
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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
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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.
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