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A Weekly Health Policy Round Up From Health Affairs            

**September 15, 2019**

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HEALTH AFFAIRS EVENTS

AGING AND HEALTH:  IMPROVING CARE FOR OLDER ADULTS

September 24, 2019
10:00 am - 12:00 pm Eastern
National Press Club - 529 14th Street NW, Washington, DC
Registration Open

On September 24, 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, confirmed speakers include:
* Timothy G. Ferris, CEO, Massachusetts General Physicians Organization

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

* 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, Associate Professor of Geriatrics and
Palliative Medicine, and Research Director, Institute for Care
Innovations at Home, Icahn School of Medicine at Mount Sinai, 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

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delivered directly to your inbox.

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THIS WEEK ON THE BLOG

FOLLOWING THE ACA

Uninsured Rate Rose In 2018, Says Census Bureau Report

By Katie Keith (9/11/19)

Yesterday, the US Census Bureau reported the first increase in the
uninsured rate since the 2010 enactment of the Affordable Care Act. From
2017 to 2018, the uninsured rate rose by 0.5 percentage points, meaning
about 1.9 million more people were uninsured in 2018 relative to 2017.
Read More >>

ACA Round-Up: Health Insurance Tax, Mental Health Parity, and SEPs

By Katie Keith (9/10/19)

Federal regulators have recently released an estimate of the health
insurance tax plan for year 2020, frequently asked questions on mental
health parity, and special enrollment periods for those affected by
Hurricane Dorian.
Read More >>

CONSIDERING HEALTH SPENDING

The HHS Proposed Rebate Rule And The Problem Of Scoring Proposed
Regulations

By Dan Crippen (9/13/19)

Congress should not be constrained in its oversight responsibilities by
the estimate of the fiscal impact of a regulation that has not, and may
never, become final. Read More >>

PAYMENT

There's No Pain-Free Way To Get Beyond Silver Loading

By Stan Dorn (9/10/19)

Until further research demonstrates the effects of such alternative
policies and identifies win-win solutions with outcomes that far surpass
the results described here, policy makers should think long and hard
before discarding the silver-loaded fruits of actuarial wisdom.
Read More >>

POPULATION HEALTH

How States Can Use County Health Rankings To Make Population
Health-Not Process-Their Bottom Line

By Harris Allen (9/10/19)

Georgia would be the first state to use county health rankings data to
structure explicit county competitions. Read More >>

                                               
                           

ACCOUNTABLE CARE

ACO Participation Numbers Worth Watching As CMS Changes Take Root

By David Pittman, Allison Brennan, and Clifton Gaus (9/11/19)

Payment and delivery reform will remain a key policy lever to control
health spending, and total-cost-of-care models have the greatest
opportunity for savings and quality improvement. Read More >>

QUALITY OF CARE

Pathway To Patient-Centered Measurement For Accountability

By Aparna Higgins, Dana Gelb Safran, Nick Fiore, Elizabeth Murphy, and
Mark B. McClellan (9/12/19)

We look forward to working with relevant stakeholders to develop a road
map of patient-centered outcomes measures that extends beyond the
federal alignment called for in the executive order to alignment between
public and private participants. Read More >>

ADDICTION

Saving A Life From Opioid Addiction Requires Bold Action From Loved Ones

By Janet Edwards (9/9/19)

Taking the time to educate and empower yourself and others in the fight
against opioid addiction is a critical first-line defense to ending the
impact of opioid abuse for all.
Read More >>

PHARMACEUTICALS & MEDICAL TECHNOLOGY

Considerations For Expanding International Reference Pricing Beyond
Medicare Part B

By Loren Adler, Steven M. Lieberman, Christen Linke Young, and Paul B.
Ginsburg (9/9/19)

Given the complications inherent in an international reference pricing
approach, it might prove preferable to have the US government directly
handle drug price regulation, potentially based on an assessment of the
value of different treatments, rather than piggybacking on other
countries and undermining their efforts to control drug costs.
Read More >>

IN THE JOURNAL

AHEAD OF PRINT

Trends In Public Opinion On US Gun Laws: Majorities Of Gun Owners And
Non-Gun Owners Support A Range Of Measures

By Colleen Barry, Elizabeth Stone, Cassandra Crifasi, Jon Vernick,
Daniel Webster, and Emma McGinty

This new study, being released ahead of print, used data from the
National Survey of Gun Policy from the years 2013, 2015, 2017, and 2019.
The surveys were administered by the Johns Hopkins Center for Gun Policy
and Research, which sampled adult gun owners and non-gun owners alike.
The findings show that large majorities of both owners and nonowners
strongly support a range of measures to strengthen US gun laws. Read
More >>

This study will also appear in the October issue of Health Affairs, a
theme issue with studies focusing on violence and health.

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ACCESS & USE

ACA's Contraceptive Coverage Requirement: Measuring Use And
Out-Of-Pocket Spending

By Carol S. Weisman, Cynthia H. Chuang, Ashley H. Snyder, Guodong Liu,
and Douglas L. Leslie

The ACA requires most private health insurance to cover contraception
without cost sharing. Long-acting reversible contraceptives (LARCs) are
among the most effective-and have the highest upfront costs for people
without health insurance. Carol Weisman and coauthors examined trends in
LARC insertions and out-of-pocket spending for LARCs before and after
the ACA requirement was implemented, using data from the Truven Health
MarketScan claims database for the period 2006-16. Read More >>

CONSIDERING HEALTH SPENDING

The Relationship Between Health Spending And Social Spending In
High-Income Countries: How Does The US Compare?

By Irene Papanicolas, Liana Woskie, Duncan Orlander, E. John Orav, and
Ashish Jha

Irene Papanicolas and coauthors evaluated data from the Organization for
Economic Cooperation and Development (OECD) on 35 OECD member states
spanning the period 1980-2015, to answer three questions: How does the
US compare to other OECD countries in terms of social spending? Do
countries that spend less on social services spend more on health care?
Is there any evidence that increases in social spending over time are
associated with decreases in health care spending? Read More >>

DETERMINANTS OF HEALTH

Financial Incentives Increase Purchases Of Fruit And Vegetables Among
Lower-Income Households With Children

By Alyssa Moran, Anne Thorndike, Rebecca Franckle, Rebecca Boulos,
Heather Doran, Aarohee Fulay, Julie Greene, Dan Blue, Jason P. Block,
Eric B. Rimm, and Michele Polacsek

Alyssa Moran and coauthors conducted a randomized controlled trial,
enrolling some 600 low-income families with children, one-third of whom
participated in the Supplemental Nutrition Assistance Program (SNAP), at
a supermarket in rural Maine. About half of the participants received a
50 percent discount at checkout on fruit and vegetables. The authors
found that the participants who received the discount showed a 27
percent increase in spending on fruit and vegetables each week, with no
increase in purchases of other, less healthful foods. Read More >>

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NARRATIVE MATTERS: HEALTH PROFESSIONS EDUCATION

Students Shouldn't Merely 'Survive' Medical School

By Eli M. Cahan

A medical student reflects on what can be done to address mental illness
among medical trainees.Read More >>

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Listen to the podcast.

BOOK REVIEWS

Beating The Flu

By Jeanne Ringel

Jeanne Ringel reviews Influenza, by Jeremy Brown, director of the Office
of Emergency Care Research at the National Institutes of Health. Read
More >>

Revisiting Health Justice

By William M. Sage

William Sage reviews Essentials Of Health Justice: A Primer, by
Elizabeth Tobin-Tyler and Joel B. Teitelbaum, finding it, "as much a
reintroduction as an introduction to its subject, refreshing readers'
recognition that America's health reflects not only its health care
system but also its sociolegal heritage." Read More >>

Welcoming Medicine To The Machine

By Dhruv Khullar

Dhruv Khullar reviews Deep Medicine: How Artificial Intelligence Can
Make Healthcare Human Again, by Eric Topol, "an exhaustive tour-de-force
review of the past, present, and future of AI in medicine." Read More >>

A Crisis Behind The Acronyms

By Emily F. Peters

Emily Peters reviews Well: What We Need To Talk About When We Talk About
Health, by Sandro Galea, a physician, epidemiologist, and dean of the
Boston University School of Public Health. 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 .  

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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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