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A Weekly Health Policy Round-Up From Health Affairs
November 15, 2020
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FOLLOWING THE ACA
How ACOs In Rural And Underserved Areas Responded To Medicare’s ACO Investment Model
By Lauren M. Scarpati, J. Michael McWilliams, Heather McPheron, Betty T. Fout, and Matthew J. Trombley (11/10/20)
To help establish accountable care organizations (ACOs) in more areas of the country, the Centers for Medicare and Medicaid Services developed the ACO Investment Model (AIM) to provide participating ACOs with up-front and ongoing monthly payments. Our evaluation thus highlights that, in spite of a lack of geographic proximity, AIM ACOs overall were able to significantly reduce costs. Read More >>
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MARKETS
Will We Ever Get Off This Escalator?
By William Kramer (11/9/20)
The most recent Kaiser
Family Foundation Employer Health Benefits Survey indicates yet another year of relentlessly rising premiums, reminding us that we cannot expect to achieve access to affordable coverage and care if we don’t deal with the cost issue. Read More >>
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GOVERNMENT PROGRAMS AND POLICIES
By Rachel Sachs (11/13/20)
Despite the Trump administration’s failure to implement its most ambitious drug pricing policy goals, the rhetoric on the subject from a Republican president may create space for executive policy making in President-elect Biden’s administration. The president-elect will also have the difficult task of restoring the public’s trust in the government’s agencies with deep scientific and public health expertise, particularly the FDA and the
CDC. Read More >>
HEALTH INFORMATION TECHNOLOGY
The Case For Mathematical Optimization In Health Care: Building A Strong Foundation For Artificial Intelligence
By Alekhya Reddy and David Scheinker (11/13/20)
Enthusiasm for the potential impact of artificial intelligence (AI) on hospital operations is often based on its impact in other industries. However, non–health care companies invest in AI after having digitized and optimized their operations with a variety of older mathematical methods. In contrast, hospitals may invest in AI
while still scheduling patient appointments using fax machines and allocating resources based largely on anecdotal experience. Read More >>
AGE-FRIENDLY HEALTH
Strengthening Family Caregiving Policies And Programs Through State Collaboration
By Courtney Roman, Rani Snyder, and Erica Brown (11/12/20)
Family caregiving provides a substantial savings to the health care system. Such caregiving is normally stressful but is even more so during a pandemic. Helping States Support Families Caring for an Aging America, an initiative that received funding from four foundations in its Phase I, helped six states to advance policy and program changes for family caregivers. Lessons learned included the importance of collecting and exchanging robust data about caregivers' role and value. Read More >>
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Hate-Motivated Behavior: Impacts, Risk Factors, And Interventions
By Robert J. Cramer, Richard C. Fording, Phyllis Gerstenfeld, Andre Kehn, Jason Marsden, Cynthia Deitle, Angela King, Shelley Smart, and Matt R. Nobles
A new health policy brief from Health Affairs with support from the Robert Wood Johnson Foundation explores the causes of and approaches to preventing hate-motivated behavior, a public health threat with structural, interpersonal, and individual repercussions.
This brief joins Health Affairs’ ongoing series of policy briefs on social determinants of health.
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IN THE JOURNAL
ORAL HEALTH
Changes In Coverage And Access To Dental Care Five Years After ACA Medicaid Expansion
By Hawazin W. Elani, Benjamin D. Sommers, and Ichiro Kawachi
Oral health is an area
of significant unmet need, particularly among people with low incomes. Hawazin Elani and coauthors, analyzing how the Affordable Care Act affected dental coverage for adults with incomes below 125 percent of poverty, find that it increased rates of dental coverage by almost 20 percentage points among this population in states that expanded Medicaid and that include dental care as a benefit. Read More >>
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CONSIDERING HEALTH SPENDING
Getting The Price Right: How Some Countries Control Spending In A Fee-For-Service System
By Michael K. Gusmano, Miriam Laugesen, Victor G. Rodwin, and Lawrence D. Brown
Fee-for-service payment is routinely blamed for excess US health spending. Michael Gusmano and coauthors analyze how physician fees are set in France, Germany, and Japan—countries that pay physicians fee-for-service. Although their approaches differ, all three countries set fees through
centralized negotiation within the context of spending constraints. Read More >>
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Health Affairs Editor-in-Chief Alan Weil interviews Michael K. Gusmano, lead author of today's featured journal article.
What can the US learn from three countries—France, Germany, and Japan—that appear to achieve economic sustainability in a fee-for-service system? Is policy importation even possible?
Listen here.
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AGE-FRIENDLY HEALTH
Cognitive Assessment At Medicare’s Annual Wellness Visit In Fee-For-Service And Medicare Advantage Plans
By Mireille Jacobson, Johanna Thunell, and Julie Zissimopoulos
The Medicare annual wellness visit—a preventive care visit free to Medicare beneficiaries enrolled in Part B—requires detection of cognitive impairment. Mireille Jacobson and coauthors surveyed an internet panel of adults ages sixty-five and older who were enrolled in fee-for-service Medicare or Medicare Advantage to measure the use of that benefit and the receipt of structured cognitive assessment by 2019. Read More >>
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ANNOUNCEMENT—AGE-FRIENDLY HEALTH
Health Affairs is beginning a new series, Age-Friendly Health, that will present articles to inform policies on the local, state, and federal levels aimed at improving the care of older adults.
The series runs through June 30, 2022. It will build upon the Aging and Health series, which began in 2015, but will also cover new issues including the impact of the COVID-19 pandemic on older adults and caregivers and take a closer look at health care equity
and disparities.
We are interested in work that spans the full range of care settings, including primary care and specialty practices, hospitals, nursing homes, other long-term care settings, and patients’ homes. We also welcome papers on related dimensions that affect care, access, and affordability, such as financing models, coverage, technology, size and composition of the workforce, and social determinants of health.
We are grateful to The John A. Hartford Foundation for providing support for our ongoing coverage of
these topics.
For more information, see our announcement page.
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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.
Copyright © Project HOPE: The People-to-People Health Foundation, Inc.
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