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A Weekly Health Policy Round Up From Health Affairs            

**December 6, 2020**

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FAST TRACK AHEAD OF PRINT

COVID-19

Increased Intensity Of PCR Testing Reduced COVID-19 Transmission Within
Countries During The First Pandemic Wave

By Ravindra Prasan Rannan-Eliya, Nilmini Wijemunige, J. R. N. A.
Gunawardana, Sarasi N. Amarasinghe, Ishwari Sivagnanam, Sachini Fonseka,
Yasodhara Kapuge, and Chathurani P. Sigera

Ravindra Prasan Rannan-Eliya and coauthors used data from multiple
online sources to quantify testing impact on COVID-19 transmissibility
in 173 countries and territories (accounting for 99 percent of the
world's cases) between March and June 2020.
Read More >>

THIS WEEK ON THE BLOG

FOLLOWING THE ACA
HHS Finalizes Rule On Risk Adjustment Data Validation

By Katie Keith (12/2/20)

On November 24 the Department of Health and Human Services (HHS) issued
a final rule to amend the Affordable Care Act's risk adjustment data
validation (RADV) program. The final rule is largely similar to the
proposed rule, issued in late May 2020; it includes two sets of changes.
First, HHS adopts three changes to its methodology for error rate
calculations. Second, HHS will change the way that it applies the RADV
results to risk adjustment transfers. Read More >>

The 2022 Proposed Payment Notice, Part 1: Exchange Provisions

By Katie Keith (11/30/20)

On November 25, the Centers for Medicare and Medicaid Services released
the proposed 2022 Notice of Benefit and Payment Parameters rule; the
"payment notice" annually spells out significant ACA-related changes
for the next plan year. This post addresses changes that generally apply
to the exchanges. Read More >>

The 2022 Proposed Payment Notice, Part 2: Medical Loss Ratios, Special
Enrollment Periods, And More

By Katie Keith (11/30/20)

This post addresses changes regarding medical loss ratio requirements,
the coverage of essential health benefits, special enrollment periods,
and reporting of prescription drug information by pharmacy benefit
managers in the proposed 2022 Notice of Benefit and Payment Parameters
rule. Read More >>

The 2022 Proposed Payment Notice, Part 3: Risk Adjustment

By Katie Keith (11/30/20)

This post considers the proposed changes to the risk adjustment program
in the proposed 2022 Notice of Benefit and Payment Parameters rule. Read
More >>

COVID-19

Long-Acting Reversible Contraception Availability After Childbirth
During The COVID-19 Pandemic

By Maria W. Steenland, Rose L. Molina, and Jessica L. Cohen (11/30/20)

Shifting care patterns away from in-person postpartum visits toward
telehealth during the COVID-19 pandemic may limit access to methods of
postpartum contraception that require in-person care. To maintain
contraceptive choice during the pandemic, hospitals must find solutions
to ongoing implementation challenges of providing immediate postpartum
long-acting reversible contraception. Read More >>

MEDICARE
Eroding Progress On Evidence And Outcomes: CMS's New Proposed Pathway
For Medical Device Coverage

By Peter J. Neumann and James D. Chambers (12/2/20)

Medicare's coverage rules serve as the gateway for the adoption and
use of new medical devices. Thus, CMS' new proposed regulation to
streamline the coverage pathway for medical devices has important
implications, not only for patient access but also for evidentiary
standards, Medicare spending, and the incentives for product
manufacturers as they invest in further advances. Read More >>

COSTS AND SPENDING

International Reference Pricing: A Lazy, Misguided, Bipartisan Plan To
Lower US Drug Prices

By Anirban Basu, Peter J. Neumann, and Sean D. Sullivan (12/2/20)

International reference pricing dodges critical drug value assessment
issues and would lead to more inaction on high drug prices in the US.
Read More >>

DISPARITIES

Building Racial Equity Into The Walls Of Health Policy

By Nathan T. Chomilo (12/1/20)

Policy is being developed quickly in the time of COVID-19. Given
preexisting racial inequities made worse by the pandemic, it is critical
to assess the racial equity impact of research and policy making from
the start.Read More >>

RURAL HEALTH

Partnering With Law Enforcement To Improve Health Outcomes In Rural
Communities

By Elizabeth Ruen, Fred Lamphere, and Wayne Booze

Many are unaware of rural law enforcement's critical role in caring for
people-for example, when residents are experiencing mental health
crises and heart attacks. The Helmsley Charitable Trust, which funds
rural health care in a seven-state Upper Midwest region, recognized this
role and launched two initiatives: Virtual Crisis Care (using
telehealth) and Automatic External Defibrillators for Law Enforcement.
With officers using these technologies, the initiatives' early results
look promising. Read More >>

QUALITY OF CARE

New Clinical Coding Guidelines Account For Patients' Social Risk: We
Should Do More To Ensure They Advance Health Care Quality And Equity

By Laura M. Gottlieb and Sarah C. DeSilvey

The new Medicare and Medicaid coding guidelines for office visits are a
big deal. Ensuring that they benefit the people who need them is a
bigger one. It is clearer now that the federal government and the
American Medical Association recognize the need to account for social
factors in payment models, but we have more work to do to ensure that
the guidelines lead to the delivery of high-quality care for all
patients. Read More >>

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MEDICARE

Remembering Phil Lee: A Life And Legacy To Be Thankful For

By Lauren LeRoy

Phil Lee's tireless commitment to health and social justice spanned
decades and touched lives far beyond those who knew him. His strength in
the face of controversy, positive attitude, relentless energy, and
generosity in making room for new and diverse voices made him a role
model and inspiration for so many working in the field. Read More >>

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IN THE JOURNAL

COVID-19

This month's issue of Health Affairs includes the final versions of four
papers that are part of the journal's Fast Track series of articles on
the COVID-19 pandemic:

Jose F. Figueroa and coauthors study community-level factors associated
with racial and ethnic disparities
;
Adam Dean, Atheendar Venkataramani, and Simeon Kimmel find that
mortality rates from COVID-19 are lower in unionized nursing homes
;
Thomas M. Selden, Terceira A. Berdahl, and Zhengyi Fang report on the
risk of severe COVID-19 within households of school employees and
school-age children
;
and John D. Birkmeyer and coauthors identify the impact of the pandemic
on hospital admissions in the United States
.

NARRATIVE MATTERS: HEALTH EQUITY

This, Too, Is What Racism Feels Like

By Brooke A. Cunningham

After George Floyd's killing, a physician reflects on how the health
effects of racism become embodied for her and other Black Americans.
Read More >>

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New podcast!

'What Are We Going To Do About It?': An Essay on Racism and Health
Inequities

Brooke A. Cunningham, Alan Weil

Listen to Brooke Cunningham, general internist and assistant professor
at the University of Minnesota, read her Narrative Matters essay and
discuss what she hopes listeners and readers take from her writing.

Listen here.

GLOBAL HEALTH POLICY

Universal Health Coverage: Are Older Adults Being Left Behind? Evidence
From Aging Cohorts In Twenty-Three Countries

By James Macinko, Flavia Cristina Drumond Andrade, Fabiola Bof de
Andrade, and Maria Fernanda Lima-Costa

As many countries aim to implement universal health coverage, James
Macinko and coauthors examine whether adults ages fifty and older are
being left out. Using survey data from twenty-three high- and
middle-income countries, the authors find that catastrophic health care
expenditures (out-of-pocket expenses that are 25 percent or more of the
household's income) were more prevalent among rural inhabitants, those
with incomes in the lowest quintile, people with a greater number of
health problems, and current and former smokers. Read More >>

GRANTWATCH

Homelessness And Health: Funders See The Connection

By Lee L. Prina

During the COVID-19 pandemic, it is hard for people experiencing
homelessness to practice social distancing in a congregate setting, says
one nonprofit's CEO. The November 2020 GrantWatch column contains a
sampling of foundations' efforts around the US, pre- and post-pandemic,
to eliminate housing instability. These ideas may be useful to other
organizations if the possible "eviction tsunami," mentioned in a New
York Times op-ed, comes at year's end. In Key Personnel Changes, read
about the new managing director of the Kresge Foundation's Health
Program and news of other foundations' key staffers. Read More >>

PRIVATE HEALTH INSURANCE

Health Benefits In 2020: Premiums In Employer-Sponsored Plans Grow 4
Percent; Employers Consider Responses To Pandemic

By Gary Claxton, Anthony Damico, Matthew Rae, Gregory Young, Daniel
McDermott, and Heidi Whitmore

The annual Kaiser Family Foundation Employer Health Benefits Survey is
the benchmark survey of the cost and coverage of employer-sponsored
health benefits in the United States.
Read More >>

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Introducing our new podcast, This Week!

Health Affairs This Week places listeners at the center of health
policy's proverbial water cooler. Each week, our trusted
editors-sometimes with help from special guests and thought leaders
-discuss this week's most pressing health policy news. All in 15
minutes or less.

In the first episode, Jessica Bylander and Rob Lott chat about COVID-19,
vaccine distribution, and emergency use authorization for vaccines.

Listen here.

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About Health Affairs

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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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