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A Weekly Health Policy Round Up From Health Affairs
December 6, 2020
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FOLLOWING THE ACA
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
>>
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
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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 >>
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MEDICARE
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 >>
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DISPARITIES
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 >>
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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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!
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.
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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 >>
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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 >>
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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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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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