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HEALTH AFFAIRS EVENTS

AGING AND HEALTH: IMPROVING CARE FOR OLDER ADULTS

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

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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PHARMACEUTICALS & MEDICAL TECHNOLOGY

Understanding The House Democrats’ Drug Pricing Package
By Rachel Sachs (9/19/19)

In this post, I first summarize key provisions from the Democrats’ proposal, explaining how it aims to lower prescription drug prices. Then, I situate this package from the Speaker within the broader set of drug pricing reforms being considered by the federal government. Finally, I present a key objection the package is likely to face from the Republican caucus and consider questions that remain for the substance of the package. Read More >>

PUBLIC HEALTH

How FDA Can Act On E-Cigarettes And Protect The Public Health
By Andrew B. Meshnick, Brian J. Miller, and Boris Lushniak (9/17/19)

Through banning flavors in both retail and online settings, increasing advertising oversight, regulating nicotine concentration, and encouraging further evidence-based research, the Food and Drug Administration can tip the balance of the e-cigarette marketplace to ensure that these products not only live up to their potential, but protect the public health.
Read More >>

ACCESS TO CARE

High Rates Of Perinatal Insurance Churn Persist After The ACA
By Jamie R. Daw, Katy B. Kozhimannil, and Lindsay K. Admon (9/16/19)

Strategies to improve continuity of coverage must be considered as part of clinical and policy solutions for improving maternal health outcomes in the US. Read More >>

Road To Universal Coverage: Addressing The Premium Affordability Gap
By Jen Mishory and Katie Keith (9/18/19)

Current proposals to expand access to coverage—such as state or federal public options, Medicaid or Medicare buy-in proposals, and single-payer plans—reflect a range of strategies to make premiums more affordable. This post discusses the impact that these different approaches would have on premium affordability for low- and middle-income families and individuals. Read More >>

MATERNAL AND CHILD HEALTH

Caught In The Crossfire Of The Trump Administration’s New SNAP Proposal: 500,000 Children
By Swapna Reddy, Gregory Sprout, Maureen McCoy, Sarah Martinelli, and Jessica Lehmann (9/18/19)

The Trump administration’s new proposal would restrict flexibility for states to grant eligibility for the Supplemental Nutrition Assistance Program (SNAP) through criteria that differ from federal standards. This measure would, by extension, have widespread eligibility implications for the National School Lunch Program (NSLP). Read More >>

PAYMENT

Data: Silver Loading Is Boosting Insurance Coverage
By Aviva Aron-Dine (9/17/19)

The enrollment gains from silver loading suggest that premium tax credit (PTC) increases could significantly increase Marketplace enrollment and reduce uninsured rates, particularly among the already PTC-eligible consumers who make up the majority of the Marketplace-eligible uninsured. Read More >>

QUALITY OF CARE

Moving More Electrons To Optimize New Adult Composite Immunization Measures
By Angela K. Shen and Elizabeth Sobczyk (9/20/19)

Composite measures go beyond vaccine-specific measures and provide a systems-wide view of preventive care performance. Having new measures that better reflect improved health outcomes, the processes that lead to them, and systems of care delivery epitomize the next generation of measures. Read More >>

Cultural Competence Is Key To Meeting Patients' Needs: One Perspective From New York City
By Hewett Chiu (9/19/19)

Cultural competence is essential to providing high-quality care and is a bedrock for meeting the needs of an increasingly diverse patient population. Throughout his career, this author has set out to change the health care system at the community level to better meet the needs of patients facing language or cultural barriers to care. Key to helping him on this path was his participation in the United Health Foundation's Diverse Scholars Initiative. Read More >>

PATIENT-CENTERED CARE

Accelerating The Shift Toward Person-Generated Real-World Evidence
By Tanisha Carino and Mark McClellan (9/19/19)

Gaps in evidence from traditional clinical trials, coupled with progress in the availability and use of standardized electronic data, has led to increasing interest in real-world data (RWD)—recently defined by the FDA as "data relating to patient health status and/or the delivery of health care routinely collected from a variety of sources." Read More >>

MEDICAID

What Some Researchers Get Wrong About Medicaid’s Income Eligibility Requirements
By Tricia Brooks (9/19/19)

The bottom line is this—the National Bureau of Economic Research working paper used as the basis for the recent Wall Street Journal commentary is relying on unadjusted self-reported survey data as a proxy for actual Medicaid income eligibility and enrollment. Read More >>

IN THE JOURNAL

EYE ON HEALTH REFORM

Texas Arguments Lead Heavy ACA Action
By Katie Keith

Katie Keith reviews the unusual chronology of Texas v. United States, which in July was discussed at a hearing before a three-judge panel of the Fifth Circuit Court of Appeals. With the US Department of Justice now supporting the decision of the lower court to invalidate the constitutionality of the Affordable Care Act (ACA), Keith details issues of standing (for Democratic attorneys general and the US House of Representatives) that could be key to the Appeals Court’s ruling. Read More >>

PAYMENT

Marketwide Price Transparency Suggests Significant Opportunities For Value-Based Purchasing
By Anna D. Sinaiko, Pragya Kakani, and Meredith B. Rosenthal

Anna Sinaiko and coauthors analyze variation in paid claims across payers and providers in Massachusetts. Overall, “prices paid for outpatient services delivered at acute hospitals were 76 percent higher than prices paid for the same services received in other settings, but there was considerable variation across service categories.” Read More >>

CULTURE OF HEALTH

Experiment To Decrease Neighborhood Poverty Had Limited Effects On Emergency Department Use
By Craig E. Pollack, Shawn Du, Amanda L. Blackford, and Bradley Herring

Isolating the effects of neighborhood characteristics on health is challenging. Leveraging the large Moving to Opportunity for Fair Housing Demonstration Program, developed by the US Department of Housing and Urban Development, Craig Pollack and coauthors focus on the emergency department (ED). They do not find “strong evidence that receipt of a housing voucher or exposure to low-poverty neighborhoods was significantly associated with reductions in long-term ED use among adults or children.” Read More >>

HOSPITALS

Emergency Department Closures And Openings: Spillover Effects On Patient Outcomes In Bystander Hospitals
By Renee Y. Hsia and Yu-Chu Shen

Renee Hsia and Yu-Chu Shen analyze how health outcomes for heart attack patients change when an emergency department opens or closes. They find that an ED closure requiring patients to travel an additional thirty minutes to a hospital already operating at or near capacity is associated with lower rates of timely treatment, higher rates of readmission, and an 8 percent increase in the likelihood of dying within one year. Read More >>

THE PRACTICE OF MEDICINE

US Physicians’ Reactions To ACA Implementation, 2012–17
By Lindsay Riordan, Rahma Warsame, Sarah Jenkins, Kandace Lackore, Joel E. Pacyna, Ryan M. Antiel, Timothy Beebe, Mark Liebow, Bjorg Thorsteinsdottir, Matthew Wynia, Susan Dorr Goold, Matthew DeCamp, Marion Danis, and Jon Tilburt

There have been few analyses of physicians’ views of the ACA, and none examining changes over time. To fill this gap, Lindsay Riordan and coauthors compared responses to their 2012 and 2017 surveys of US physicians’ perceptions and approval of the ACA.
Read More >>

The Practice Of Medicine series is supported by The Physicians Foundation.

GLOBAL HEALTH POLICY

In Low- And Middle-Income Countries, Is Delivery In High-Quality Obstetric Facilities Geographically Feasible?
By Anna D. Gage, Fei Carnes, Jeff Blossom, Jalemba Aluvaala, Archana Amatya, Kishori Mahat, Address Malata, Sanam Roder-DeWan, Nana Twum-Danso, Talhiya Yahya, and Margaret E. Kruk

Anna Gage and coauthors modeled the geographic feasibility of service delivery redesign that shifted deliveries from primary care clinics to hospitals in Haiti, Kenya, Malawi, Namibia, Nepal, and Tanzania. Under the authors’ hospital-only redesign, between 72.9 percent (Tanzania) and 98.3 percent (Haiti) of pregnant women would need to travel two hours or less, an increase in average travel time from seven minutes (Kenya) to forty-six minutes (Tanzania). While the authors acknowledge the challenges of implementing these changes, they note that because primary care facilities are not able to consistently provide lifesaving care, it is time to consider a hospital-only approach. Read More >>

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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