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A Weekly Health Policy Round Up From Health Affairs            

**December 20, 2020**

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AHEAD OF PRINT

National Health Care Spending In 2019: Steady Growth For The Fourth
Consecutive Year

By Anne B. Martin, Micah Hartman, David Lassman, Aaron Catlin, and The
National Health
Expenditure Accounts Team

A new analysis from the Office of the Actuary at the Centers for
Medicare and Medicaid Services (CMS) estimates that in 2019 health care
spending in the United States increased 4.6 percent to $3.8 trillion, or
$11,582 per person. The 4.6 percent growth rate in 2019 was similar to
the rate in 2018 (4.7 percent) and was consistent with the average
annual spending growth rate of 4.5 percent that has been observed since
2016. Faster growth in personal health care spending was offset by a
decline in the net cost of health insurance.
Read More >>

IN THE JOURNAL

CLIMATE & HEALTH

Several articles in our December issue examine the health-related costs
of climate change. An analysis from Vijay S. Limaye and colleagues
identifies ways to address the challenges that come withestimating the
price tag of climate-sensitive health outcomes
;
Noah Scovronick and coauthors break down economic methods routinely used
to recommend climate policies
;
and economist Howard G. Birnbaum and coauthors describe how to gain a
more complete picture of the chain of health care costs associated with
air pollution
.

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The National School Lunch Program benefits more than 30 million US
youth, but little is known about the environmental footprint of lunches
served through the program. Mary Kathryn Poole and coauthors analyzed
the composition of more than 5,000 school lunches to see how they
compared with benchmarks
developed
by the EAT-Lancet Commission's healthy reference diet. Making small
changes to school lunches could lead to meaningful improvements in food
production and positive impacts on environmental health. Hear more from
Poole on this week's episode of A Health Podyssey
.

Extreme weather events are becoming more severe due to climate change.
This month's issue includes three articles about how climate
influences the hazard profile of hurricanes, and the stressors that
survivors experience in the aftermath of these storms. James M. Shultz
and coauthors focus onthe mental health effects of hurricanes
;
Ethan J. Raker and coauthors share insights from the Resilience in
Survivors of Katrina (RISK) Project
;
and Saria Hassan and coauthors review the challenges of chronic disease
management in the Caribbean after natural disasters
.

How do we cultivate new knowledge and skill sets among both health
professionals and K-12 and undergraduate students to prepare them to
confront the health effects of climate change? In this month's Leading
to Health article, reporter Michele Cohen Marill reflects on how medical
students are working with patients amid growing climate health risks

and why medical schools are reshaping the core curriculum in light of
the climate crisis. In addition, Jay Lemery and colleagues put forward a
road map for individual providers, health educators, and health care
systems
,
while Vijay S. Limaye and coauthors introduce the concept of climate and
health literacy
.

THIS WEEK ON THE BLOG

COVID-19

Emergency Use Authorization For COVID-19 Monoclonal Antibodies:
Challenges And Lessons Learned

By Colette DeJong, Bernard Lo, and Alice Hm Chen (12/17/20)

SARS-CoV-2 monoclonal antibodies (mAbs) are among the latest
investigational COVID-19 therapies to receive emergency use
authorization from the FDA. It is essential that we learn from early
experiences and mistakes with mAbs and avoid similar mistakes with
future COVID-19 therapies. Read More >>

To Correct Population Health Disparities, Reinvigorate Public Health
Systems: The Continuing Lessons Of COVID-19

By Ronald O. Valdiserri (12/17/20)

Reflecting on how our country has responded to the COVID-19 pandemic
offers insights into why a health care system that has been designed and
financed to address individual, often acute, medical needs cannot, by
itself, ensure improvements in health at a population level.
Read More >>

COVID-19 Shocks The US Health Sector: A Review Of Early Economic Impacts

By George Miller, Corwin Rhyan, Ani Turner, and Katherine Hempstead
(12/16/20)

Early analysis of 2020 Bureau of Economic Analysis data suggests ways
that next year's report from the CMS actuaries will look different
from this year's-or any year's before that-with hospital
spending down while prices are up, home health care substituting for
nursing home care, and some professional services in dire straits. Read
More >>

FOLLOWING THE ACA

Final Rule on Grandfathered Health Plans Will Allow Higher Consumer
Costs

By Katie Keith (12/15/20)

On December 11, the Departments of Labor, Health and Human Services, and
Treasury issued a new final rule adjusting the requirements that group
plans and insurers must follow to maintain their "grandfathered"
status under the ACA. Although the changes are relatively minor, the new
rule will enable plans to impose higher cost-sharing requirements
without losing grandfathered status. Read More >>

DISPARITIES

New Organ Donation Rule Is A Win For Black Patients And Health Equity

By Ben Jealous, Jayme Locke, and Greg Segal (12/17/20)

Recent reforms to the organ donation system could help address racial
inequities in access to organ transplants and should be implemented with
due urgency. Read More >>

PHARMACEUTICALS & MEDICAL TECHNOLOGY

Purdue's Demise Could Be A New Beginning For The Pharmaceutical
Industry

By Taleed El-Sabawi and Leo Beletsky (12/18/20)

As part of its recent settlement, Purdue Pharmaceuticals should be
required to restructure as a nonprofit public benefit pharmaceutical
company focused on population health and addressing some of the roots of
the opioid crisis. Read More >>

PAYMENT

Medicare Payment Reform's Next Decade: A Strategic Plan For The Center
For Medicare And Medicaid Innovation

By Amol S. Navathe, Bob Kocher, Ezekiel J. Emanuel, Sherry Glied, and
Farzad Mostashari (12/18/20)

The COVID-19 Public Health Emergency has once again laid bare stark
disparities for low-income and minority communities. But it has also
highlighted the dramatic scope and scale of shifts-such as more
telemedicine and home care-that the national health delivery system
can achieve. We believe that as the Center For Medicare And Medicaid
Innovation embarks upon its second decade, it must consolidate and
institutionalize these shifts and strategically test and scale new
payment models. Read More >>

Unpacking The No Surprises Act: An Opportunity To Protect Millions

By Jack Hoadley, Katie Keith, and Kevin Lucia (12/18/20)

As we wait to see if Congress will pass a COVID-19 relief package and/or
a government spending bill, one key question is whether one of those
vehicles will include new compromise legislation-the No Surprises
Act-to comprehensively protect consumers from surprise medical bills.
Read More >>

LEGAL & REGULATORY ISSUES

Restoring The Preemption Status Quo: Rutledge, ERISA, And State Health
Policy Efforts

By Carmel Shachar and I. Glenn Cohen (12/17/20)

The Rutledge decision represents a return to the pre-Gobeille ERISA
preemption status quo, but not a new path forward in balancing ERISA and
state health care reforms. There is still a significant need for
Congress to reconsider the broad preemption mandate it created in ERISA,
especially in the context of health care policy.Read More >>

The Implications Of Rutledge v. PCMA For State Health Care Cost
Regulation

By Erin C. Fuse Brown and Elizabeth Y. McCuskey (12/17/20)

The Supreme Court's Rutledge decision opens up further avenues beyond
pharmacy benefit managers to broader state health reforms aimed at
reigning in the costs of health services and prescription drugs,
protecting consumers, and expanding affordable access to more people.
Read More >>

TELEHEALTH

Our Health Care System Wasn't Designed To Support Telehealth. Now
It's Time For A Makeover

By Sean Cavanaugh (12/16/20)

Today, a lot of people in health care are asking: What is the future for
telehealth? By examining its initial design, we can find clues as to the
best path forward for virtual care. Read More >>

GLOBAL HEALTH

In Global Efforts To End HIV And Advance Reproductive Health,
President-Elect Joe Biden Should Seize The Opportunity For Bold
Leadership

By Monica Kerrigan (12/16/20)

The Trump era and the COVID-19 pandemic have threatened to reverse
decades of progress in global efforts to end HIV and advance
reproductive health, but they leave us with an opportunity for positive
disruption. To achieve success, the Biden administration must not play
it safe-they must go above and beyond what has been done before, and
they must start now. Read More >>

MEDICARE

The Coming Crisis For The Medicare Trust Fund

By David Muhlestein (12/15/20)

The Medicare Trust Fund's potential exhaustion in 2024 represents a
significant threat to the program. As it has done over the past 40 years
in the face of such threats, Congress must now rise to the task of
improving and preserving the Medicare program for future generations.
Read More >>

ACCESS TO CARE

Too Big To Ignore: 7 Recommendations To Address Our Growing Mental
Health Crisis

By David Wennberg and Patrick J. Kennedy (12/14/20)

The COVID-19 pandemic has exacerbated the ongoing mental health crisis
in the US. Policy makers can wait no longer. David Wennberg and Patrick
J. Kennedy propose seven steps to take toward a mental health care
overhaul now. Read More >>

HEALTH AFFAIRS BRANDED POST

Support the One Year Delay of the Medicare Advantage VBID Hospice
Component

By S. Edo Banach
Supported by National Hospice and Palliative Care Organization

The CMS Innovation Center's Medicare Advantage Value-Based Insurance
Design (MA VBID) Model could serve as a good opportunity to test
enhancements in care coordination between health care systems while
expanding access to hospice and palliative care. Read More >>

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Snow Can't Stop The COVID-19 Vaccine Supply Chain

Listen to Jessica Bylander and Vabren Watts enter the snow discourse and
discuss the latest on COVID-19 vaccines.

Listen here.

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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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