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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.
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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 with estimating 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.

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 on the 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.
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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.
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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 >>

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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