Preview

THIS WEEK ON THE BLOG

FOLLOWING THE ACA

Fifth Circuit Hears Oral Arguments In Texas v. United States
By Katie Keith (7/9/19)

Yesterday, a three-judge panel of the Fifth Circuit Court of Appeals held a 1.5-hour hearing in Texas v. United States, a lawsuit challenging the constitutionality of the individual mandate and, with it, the entire ACA. Read More >>

Texas v. United States: Where We Are Now And What Could Happen Next
By Katie Keith (7/9/19)

This post summarizes the background of the case, the current posture of the parties, some key issues to watch for during oral argument, and what could happen next. Read More >>

ACA Round-Up: Texas v. U.S., Montana Waiver, Risk Adjustment Report, and More
By Katie Keith (7/8/19)

Recent days have brought a flurry of activity in Texas v. United States, the lawsuit challenging the validity of the ACA. Montana’s reinsurance waiver was deemed complete, and New Jersey and Pennsylvania passed legislation to transition to state-based marketplaces. Finally, CMS released its summary risk adjustment report for 2018 detailing about $10.4 billion in transfers. Read More >>

PRIVATE HEALTH INSURANCE

Using All-Payer Data To Conduct Cross-State Comparisons Of Health Insurance Enrollment
By Sarah H. Gordon (7/12/19)

All-payer claims databases are an important tool for studying how Americans move through the health insurance system. Read More >>

POPULATION HEALTH

Implementing Population Health In The US: Lessons From Spain
By Roberto Nuño-Solinís, Stephen M. Shortell, Richard M. Scheffler, and Meg A. Kellogg (7/9/19)

A prime example is the Basque Region of Spain, which over the past eight years has engaged in a transformational population health improvement initiative with important lessons and insights for the US in each of the areas identified. Read More >>

MEDICARE

CMS’s International Pricing Model For Medicare Part B Drugs: Implementation Issues
By Steven Lieberman and Paul B. Ginsburg (7/9/19)

To lower the Part B portion of drug spending, the Trump Administration has proposed a demonstration project tying Medicare reimbursement for outpatient, physician-administered drugs to international prices. Read More >>

A Market-Oriented Framework For Reforming Medicare Part B Drug Payment
By Joseph Antos and James C. Capretta (7/9/19)

Those reforms would promote competition but also impose tighter price regulation using international reference pricing. This hybrid policy is not as unusual as it first appears.
Read More >>

MEDICAID

For An Option To Address Social Determinants Of Health, Look To Medicaid
By Karen DeSalvo and Michael O. Leavitt (7/8/19)

Partnerships between state Medicaid programs and key stakeholders, such as MCOs, health care providers, and consumers, to pilot and evaluate strategies to address SDOH pose a unique opportunity to develop promising models. Read More >>

PAYMENT

Resolving Surprise Medical Bills
By Kevin A. Schulman, Arnold Milstein, and Barak D. Richman (7/10/19)

If Congress can maintain the proposed cap approach, it will take advantage of a unique opportunity to provide both a solution to surprise bills and a tremendous step forward in reducing the high cost of health care. Read More >>

BEHAVIORAL HEALTH CARE

Serving Those Who Serve: Upstream Intervention And The Uphill Battle Of Veteran
Suicide Prevention In The US
By Matthew Speer, Megan Anne Phillips, Thomas Winkel, Wanda Wright, Nicola Winkel, and Swapna Reddy (7/11/19)

This blog post sheds light on the pervasiveness of suicide among veterans in the United States and the need for initiatives similar to a statewide community-based program in Arizona that has led the way in addressing this crisis. Read More >>

HEALTH EQUITY

Engaging Youth To Advance Community Health, Equity, And Safety
By Marian Mulkey and Adiel Suarez-Murias (7/10/19)

Engaging and supporting youth as allies to advance community health, equity, and public safety is an approach that funders and practitioners often overlook. Yet youth are at the front lines in experiencing poor conditions, and these young people have a long-term stake in community well-being. Engaging young people benefits those involved. Also, available evidence suggests that this approach can improve community outcomes. Read More >>

IN THE JOURNAL

EYE ON HEALTH REFORM

ACA Heads Back To Supreme Court

Katie Keith previews a case the Supreme Court has agreed to hear in the next term, Moda Health Plan, Inc. v. United States. The case concerns whether insurance companies should be fully reimbursed by the Department of Health and Human Services (HHS) for losses during the first years of the Affordable Care Act (ACA) Marketplaces. Keith traces the history of the risk corridors program, which was one of the ACA’s premium stabilization efforts, and the paths the insurance companies’ legal challenges have taken since 2016, following HHS’s reduced risk corridor payments to those companies. Read More >>

PAYMENT

Air Ambulances With Sky-High Charges
By Ge Bai, Arjun Chanmugam, Valerie Y. Suslow, and Gerard F. Anderson

Ge Bai and colleagues analyze Medicare payment data and find that charges for air ambulance services were significantly higher than what Medicare paid for the same services in 2016. Read More >>

NURSES

In Hospitals With More Nurses Who Have Baccalaureate Degrees, Better Outcomes For Patients After Cardiac Arrest
By Jordan M. Harrison, Linda H. Aiken, Douglas M. Sloane, J. Margo Brooks Carthon, Raina M. Merchant, Robert A. Berg, Matthew D. McHugh, and for the American Heart Association’s Get With the Guidelines–Resuscitation Investigators

Jordan Harrison and coauthors add to the evidence base regarding the relationship between nursing education and patient outcomes. Based on data from four representative states, they find that a 10-percentage-point increase in the share of hospital nursing staff with a bachelor’s degree corresponds with a 24 percent increase in a patient’s odds of surviving an in-hospital cardiac arrest with limited cerebral damage. Read More >>

NURSING HOMES

Daily Nursing Home Staffing Levels Highly Variable, Often Below CMS Expectations
By Fangli Geng, David G. Stevenson, and David C. Grabowski

Fangli Geng and coauthors use payroll data to measure nursing home staffing levels. Among their findings: "75 percent of nursing homes were almost never in compliance with what CMS expected their RN staffing level to be." Read More >>

DETERMINANTS OF HEALTH

To Improve Outcomes, Health Systems Invest In Affordable Housing
By David Tuller

In this month’s Leading to Health, David Tuller describes how health care networks in Portland, Oregon, are helping expand access to stable housing and supportive services.
Read More >>

This article appears in Health Affairs’ series on Leading to Health.

Call For Submissions: Narrative Matters Poetry Contest 2019

The Narrative Matters section of Health Affairs is seeking poetry submissions for an upcoming issue of the journal.

We are holding a poetry contest, from July 1 to August 31, looking for well-crafted poems that touch on topics related to health and health policy. Three winning poems will be announced in September. Winning poets will receive a monetary prize—$500 for first place, $300 for second, and $100 for third—as well as publication in Health Affairs, and two copies of the issue containing the winning poem.

All entries will be read and judged by Health Affairs staff.

Limit 3 poems submitted per person. Each poem—in pdf or word doc format—should be submitted as a separate entry through our submission portal here.
Poems must be no longer than a single-spaced page, with double spaces between stanzas
Font size no smaller than 11 point.
Poems must be written in English.
Poems must be previously unpublished.
Poems themselves should contain no personal identifiers.

You can read some earlier poems published by Health Affairs, including the winners of the 2015 Narrative Matters poetry contest, poems by patients and consumers, poems on vulnerable populations, and poems on the cancer experience.

We look forward to reading your submissions!

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.
Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, United States

Privacy Policy

To update your email preferences or to unsubscribe from this email, click here.