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A Weekly Health Policy Round Up From Health Affairs            

**January 17, 2021**

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IN THE JOURNAL

The Top Twenty Most-Read Health Affairs Articles Of 2020

As 2021 begins, Health Affairs has taken one last look back at 2020 to
tally its twenty most-read articles of 2020, an annual tradition.

It is no surprise that COVID-19-related content-including rapid
research and findings related to face mask mandates, social distancing,
community testing, nursing home resources, and vaccine
implementation-dominated the list.

Atop this year's list is a study published in June by Wei Lyu and
George Wehby, both from the University of Iowa, estimating the effect of
face cover mandates

between April 1 and May 21, 2020. According to the authors, face mask
mandates resulted in preventing as many as 230,000-450,000 US COVID-19
cases by May 22. Since its publication the study has been repeatedly
cited-both in the media and in a range of other sources-in
discussions about the benefits of face coverings.

Several other topics covered by Health Affairs were also popular in
2020: the Affordable Care Act's individual mandate
,
Medicaid work requirements
,
out-of-pocket spending on maternity care
,
national health spending projections for the decade ahead
,
and social determinants of health
.

INCOME INEQUALITY

The Affordable Care Act Reduced Income Inequality In The US

By Matthew Buettgens, Fredric Blavin, and Clare Pan

Matthew Buettgens and colleagues from the Urban Institute show that the
Affordable Care Act's (ACA's) coverage expansion reduced income
inequality in 2019 compared with a simulated baseline scenario without
the ACA. Nonelderly adults with the lowest incomes experienced
significant increases in income when a health-inclusive poverty measure
was used. Read More >>

Income-Related Inequality In Affordability And Access To Primary Care In
Eleven High-Income Countries

By Michelle M. Doty, Roosa S. Tikkanen, Molly FitzGerald, Katharine
Fields, and Reginald D. Williams

A survey of noninstitutionalized adults in eleven countries shows that
US residents with lower incomes rank last or near last on health status,
material hardships, affordability, and some measures of primary care
access. Michelle Doty and coauthors from the Commonwealth Fund found
that more than one-third of US adults with lower incomes reported having
two or more chronic conditions, which is significantly more than their
counterparts from the other countries surveyed. Read More >>

PATIENTS & CONSUMERS

What Is The Value Of A Star When Choosing A Provider For Total Joint
Replacement? A Discrete Choice Experiment

By Adam J. Schwartz, Kathleen J. Yost, Kevin J. Bozic, David A. Etzioni,
T. S. Raghu, and Irfan Emrah Kanat

Adam Schwartz and coauthors examine the perspective of arthroplasty
patients making trade-offs among quality, cost, and distance traveled
when seeking care. Learn what the authors found in their discrete choice
study about the patient-perceived monetary value of a
higher-star-ranking doctor. Read More >>

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And The Value Of An Additional Star For Physicians And Hospitals Is...

Listen to Health Affairs Editor-in-Chief Alan Weil interview Adam
Schwartz, associate professor of orthopedic surgery at the Mayo Clinic
College of Medicine and Science, on the fiscal value of an additional
hospital or physician star rating when choosing a provider for total
joint replacement.

Listen here.

MEDICAID

Avoiding Medicaid: Characteristics Of Primary Care Practices With No
Medicaid Revenue

By Steven B. Spivack, Genevra F. Murray, Hector P. Rodriguez, and
Valerie A. Lewis

In this month's issue Steven B. Spivack from Yale School of Medicine
and coauthors address the ongoing concern about primary care access for
Medicaid patients. In this Practice of Medicine article, the authors
fill a gap in studies on provider participation by examining
characteristics of primary care practices associated with Medicaid
participation. Learn about the findings of their nationally
representative survey. Read More >>

This paper appears in an ongoing

**Health Affairs**article series, The Practice of Medicine
, which is
supported by The Physicians Foundation.

Medicaid Expansion: Effects On Hospital Finances And Implications For
Hospitals Facing COVID-19 Challenges

By Fredric Blavin and Christal Ramos

Also in this month's issue is a new analysis of Medicaid expansion.
Fredric Blavin and Christal Ramos find that the early positive effects
of the Affordable Care Act's Medicaid expansion on hospital finances
were sustained in 2016 and 2017. Read more about the benefits that
different types of hospitals received and how COVID-19 impacted their
finances. Read More >>

CHILDREN'S HEALTH

Understanding Variation In Nonurgent Pediatric Emergency Department Use
In Communities With Concentrated Disadvantage

By Kristin N. Ray, Kristin A. Yahner, Jamil Bey, Katherine C. Martin,
Arrianna M. Planey, Alison J. Culyba, and Elizabeth Miller

Kristin N. Ray of UPMC Children's Hospital and coauthors analyze
research to provide insight on the variation in nonurgent pediatric
emergency department use in communities with concentrated disadvantage.
Read their recommendations to stakeholders for increasing health equity.
Read More >>

ORGANIZATION OF CARE

Geographic Variation In The Consolidation Of Physicians Into Health
Systems, 2016-18

By Laura Kimmey, Michael F. Furukawa, David J. Jones, Rachel M. Machta,
Jing Guo, and Eugene C. Rich

Laura Kimmey and coauthors explore the reasons behind doctor market
concentration in recent years. Read More >>

REQUEST FOR ABSTRACTS-Perinatal Mental Health

Deadline: February 1, 2021
Preparation and formatting guidelines

Submit abstracts via our online submission form

**Health Affairs** is planning a cluster of papers on perinatal mental
health, to be published in October 2021. We plan to publish
approximately 10 peer-reviewed articles from leading researchers,
scholars, policy analysts, and health care stakeholders.

**Health Affairs** thanks the Zoma Foundation, the Perigee Fund, and the
California Health Care Foundation for their generous support of this
issue. Read More >>

THIS WEEK ON THE BLOG

COVID-19

The US Must Prioritize Vaccine Distribution To Undocumented Immigrants
And Immigrants In Detention Centers

By Divya Manoharan, Cesar A. Lopez, Kate Sugarman, Ranit Mishori, and
Zackary Berger (1/11/21)

Undocumented immigrants and immigrants in detention centers-groups who
are already particularly vulnerable to COVID-19 and other health
risks-must be included and prioritized in COVID-19 vaccination
distribution efforts. Read More >>

HEALTH INFORMATION TECHNOLOGY

Improving Interoperability By Moving From Perfection To Pragmatism

By Julia Adler-Milstein, Aaron B. Neinstein, and Russell J. Cucina
(1/13/21)

When data are viewable but not combined, clinicians are less likely to
use data from outside sources. We posit that it is time to revisit the
decision of prioritizing perfection over pragmatism so as to shift to an
approach that achieves clinically functional interoperability by
combining data. This new pragmatic approach must recognize the
limitations of standards and increasingly engage clinicians in driving
decisions about how to deliver functional solutions. Read More >>

MEDICAID

Expanding Postpartum Medicaid Benefits To Combat Maternal Mortality And
Morbidity

By Gray Babbs, Lois McCloskey, and Sarah H. Gordon (1/14/21)

Even if Medicaid coverage is extended to cover the full postpartum year,
new mothers may not receive the care they need if Medicaid does not
cover all evidence-based benefits. Postpartum benefits should be
standardized to include postpartum mental health screening and care,
home visiting, lactation consultation, and family planning services.
Read More >>

In Its First 100 Days, The Biden Administration Must Restore The Soul Of
Medicaid

By Nicole Huberfeld and Paul Shafer (1/11/21)

To effectively confront the health and economic crises facing the nation
now and into the future, maintaining a robust Medicaid program is
essential. No other public program has the reach and power to affect
population health that Medicaid does, particularly for historically poor
and oppressed communities. Time is of the essence to rebuild and
preserve Medicaid as a source of hope and help, not one of frustration
and fear. Read More >>

PUBLIC HEALTH

Public Health Emergency Reform Is Coming-These Six Principles Should
Guide It

By Lindsay F. Wiley (11/12/21)

State legislatures considering reform of public health emergency
response authority must put health-protective measures on a firmer
footing for the coming months of this crisis-and the next one. Read
More >>

LEGAL & REGULATORY ISSUES

HHS Finalizes New Rules On Regulatory Processes

By Katie Keith (1/14/21)

With Inauguration Day fast approaching, the Trump administration
continues to try to leave a lasting mark on the federal government. The
focus of this post is on two recent final rules issued by the Department
of Health and Human Services that affect the "rules about the rules"
and regulatory processes at the department: the "good guidance" rule
and the "sunset" rule. Read More >>

PHARMACEUTICALS & MEDICAL TECHNOLOGY

What Will Replace The Unapproved Drugs Initiative?

By Allan Coukell (11/15/21)

In late 2020, the National Drug Code database still listed more than
1,500 unapproved prescription drugs, although it is unclear which of
these have approved alternatives, how many are still marketed, and which
products sell in meaningful volumes. Read More >>

HEALTH EQUITY

Incorporating Health Equity Into An Initiative To Transform Care For
Older Adults

By Faith Mitchell (11/14/21)

Funded by The John A. Hartford Foundation, the Age-Friendly Health
Systems initiative at the Institute for Healthcare Improvement will also
look at equity. After documenting the racial and ethnic breakdown of
their patients, participating health care providers will analyze health
outcomes, stratified by race and ethnicity, and take follow-up actions,
as needed, to address disparities. The American Hospital Association and
Catholic Health Association of the United States are partnering on the
age-friendly initiative. Read More >>

FOLLOWING THE ACA

The 2022 Final Payment Notice (Sorta)

By Katie Keith (11/15/21)

On January 14, 2021, the Centers for Medicare and Medicaid Services
released its final 2022 Notice of Benefit and Payment Parameters rule.
The final 2022 "payment notice" adopts only the most controversial
changes included in the proposed rule, but it will likely be subject to
a regulatory freeze and eventual modification by the Biden
administration. Read More >>

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What Could Medicaid And COVID-19 Vaccine Distribution Look Like Under A
Biden Administration?

Listen to editors Chris Fleming and Jessica Bylander discuss the
COVID-19 vaccine rollout and what the Biden administration may do with
Medicaid block grants and work requirements.

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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