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A Weekly Health Policy Round Up From Health Affairs
January 17, 2021
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IN THE JOURNAL
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 >>
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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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.
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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 >>
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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 >>
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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
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
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
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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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.
Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, United States
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