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IN THE JOURNAL

NEW ISSUE:
VITAL DIRECTIONS, QUALITY & MORE

The February issue of Health Affairs contains studies about racial disparities in mortality during COVID-19, physicians’ unequal treatment of people with disabilities, the Affordable Care Act’s impact on cancer detection, and policy aspects of Medicare and Medicaid. It also includes a cluster of articles produced in partnership with the National Academy of Medicine’s Vital Directions for Health and Health Care 2021 project.

Read the February 2021 table of contents.

Read "From the Editor-in-Chief."

THIS WEEK ON THE BLOG

COVID-19

Workers With COVID-19 Vaccine Side Effects Deserve Time Off To Recover
By Dorit Rubinstein Reiss and Arthur L. Caplan (2/5/21)

COVID-19 vaccines have high rates of temporary and unpleasant, sometimes debilitating—but not dangerous—side effects. That means the recipient’s immune system is vigorously responding to the vaccine, but vaccine recipients may need to take a couple of days to rest. Read More >>

An Alternative Vaccine Strategy To Reduce COVID-19 Morbidity And Mortality
By Michael H. Criqui and Robert M. Kaplan (2/4/21)

Although we understand the argument for sticking with the original COVID-19 vaccine schedule, we worry that analysts have concentrated on the risks of deviating from the prescribed schedule while ignoring the risks of adhering to it. Read More >>

Equity Metrics: Toward A More Effective And Inclusive Pandemic Response
By Priya B. Shete, Jason Vargo, Alice Hm Chen, and Kirsten Bibbins-Domingo (2/3/21)

As COVID-19 vaccine distribution scales up, health equity metrics—rooted in place-based social vulnerability indices—should be used to guide local vaccine allocation and monitoring. Read More >>

Expanded Coverage For COVID-19 Testing Must Include Limits On Costs
By Loren Adler and Sabrina Corlette

Mandating that insurers cover more COVID-19 tests without cost sharing is a welcome policy change, but a few gaps remain that likely require congressional legislation to address. Read More >>

To Improve COVID-19 Vaccine Distribution, Engage Behavioral Health Providers
By Jonathan D. Brown (2/2/21)

As states refine their plans to distribute COVID-19 vaccines, they should engage behavioral health providers to develop strategies to reach the populations they serve. Read More >>

FOLLOWING THE ACA

ACA Litigation Round-Up: A Status Check
By Katie Keith (2/1/21)

Even as attention shifts to the executive and legislative branches, the judiciary will continue to play a significant role in ACA implementation. As we begin a new year, this post provides a status update on the many ACA lawsuits to keep an eye on. Read More >>

SUBSTANCE USE

New Interventions To Address Substance Use Disorder Must Take Financial Sustainability Into Account
By Dominic Hodgkin, Constance M. Horgan, Maureen Stewart, and Stephanie Jordan Brown (2/5/21)

If new interventions are not financially sustainable, they might not be maintained in the organizations testing them and might not be taken up by the wider health care system—which means that they won’t have any lasting impact on the opioid epidemic or substance use more generally. Read More >>

HEALTH EQUITY

Philanthropy's Increased Focus On Health Equity Post–COVID-19
By Cara James (2/4/21)

Most of the foundation executives and program staff surveyed by Grantmakers In Health said that since March 2020 (when COVID-19 started to flare up in the US), their health equity programming has changed or will change. Respondents also talked about their foundations' initiatives on diversity, equity, and inclusion, right in their own organizations. The most common challenge reported was getting their boards of trustees' support for these external and internal equity efforts. Read More >>

MEDICAID

Strategic Priorities For The Centers For Medicare And Medicaid Services To Advance Medicaid Reform
By Amol S. Navathe, Mark B. McClellan, Christopher Chen, Judy Zerzan, Julian Harris, Bob Kocher (2/1/21)

There is tremendous opportunity to improve the health and well-being of Medicaid beneficiaries while improving health care outcomes, equity, and the stability of state budgets. There are several reasons, described here, why CMS should be assertive in supporting greater Medicaid reform. Read More >>

PHARMACEUTICALS & MEDICAL TECHNOLOGY

Helping Consumers Afford Prescription Drugs: An Antitrust Agenda For The New Congress
By Michael A. Carrier (2/1/21)

Enactment of bipartisan antitrust legislation targeting pay-for-delay settlements, product hopping, patent thickets, and citizen petitions would be an important and practical next step to lower prescription drug costs for all Americans. Read More >>

MEDICARE

Rating The Medicare Advantage Star Ratings—Improving The Status Quo
By Soleil Shah and Eric Sun (2/4/21)

As Medicare Advantage enrollment rises, the star ratings system will be an increasingly important tool for helping Medicare patients access high-quality health coverage.
Read More >>

FAST TRACK AHEAD OF PRINT

COVID-19 VACCINE DEVELOPMENT MODELS

How New Models Of Vaccine Development For COVID-19 Have Helped Address An Epic Public Health Crisis
By David E. Bloom, Daniel Cadarette, Maddalena Ferranna, Randall N. Hyer, and Daniel L. Tortorice

David Bloom and coauthors analyze how deployment of substantial financial and human resources, expanded and novel forms of cooperation, and a range of innovations have contributed to the development of COVID-19 vaccines in record time. Read More >>

Reflections On Governance, Communication, And Equity: Challenges And Opportunities In COVID-19 Vaccination
By Daniel Salmon, Douglas J. Opel, Matthew Z. Dudley, Janesse Brewer, and Robert Breiman

Daniel Salmon and coauthors characterize public perceptions during the roll out of the COVID-19 vaccine and the impact on vaccine informed decision making, the potential for vaccine equity to help address underlying health disparities, vulnerabilities of the vaccine program, and the role of health care providers and science to affect vaccine decision making and communications. Read More >>

The COVID-19 Innovation System
By Bhaven N. Sampat and Kenneth C. Shadlen

Bhaven Sampat and coauthors take stock of the key features of the COVID-19 innovation system, and ask whether this model is useful only for crisis times or whether biomedical innovation policy in “normal” times might productively incorporate some elements of the COVID-19 model. Read More >>

OPIOID USE DISORDER

Admission Practices And Cost Of Care For Opioid Use Disorder At Residential Addiction Treatment Programs In The US
By Tamara Beetham, Brendan Saloner, Marema Gaye, Sarah E. Wakeman, Richard G. Frank, and Michael Lawrence Barnett

Tamara Beetham and coauthors audited 368 residential addiction treatment programs in the US. They find that 65 percent of for-profit programs use one or more aggressive recruitment techniques compared with only 9 percent of nonprofit programs. Read More >>

QUALITY

Higher Medicare Advantage Star Ratings Are Associated With Improvements In Patient Outcomes
By David J. Meyers, Amal N. Trivedi, Ira B. Wilson, Vincent Mor, and Momotazur Rahman

David Meyers and coauthors use data from a natural experiment to quantify the degree to which Medicare Advantage plans with higher star ratings provide better care.
Read More >>

Variation In Emergency Department Admission Rates Among Medicare Patients: Does The Physician Matter?
By Peter B. Smulowitz, A. James O’Malley, Lawrence Zaborski, J. Michael McWilliams, and Bruce E. Landon

Peter Smulowitz and coauthors describe physician-level variation in emergency department admission rates for Medicare fee-for-service patients. Read More >>

CONSIDERING HEALTH SPENDING

Annual Out-Of-Pocket Spending Clusters Within Short Time Intervals: Implications For Health Care Affordability
By Steven Chen, Paul R. Shafer, Stacie B. Dusetzina, and Michal Horný

Steven Chen of Emory University and coauthors analyze the distribution of out-of-pocket spending throughout the year to draw insights about the implications for health care affordability. Read More >>

Beyond The High Prices Of Prescription Drugs: A Framework To Assess Costs, Resource Allocation, And Public Funding
By Jonathan J. Darrow and Donald W. Light

Jonathan J. Darrow of Harvard Medical School and Donald W. Light of the Rowan University School of Osteopathic Medicine provide a comprehensive framework for legislators and scholars to use in assessing the total societal costs of drugs. Read More >>

These articles appear in the series Considering Health Spending.

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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