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A Weekly Health Policy Round Up From Health Affairs            

**September 29, 2019**

THIS WEEK ON THE BLOG

FOLLOWING THE ACA

ACA Update: Risk Adjustment Litigation, DSH Cut Methodology

By Katie Keith (9/27/19)

Litigation continues over the ACA's risk adjustment program, including
oral arguments held in the Tenth Circuit Court of Appeals on September
25, 2019. On September 24, CMS issued a new final rule outlining
methodology to make reductions to state Medicaid Disproportionate Share
Hospital (DSH) allotments. Read More >>

ACA Round-Up: MLR Rebates, Insurer Competition, New Guidance On EDE

By Katie Keith (9/23/19)

Recent weeks have brought new analyses of the individual health
insurance market.
Read More >>

PHARMACEUTICALS & MEDICAL TECHNOLOGY

A Civic Duty To Improve Access To Generic Pharmaceuticals

By Shelley Lyford (9/26/19)

Seven health care systems and three philanthropic organizations launched
a nonprofit generic drug company in 2018 with a mission to ensure that
essential generic drugs are both accessible and affordable. The focus is
on improving hospitals' access to generics. The president and CEO of the
Gary and Mary West Foundation and West Health explains why and how
Civica Rx was established and provides some updates. Read More >>

Next Steps For Netflix: Can 'All You Can Treat' Contracts Work
Beyond Hepatitis C?

By Mark Trusheim and Peter B. Bach (9/25/19)

In 2016, working with Senator William Cassidy (R-LA), we developed the
"Netflix model" for financing hepatitis C virus treatment for a defined
population. The name reflects the model's central feature: a flat fee
in exchange for unlimited supply, analogous to the monthly subscription
fee paid by binge watchers to the video streaming service. Read More >>

Methadone Barriers Persist, Despite Decades Of Evidence

By Alaina McBournie, Alexandra Duncan, Elizabeth Connolly, and Josh
Rising (9/23/19)

Given the importance of increasing access to opioid use disorder (OUD)
treatment, states and the federal government should take the steps
outlined here to improve access to methadone and integrate OUD care with
the rest of the delivery system. This will ensure that patients with OUD
have access to convenient and tailored treatment regardless of where
they live.
Read More >>

ACCESS TO CARE

After Title X Regulation Changes: Difficult Questions For Policy Makers
And Providers

By Nakisa B. Sadeghi and Leana S. Wen (9/24/19)

The Trump administration's Title X revision is an intrusion on medical
practice that will reduce access to care for the most vulnerable, but it
is by no means an isolated event. Every new restriction brings up
challenging questions for providers and policy makers, whose ultimate
responsibility must be the patients and communities they serve. Read
More >>

HEALTH INFORMATION TECHNOLOGY

Remembering Don Lindberg: A Transformative Leader

By Robert A. Logan (9/27/19)

Donald A.B. Lindberg, who died on Aug. 17 at age 85, is a primary reason
we have access to PubMed, MedlinePlus.gov, Clinicaltrials.gov, GenBank,
a host of other biomedical databases, and the Internet. Read More >>

GLOBAL HEALTH

The Global Community Has Pledged To Achieve Universal Health Coverage:
What's It Going To Take?

By Marina Carter and Aaron Emmel (9/23/19)

This will be an unprecedented moment in public health: according to the
declaration being negotiated at the UN High-Level Meeting on Universal
Health Coverage, a commitment to achieve universal health coverage by
2030 is being made globally "for the first time." Whether the new
commitment succeeds will depend on a large degree of advocacy at the
national level. Read More >>

PUBLIC HEALTH

Learning The Lessons of Tobacco: A Public Health Approach To The Opioid
Settlements

By Faith Khalik, Wendy E. Parmet, and Leo Beletsky (9/26/19)

As the opioid litigation draws toward a conclusion, we have an
opportunity to apply lessons learned from past mistakes, potentially
saving thousands of lives. Read More >>

IN THE JOURNAL

AHEAD OF PRINT

Health Benefits In 2019: Premiums Inch Higher, Employers Respond To
Federal Policy

By Gary Claxton, Matthew Rae, Anthony Damico, Gregory Young, Daniel
McDermott, and Heidi Whitmore

The annual Kaiser Family Foundation Employer Health Benefits Survey
found that in 2019 the average annual premium for single coverage rose 4
percent to $7,188, and the average annual premium for family coverage
rose 5 percent to $20,576. Covered workers contributed 18 percent of the
cost for single coverage and 30 percent of the cost for family coverage,
on average, with considerable variation across firms. Read More >>

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CULTURE OF HEALTH

When Crises Converge: Hospital Visits Before And After Shelter Use Among
Homeless New Yorkers

By Dan Treglia, Eileen L. Johns, Maryanne Schretzman, Jacob Berman,
Dennis P. Culhane, David C. Lee, and Kelly M. Doran

People who are homeless have been shown to use more hospital-based care
than others, but little research has explored hospital use immediately
before and after a shelter stay. In one of the first studies of its
kind, Dan Treglia and coauthors linked administrative records from New
York City's municipal shelter system with hospital records to assess
the emergency department and inpatient hospital use of homeless adults
before and after stays in shelters. Read More >>

Enabling Services Improve Access To Care, Preventive Services, And
Satisfaction Among Health Center Patients

By Dahai Yue, Nadereh Pourat, Xiao Chen, Connie Lu, Weihao Zhou, Marlon
Daniel, Hank Hoang, Alek Sripipatana, and Ninez A. Ponce

Dahai Yue and coauthors examined how the receipt of enabling services
(including care coordination; health education; transportation; and
assistance with obtaining food, shelter, and benefits) influenced
patient health care outcomes. Read More >>

Transforming City Streets To Promote Physical Activity And Health Equity

By Keshia M. Pollack Porter, Tyler Prochnow, Patricia Mahoney, Haley
Delgado, Christina N. Bridges Hamilton, Emily Wilkins, and M. Renée
Umstattd Meyer

Play Streets is a place-based intervention that is typically organized
by local governments or community organizations and involves temporarily
closing streets to create safe places and free opportunities for
physical activity. In this descriptive study Keshia Pollack Porter and
colleagues examined 162 of Chicago's PlayStreets, held in the summer
of 2018, to assess the volume and type of physical activity among youth
participants and the variety of services provided to residents.Read More
>>

MEDICAID

The Dynamics Of Medicaid Enrollment, Employment, And Beneficiary Health
Status

By Jessica P. Vistnes and Steven C. Hill

Jessica Vistnes and Steven Hill examine the characteristics of new
nonelderly adult Medicaid enrollees and find that about one-quarter of
them report either a decline in their physical or mental health or loss
of a job in the period prior to their enrollment. Read More >>

BEHAVIORAL HEALTH CARE

Prescription Drug Monitoring Program Mandates: Impact On Opioid
Prescribing And Related Hospital Use

By Hefei Wen, Jason M. Hockenberry, Philip J. Jeng, and Yuhua Bao

Comprehensive mandates for prescription drug monitoring programs (PDMPs)
require state-licensed prescribers and dispensers both to register with
and to use the programs in most clinical circumstances. Using Medicaid
prescription data and hospital utilization data for the period
2011-16, Hefei Wen and coauthors estimated the association of
comprehensive PDMP mandates with the rates of opioid prescriptions and
opioid-related inpatient stays and emergency department visits. Read
More >>

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