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The Latest Research, Commentary, And News From Health Affairs

April 4, 2021

Dear John,

Read on for highlights from Health Affairs from March, and a sneak peek
at the April issue.

Nursing Home Staff Turnover, The American Rescue Plan & More

Ashvin Gandhi and coauthors found that the annual median turnover rate
for registered nurses working in nursing homes was in excess of 100
percent
,
which had implications for COVID-19 care, as discussed in the New York
Times
.
David Grabowski, one of the study's authors, went on A Health Podyssey

to discuss the research.

Health Affairs and the National Academy of Medicine hosted the Vital
Directions for Health and Health Care: Priorities for 2021 Virtual
Briefing
,
during which notable policy makers and health care providers discussed
health equity across the five priority areas recently outlined in Health
Affairs .

Maximilian Pany and coauthors found that patients who have their care
managed by teams, rather than by solo providers, were more likely to
have their chronic conditions brought under control
,
and discussed their research on A Health Podyssey
.

Katie Keith wrote a blog post about the final coverage provisions in the
American Rescue Plan

and what comes next.

Four papers on COVID-19 vaccines and treatments

illustrated how "the COVID-19 innovation system represents a departure
from business as usual."

In a Narrative Matters essay and corresponding podcast
,
Sharon Griswold argued that the bankruptcy and subsequent closure of
Hahnemann University Hospital demonstrates the need for health care and
graduate medical education policy reform
.

Christopher Whaley joined Alan Weil on A Health Podyssey

to discuss a bundled payment program in a commercially insured
population that led to price reductions of more than 10 percent per
procedure
.

In her GrantWatch column, Lee L. Prina highlights foundations supporting
long-term care efforts around the country
.
Projects focus on the needs of caregivers, insurance for long-term
services and supports, and assisted living for people dually enrolled in
Medicare and Medicaid. The column features insights into Johns
Hopkins' Community Aging in Place-Advancing Better Living for Elders
program, a documentary on COVID-19's impact on long-term care, and
more.

The April 2021 issue of Health Affairs includes articles on some of our
most popular topics: access to care, how the Affordable Care Act (ACA)
affects coverage, the effects of health spending policies, and much
more.

The issue includes research on:

* Out-of-pocket costs for Medicare beneficiaries with incomes just above
the coverage "cliff"

* How the use of medication to treat opioid use disorder by individuals
referred to treatment by a criminal justice agency differed in states
that expanded Medicaid compared to those that did not

* The ACA's effect on use of long-acting reversible contraceptives for
women enrolled in high-deductible health plans

* How coverage compared for women before and after giving birth in
states that did and did not expand Medicaid after the ACA's
implementation

* The costs associated with urgent care centers, surprise billing for
emergency department use, referrals made after telemedicine visits in a
commercially insured population, and medical device company payments to
physicians

* Accounting for patients' social risk factors when adjusting quality
metrics used to judge hospital performance

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Eviction And Health: A Vicious Cycle Exacerbated By A Pandemic

A new health policy brief

from **Health Affairs** with support
from the Robert Wood Johnson Foundation
highlights the prevalence of eviction and how additional consequences of
COVID-19 have affected the health of evicted households and their
communities. This brief joins

**Health Affairs'** ongoing series of policy briefs on the social
determinants of health
.
It is authored by Gracie Himmelstein and Matthew Desmond, researchers
from Princeton University's Eviction Lab. Desmond is the Pulitzer
Prize-winning author of Evicted: Poverty and Profit in the American
City.

Read More

Featured Journal Articles

High Nursing Staff Turnover In Nursing Homes Offers Important Quality
Information

Ashvin Gandhi, Huizi Yu, and David C. Grabowski

Provider Teams Outperform Solo Providers In Managing Chronic Diseases
And Could Improve The Value Of Care

Maximilian J. Pany, Lucy Chen, Bethany Sheridan, and Robert S. Huckman

Graduate Medical Education Should Not Be A Commodity

Sharon Griswold

An Employer-Provider Direct Payment Program Is Associated With Lower
Episode Costs

Christopher M. Whaley, Christoph Dankert, Michael Richards, and Dena
Bravata

Long-Term Care Efforts Supported By Foundations

Lee L. Prina

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Nursing Homes Have A Staff Turnover Crisis-Even Before COVID-19

Nursing homes are challenging places to work. David Grabowski of Harvard
Medical School notes in today's episode of A Health Podyssey, "We knew
the nursing home system was broken before the COVID-19 pandemic."

Grabowski recently coauthored two papers in our March 2021 issue on the
topic of nursing home staffing. One article noted that Medicare's new
patient-driven payment model resulted in reductions in therapy staffing
in skilled nursing facilities. A second found that the mean annual
nursing staff turnover rate was an eye-popping 128 percent.

Post-pandemic, the implications of a nursing home's high staffing
turnover rate is clear: it could lead to health and safety risks for
residents.

Listen Here

On The Blog This Week

Six Principles To Ensure Clinician Well-Being: Lessons From COVID-19's
Darkest Days For A New Way Of Working

Lisa S. Rotenstein, Daiva Braunfelds, and Diane Sliwka

Rethinking ICU Allocation In Times Of Crisis

Michael Nurok

Reproductive Rights And Justice: A Critical Opportunity For The Biden
Administration To Protect Hard-Fought Gains

Swapna Reddy, Mary Saxon, Yeonsoo Sara Lee, and Nina Patel

The Need For Accurate Contraceptive Awareness And Advocacy Among Health
Care Providers

Jenny A. Higgins, Lindsay M. Cannon, Laurel W. Rice, and David K. Turok

Misperceptions Of People With Disabilities Lead To Low-Quality Care: How
Policy Makers Can Counter The Harm And Injustice

Andrés J. Gallegos

Measuring Mortality In The Pandemics Of 1918-19 And 2020-21

E. Thomas Ewing

Low-Income COVID-19 Patients Die Needlessly Because They Are Stuck In
The Wrong Hospitals-While The Right Hospitals Too Often Shut Them Out

Caroline Kelly, William F. Parker, and Harold A. Pollack

[link removed]

Drug Pricing On The Agenda For Massive Infrastructure Bill

Listen to Chris Fleming and Washington University's Rachel Sachs break
down H.R. 3, which contains a series of far-reaching drug pricing
reforms. Provisions of H.R. 3 could be included as part of a massive
infrastructure package proposal.

Listen Here

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mailto:[email protected]

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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