Evaluating Temporary Changes to Medicare in Response to COVID-19
In response to the COVID-19 pandemic, Congress and the Trump administration made more than 200 temporary policy and regulatory changes to Medicare. Some have already become permanent, and the others are likely to remain in effect until the end of 2021. In a new issue brief, Jennifer Podulka and Jonathan Blum of Health Management Associates lay out a framework to help policymakers assess the future of the temporary policies. They also call for a substantial research effort to determine the effects of these changes.
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The Pandemic Playbook: Lessons on Responding to COVID-19 from Around the World
What can the United States learn from how other nations have responded to the COVID-19 pandemic? And what did we get right? On To the Point, the Commonwealth Fund’s Reginald D. Williams II interviews Vox senior correspondent Dylan Scott on what he and his colleagues learned from their reporting on the successes and setbacks of pandemic-response strategies in Germany, Senegal, South Korea, the United Kingdom, the U.S., and Vietnam. The findings are detailed in
The Pandemic Playbook, produced by Vox with support from the Commonwealth Fund.
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Trends in Pediatric Primary Care Visits During the COVID-19 Pandemic
At the outset of the COVID-19 pandemic, the volume of outpatient medical practice visits declined by almost 60 percent. While a rebound followed in most other specialties, pediatric primary care visits remained suppressed. In a new Commonwealth Fund–supported article published in Academic Pediatrics, researchers compared child visit rates from January–October 2020 to January–October 2018 and 2019. They report that the remaining cumulative deficit in pediatric primary care visits as of October 2020 resulted from fewer problem-focused visits; rates of preventive visits and vaccination exceeded rates in prior years.
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Other Recent Publications | |
Birth Equity for Veterans and Servicemembers
There are more women serving in the U.S. military and women veterans than ever before and many are in their childbearing years. On To the Point, Jodie Katon of the University of Washington and the Commonwealth Fund’s Laurie Zephyrin, M.D., detail needed improvements to maternal health policies and practices for pregnant and birthing servicemembers and veterans. Investing in culturally concordant midwifery, independent community-based birth center care, and doula support, along with maternity care coordination for those in the VA Health Care system could ensure healthy pregnancies, births, and babies, the authors say.
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What the Biden Administration Can Do to Strengthen Health Care Coverage
The Biden administration has pledged to use its executive authority to strengthen and expand access to health care coverage under the Affordable Care Act and through Medicaid. In a new issue brief, Georgetown University’s Katie Keith analyzes executive branch policy options based on recommendations from a diverse group of health care stakeholders. Top recommendations included increasing funds for outreach and enrollment, fixing the “family glitch,” limiting the availability of noncomprehensive coverage options, and revisiting policies on state innovation waivers.
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Fixing the Affordable Care Act’s “Family Glitch”
The Affordable Care Act’s “family glitch” affects millions of people, primarily family members of low- and middle-income workers. It exists because employer health coverage is deemed affordable for a worker’s family members even if the plan premium exceeds the employee-only rate of 9.83 percent of household income. With an offer of “affordable” employer coverage, they are ineligible for subsidies when buying a marketplace plan. Health law expert Timothy S. Jost explains on To the Point
that the family glitch could be fixed through regulation at an estimated cost of $4.5 billion a year, an amount he says is “insignificant compared to the total cost of ACA coverage.”
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States That Expand Medicaid Will See Major Gains in Employment, Coverage, and Economic Growth
The American Rescue Plan offers financial incentives to expand Medicaid in the 14 states that have not yet done so under the ACA. According to researchers at George Washington University, increasing eligibility for the program would lead to more than 1 million new jobs nationally, with Texas, Florida, North Carolina, Georgia, and Missouri seeing the largest gains. The researchers also find that nearly 4.5 million uninsured people are expected to gain health coverage. Their report details how much state economies, tax revenues, and personal income would grow in the holdout states following expansion.
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The Case for Reforming Drug Pricing in the United States
Drug prices in the United States are the highest in the world, and patients here are more likely to report that they can’t afford their medications. So, it’s no surprise that the American public has long supported drug-pricing reform. On To the Point, the Commonwealth Fund’s Lovisa Gustafsson and Rachel Nuzum argue that addressing drug pricing could provide significant savings to patients and the government; an existing proposal could save almost $500 billion over 10 years. And they say that efforts to address drug affordability need not stifle pharmaceutical innovation.
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Can External Reference Pricing Reduce Drug Prices in the U.S.?
To control prescription drug prices, some policymakers have proposed using external reference pricing (ERP), which would base the prices for drugs in the United States on those in other countries. In a new issue brief, Daniel Ollendorf and colleagues at Tufts Medical Center examine ERP programs in other high-income countries to assess the potential for adoption in the U.S. They find that while the U.S. might reap billions in savings from ERP initially, the authors conclude those benefits would be difficult to sustain. They suggest that “ERP may be best utilized as a supportive pricing policy rather than the primary lever.”
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Essential Facts About Medicare Drug Pricing Reform
Congress has been showing increasing interest in ways to rein in high prescription drug prices. Last week the powerful House Committee on Oversight and Reform held a hearing on “unsustainable drug prices” that examined the pricing and business practices of AbbVie, one of the major players in the biopharmaceutical market. To help you better understand some of the pricing reform options now being discussed by policymakers, the Commonwealth Fund offers two explainers — on
Medicare Part D Redesign and Medicare Drug Price Negotiation — that break it all down. |
Blumenthal: Reduce Drug Prices, Increase Federal Funding of Biomedical R&D
Americans pay sky-high prices for many prescription drugs, yet the U.S. pharmaceutical industry says reducing those prices will stifle lifesaving innovation. In an op-ed published in STAT,
Commonwealth Fund President David Blumenthal, M.D., argues that it’s not an either/or choice. The private sector dominates U.S. biomedical research and development in part because it has free rein to set prices, resulting in huge profits and research funding capacity. By contrast, the National Institutes of Health is able to fund only a fraction of the grant applications it receives. This imbalance, Blumenthal says, could be corrected by having Medicare pay less for prescription drugs and putting the savings toward more federally funded research.
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How a Blockbuster Drug’s Patent Wall Is Costing Consumers
Nearly 130 patent applications have been filed for Keytruda, the blockbuster cancer drug, with 53 patents granted so far. The most recent ones are set to expire in 2036. A new report from the Initiative for Medicines Access & Knowledge (I-MAK) examines the “patent wall” for Keytruda that ensures a monopoly for the drug’s maker for at least 35 years. The extended patent protection could cost Americans $137 billion, the researchers say. Conducted with support from the Commonwealth Fund, the new research sheds light on how manufacturers are increasingly using defensive patent strategies for biologic drugs.
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Hospital-at-Home: Delivering Acute Care Services to Patients with Complex Illnesses
Medically Home, a company that partners with health systems and other providers to deliver acute care services in the homes of patients with serious or complex illnesses, recently announced that Kaiser Permanente and Mayo Clinic invested $100 million in the company. Both had pilot tested Medically Home model and found it reduced readmissions and improved patient satisfaction. Medically Home was featured in the
July 2020 issue of Transforming Care, which described a variety of ways hospital-at-home models have been used to increase hospital capacity during the pandemic. |
Podcast: Designing Health Care for Trauma Survivors
Many of us can recall a time we felt nervous about seeing a doctor. Now, imagine how much more stress you would feel if you had experienced trauma — from domestic violence or human trafficking, for example. Family medicine physician Anita Ravi, M.D., cares for trauma patients. On the latest episode of The Dose podcast, Ravi and Keisha Walcott, one of her former patients, talk about how to design health systems for women and girls who have experienced gender-based violence. Ravi and Walcott explain how health, poverty, and trauma are interlinked and why providers must address all three.
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Distributional Effects of Alternative Health Reform Proposals
Researchers at the Urban Institute recently examined two health reform proposals, one incremental and the other more comprehensive, with each financed by alternative tax strategies. Their study shows that both reforms would yield coverage gains for the uninsured and improved affordability for others. The incremental reform would add coverage for 14.8 million people and the comprehensive reform 27.2 million. The annual federal cost of the incremental reform would be $103.6 billion and the comprehensive reform $168.7 billion.
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