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The Commonwealth Fund Connection

A roundup of recent Fund publications, charts, multimedia, and other timely content.




June 11, 2021

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COVID-19


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How Can States Accelerate COVID-19 Vaccination?
While more than 60 percent of U.S. adults have received at least one COVID-19 shot, progress across states is uneven. And the states that have historically performed well on measures of health care access and patient engagement are the ones seeing higher vaccination rates, according to Commonwealth Fund researchers. Writing on To the Point, David Radley and colleagues contend all states could reach the desired rate of 70 percent by adopting local approaches to vaccine delivery that allow people to get their shots in the most convenient and comfortable ways possible.

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New Tool Can Help Ensure Equitable Access to COVID-19 Vaccines
COVID-19 vaccinations are available at 52,000 sites across the United States. But because these sites aren’t evenly distributed, 24 million people live in “vaccine deserts.” The new
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Vaccine Equity Planner can help state and local officials determine where these vaccine deserts are and ensure no one in America is left behind. The free, data-driven tool, funded by Google, was developed by Ariadne Labs and Boston Children’s Hospital, with additional support provided by the Commonwealth Fund.

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“It’s Really, Truly Everywhere”: How the Opioid Crisis Worsened with COVID-19
When the pandemic hit last March, the U.S. was facing another major public health crisis — the opioid epidemic. Between COVID-19 lockdowns and economic devastation, experts believe around 90,000 people died of a drug overdose in 2020. On the latest episode of The Dose podcast, Johns Hopkins's Brendan Saloner and the Commonwealth Fund’s Jesse Baumgartner discuss why drug deaths are rising and how policymakers can fix the problem.

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How Did COVID-19 Affect Medicare Spending?
Despite its otherwise devastating effects, the COVID-19 pandemic did not have a major financial impact on Medicare in 2020, according to research published in Annals of Internal Medicine. In an accompanying editorial, the Commonwealth Fund’s David Blumenthal, M.D., and Gretchen Jacobson note that the new study puts COVID-19’s financial burden into perspective, while also shedding light on how the pandemic has affected medical care for vulnerable groups.

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Renewed Calls for Home-Based Palliative Care
The Washington Post recently
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reported that palliative care organizations are in discussions with the Biden administration to create a demonstration program for home-based palliative care through Medicare — welcome news for the tens of thousands of Americans who have experienced long-term debilitating symptoms from COVID-19. Last fall, the Commonwealth Fund’s Martha Hostetter and Sarah Klein
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detailed the vital role that palliative care programs have been playing during the pandemic.


Other Recent Publications


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See How Racism Is Entrenched in U.S. Health Care
COVID-19 has devastated many Black and Latinx/Hispanic communities in the United States, erasing recent life expectancy gains and worsening disparities in health. But these inequities aren’t new: they stem from a long history of structural racism in American policies. In 23 charts, Commonwealth Fund researchers illustrate difference among white, Black, and Latinx/Hispanic communities across a range of indicators related to insurance coverage and access to care, receipt of medical services, health status, and mortality. The authors also highlight national and state-level barriers to progress.

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The ACA Narrowed Racial Disparities, Especially in States That Expanded Medicaid
The Affordable Care Act helped to significantly reduce racial and ethnic disparities in health insurance coverage and improve access to care. But U.S. uninsured rates for Black and Latinx/Hispanic adults remain significantly higher compared to white adults, with a larger divide in many of the states that have not yet expanded Medicaid. The Commonwealth Fund’s Jesse Baumgartner, Sara Collins, and David Radley examined trends in racial and ethnic disparities across three key measures: having insurance; going without care because of the cost; and having a usual health care provider.

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A Workaround for Covering the Uninsured in States That Haven’t Expanded Medicaid
How can Congress extend health care coverage to uninsured residents of states that have chosen not to expand Medicaid eligibility? George Washington University researchers have a solution, inspired by a workaround for covering legal immigrants, who are barred from accessing public benefits like Medicaid for five years after entering the U.S. Just as recently arrived legal immigrants can now buy subsidized marketplace coverage during the five-year waiting period, the researchers say a similar strategy could work for low-income people in states that haven’t expanded Medicaid.

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Insuring More People in the “Coverage Gap”
For the past seven years, Americans of all income levels in most of the U.S. have been able to obtain affordable insurance coverage. But at least 2.2 million low-income people in the 14 states that haven’t yet expanded Medicaid eligibility are in the “coverage gap”: they can neither enroll in traditional Medicaid nor afford marketplace coverage. Sherry Glied of New York University and Richard Frank of Harvard Medical School explore the advantages and shortcomings of three options that federal policymakers are considering for covering this population.

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States with the Fastest-Growing Populations Rank Last in Health
The 2020 census shows that states with the fastest-growing populations — including Texas, Florida, and Georgia — consistently rank last when it comes to health and health care. In a Harvard Business Review op-ed, the Commonwealth Fund’s David Blumenthal, M.D., and David Radley explain that these states rank so poorly largely because of the roadblocks their residents face in accessing and affording health care. Fast-growing states rank poorly in other areas, too, including infant mortality and premature death.

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Auto-Enrollment: A Feasible Path to Universal Health Coverage
Automatic enrollment of the uninsured in private or public health insurance may represent the most feasible way for the U.S. to achieve near-universal coverage. In a new report, analysts led by the Urban Institute’s Linda Blumberg explore how two different strategies might work. Both would require new administrative systems and enhanced marketplace subsidies, and each would operate more smoothly if paired with a public insurance option.

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Finding the Right Levers to Make Health Care Accountable
The federal Center for Medicare and Medicaid Innovation tests models for raising the performance of U.S. health care on quality, equity, and cost. While the Innovation Center, as it’s also known, has had some success, its methods leave room for improvement, say the Commonwealth Fund’s David Blumenthal, M.D., Corinne Lewis, and Melinda Abrams. They offer a framework for holding providers, health plans, and others accountable, and they highlight some promising approaches, from physician-led accountable care organizations to home-based care programs.

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