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A Weekly Health Policy Round Up From Health Affairs
July 21, 2019
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HEALTH AFFAIRS EVENTS
HEALTH SPENDING: MOVING FROM THEORY TO ACTION
Wednesday, September 11, 2019
9:00 am – 3:00 pm Eastern
National Press Club – Washington, DC
REGISTRATION NOW OPEN
Eighteen months ago, Health Affairs teamed with the National Pharmaceutical Council and Anthem, Inc. to launch a multi-year project to promote an evidence-based conversation about health spending. To continue the discussion, Health Affairs and the National Pharmaceutical Council are hosting a forum that will address:
- The pressures presented
by soaring health costs on individuals, employers, and government
- Strategies among payers and others to promote cost effective care
- Efforts currently underway to bring costs under control
Speakers include:
- Mandy Cohen, Secretary, North Carolina Department of Health and Human Services
- Patrick Conway, President and CEO, Blue Cross and Blue Shield of North Carolina
- Robert W. Dubois, Executive Vice President and Chief Science Officer, National Pharmaceutical Council
- Christopher F. Koller, President, Milbank Memorial Fund
- Reed Tuckson, Managing Director, Tuckson Health Connections, LLC
- Alan Weil, Editor-in-Chief, Health Affairs
Be part of the conversation on September 11.
Get event-specific emails delivered directly to your
inbox.
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FOLLOWING THE ACA
Third Circuit Blocks Trump Contraceptive Rules
By Katie Keith (7/16/19)
As a result of this ruling, a nationwide injunction remains in effect. With those rules enjoined, the Obama-era accommodations process had remained in place. Read More >>
MEDICARE
More ACOs Taking Accountability Under MSSP Through ‘Pathways To
Success’
By Seema Verma (7/17/19)
The Trump Administration is finding new ways to lower costs, improve efficiency and quality, and protect the Medicare program for future generations. We appreciate health care providers joining us in this effort and embarking on a new model of care delivery. Together we can move towards a health care system that rewards high quality at a low cost, to generate more value for patients and improve health outcomes. Read More >>
BEHAVIORAL HEALTH CARE
After School Shootings, Children And Communities Struggle To Heal
By Ariella Iancu, Lisa Jaycox, Joie D. Acosta, Frank G. Straub, Samantha Iovan, Christopher Nelson, and Mahshid Abir (7/19/19)
Building community resilience, implementing evidence-based mental health support early, and providing access for survivors and the community immediately post-incident and in the long term could help promote healing and prevent more tragedy. Read
More >>
PHARMACEUTICALS AND MEDICAL TECHNOLOGY
Biosimilar Approvals And The BPCIA: Too Soon To Give Up
By Jonathan J. Darrow (7/19/19)
If biosimilars prove to be reasonable substitutes for their reference products, skepticism of prescribers and patients will wane just as it has with respect to small-molecule drugs over the past several decades. Although it is unclear to what extent the BPCIA will ultimately prove a success, its abandonment would be premature. Read More >>
PAYMENT
Rep. Ruiz’s Arbitration Proposal For Surprise Billing (H.R. 3502) Would Lead To Much Higher Costs And Deficits
By Loren Adler, Erin Duffy, Paul B. Ginsburg, Mark Hall, Erin Trish, and Christen Linke Young
(7/16/19)
The new legislation introduced by Rep. Ruiz would, like other proposals, prohibit balance billing for surprise out-of-network services and limit patient cost-sharing to standard in-network amounts. Read More >>
Successfully Splitting The Baby: Design Considerations For Federal Balance Billing Legislation
By Sabrina Corlette, Jack Hoadley, and Kevin Lucia (7/15/19)
As congressional leaders craft balance billing protections that can gain support—or at least the absence of opposition—from health industry stakeholders, some state legislatures have charted potential paths forward. Read More >>
V-BID X: Creating A Value-Based Insurance Design Plan For The Exchange Market
By Haley Richardson, Michael Budros, MPP Michael Chernew, and A. Mark Fendrick (7/15/19)
Value-Based Insurance Design (V-BID), which aligns patients’ out-of-pocket costs with the value of services, offers a route to mitigating the negative impacts of increased cost sharing, namely
the underutilization of evidence-based, high-value care. Read More >>
WORKFORCE IN THE COMMUNITY
A Backstory To Michael Ogg’s Narrative Matters Essay: Why He Needed To Leave PACE
By Lisa I. Iezzoni (7/18/19)
This blog post joins an emotionally laden niche genre written by people with long experience as clinicians, health policy researchers, or putative health care experts who describe feeling frustrated, baffled, buffeted, and sometimes ultimately helpless to rescue a loved one
or friend from a dysfunctional and even dangerous health care system. Read More >>
MATERNAL AND CHILD HEALTH
To Help Fix The Maternal Health Crisis, Look To Value-Based Payment
By Clare Pierce-Wrobel and Katie Green (7/16/19)
The health care system can and should be held accountable for reducing disparities in outcomes as a part of an outcomes-driven maternity payment model. Read More >>
ACCESS TO CARE
Autistic Perspectives Needed: Community Participation Services And Research Are At A Critical Juncture
By Lindsay Shea, Whitney Schott, Julia Bascom, and Amy R. Pettit (7/17/19)
Autistic voices and perspectives will be critical to shape a service system that can effectively meet
their needs, but it remains unclear whether states’ public comment periods and feedback processes have included effective mechanisms for this group to be heard.
Read More >>
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IN THE JOURNAL
DISPARITIES
The Role Of Social Risk Factors In Dialysis Facility Ratings
And Penalties Under A Medicare Quality Incentive Program
By Andrew C. Qi, Anne M. Butler, and Karen E. Joynt Maddox
Andrew Qi and coauthors find that dialysis facilities in low-income areas and with high proportions of patients who are black or dually eligible for Medicaid performed worse and were penalized more under the End Stage Renal Disease Quality Incentive Program.
Read More >>
Racial And Ethnic Disparities In Care Following The New York State Sepsis Initiative
By Keith Corl, Mitchell Levy, Gary Phillips, Kathleen Terry, Marcus Friedrich, and Amal N. Trivedi
In 2013 New York State undertook a major initiative that required hospitals to adopt an evidence-based protocol for sepsis
care. Keith Corl and coauthors find overall improvements in care and no evidence of racial disparities in treatment within hospitals. However, because hospitals primarily serving black patients had smaller improvements, the initiative widened the sepsis care quality gap between blacks and whites. Read More >>
THE PRACTICE OF MEDICINE
Accuracy Of The Relative Value Scale Update Committee’s Time
Estimates And Physician Fee Schedule For Joint Replacement
By John W. Urwin, Emily Gudbranson, Danielle Graham, Dawei Xie, Eric Hume, and Ezekiel J. Emanuel
John Urwin and coauthors use EHR time-stamp data from the University of Pennsylvania Health System to examine physicians’ time spent conducting knee and hip replacements. They find that the time estimates used by Medicare to set the physician relative value fee schedule, based on physician surveys, are greatly overstated, including by 50 percent or more for revision procedures. Read More >>
This article appears in Health Affairs’ series on The Practice of Medicine.
AGING & HEALTH
A National Examination Of Long-Term Care Setting, Outcomes, And Disparities Among Elderly Dual Eligibles
By Rebecca J. Gorges, Prachi Sanghavi, and R. Tamara Konetzka
Rebecca Gorges and coauthors find that, on average, home and community spending is higher for non-Hispanic whites than for blacks or Hispanics of any race and that blacks have the highest rates of hospitalization, including those that are potentially avoidable.
Read More >>
This article appears in Health Affairs’ series on Aging & Health.
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MEDICAID
Growth Of Public Coverage Among Working Families In The Private Sector
By Douglas Strane, Genevieve P. Kanter, Meredith Matone, Ahaviah Glaser, and David M. Rubin
Douglas Strane and coauthors examine enrollment of children in working families in Medicaid or CHIP in the period 2008–16. They find that among low-income families, children’s public health insurance coverage was highest for those with parents employed at small private firms. Read More >>
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NARRATIVE MATTERS
Dying To Access Methadone
By Jessica L. Gregg
A cancer patient who uses heroin can’t gain reasonable access to methadone to treat his disorder until he qualifies for hospice.
Read More >>
Listen to the podcast here.
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Call For Submissions: Narrative Matters Poetry Contest 2019The Narrative Matters section of Health Affairs is seeking poetry submissions
for an upcoming issue of the journal.
We are holding a poetry contest, from July 1 to August 31, looking for well-crafted poems that touch on topics related to health and health policy. Three winning poems will be announced in September. Winning poets will receive a monetary prize—$500 for first place, $300 for second, and $100 for third—as well as publication in Health Affairs, and two copies of the issue containing the winning poem.
All entries will be read and judged by Health Affairs staff.
- Limit 3 poems submitted per person. Each poem—in pdf or word doc format—should be submitted as a separate entry through our submission portal here.
- Poems must be no longer than a single-spaced page, with double spaces between stanzas
- Font size no smaller than 11 point.
- Poems must be written in English.
- Poems must be previously unpublished.
- Poems themselves should contain no personal identifiers.
You can read some earlier poems published by Health Affairs, including the winners of the 2015 Narrative Matters poetry contest, poems
by patients and consumers, poems on vulnerable populations, and poems on the cancer experience.
We look forward to reading your submissions!
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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.
Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, United States
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