As a new year begins, this issue of the journal reflects the varied roles that Health Affairs plays in health policy. It includes the federal government’s annual national health expenditures report, by Micah Hartman and colleagues, revealing anearly 10 percent increase in health spending in 2020 due almost entirely to growing federal expenditures associated with the COVID-19 pandemic.
George Wehby links birth certificate data to standardized test scores for children in Iowa and provides strong evidence that
the Affordable Care Act (ACA) insurance expansions led to improvements in reading scores, particularly among children in households of mothers with a high school education or less, in the third and fourth years after Iowa’s expansion.
Toward the end of the open enrollment period in California’s ACA Marketplace, Covered California, tens of thousands of people begin but do not complete the process. Rebecca Myerson and coauthors report results from a randomized trial showing that personalized telephone calls from service center representatives to discuss consumers’ options increase enrollment for lower-income households, with particularly large increases seen among adults older than age fifty.
Sarah Gordon and coauthors analyze data from Colorado, which in July 2021 extended postpartum Medicaid coverage for twelve months. They find that the extension is likely to improve the stability of health insurance coverage in the postpartum year.
With an aim to increase the nurse supply, the ACA Graduate Nurse Education Demonstration provided federal funding to offset the clinical training costs of advanced practice nurses from 2012 to 2018. Joshua Porat-Dahlerbruch and coauthors report that the program was "associated with a significant average increase of twenty-eight [nurse practitioner (NP)] graduates and eighty-nine NP enrollees per school of nursing throughout the demonstration period."
Aaron Schwartz and coauthors characterize coverage denials in Aetna’s Medicare Advantage (MA) plans and find that during 2014–19, service denial rates increased by 15 percent, and spending denial rates increased by 60 percent. Overall
they report $416 million in denied spending resulting from Medicare or MA plan coverage criteria, with 0.81 denials and $60 of denied spending per beneficiary annually.
In 2016 CMS introduced Current Procedural Terminology codes that allow billing for advance care planning in fee-for-service Medicare, but their use remains low. Based on 272 interviews with key staff from eleven health systems, Keren Ladin and coauthors identify barriers — ranging from concerns about patient ethics to workflow burden — that reflect the challenges associated with using the codes.
Join Health Affairs for afree virtual event! In addition to the new journal edition, we produce a
variety of events that relate to our research and bring health policy professionals up to speed on the latest in health policy research.
Alongside the issue release, we invite
authors from the issue to speak with Editor-in-Chief Alan Weil on our A Health Podyssey podcast, which features interviews with leading and up-and-coming researchers in health services and health policy.
Health Affairs is the leading peer-reviewedjournalat 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.
