Forefront: Health and Human Services' Overdose Prevention Strategy
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Monday, January 24, 2022 | The Latest Research, Commentary, And News
From Health Affairs

Dear John,

Join Health Affairs on Friday, January 28, for a free virtual briefing
"Caring for Those with Complex Needs." Register here
to attend.

Medicare Programs

In their January paper, Aaron Schwartz and coauthors characterized
coverage denials in Aetna's Medicare Advantage (MA) plans

and found that during 2014-19, service denial rates increased by 15
percent and spending denial rates increased by 60 percent.

Overall they reported $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 another January paper, Matthew Trombley and coauthors estimated net
savings of $381.5 million over three years of the Accountable Care
Organization (ACO) Investment Model (AIM)
.

Yet they found that "nearly two-thirds of AIM ACOs exited the Medicare
Shared Savings Program when faced with the requirement to assume
downside financial risk, starting in year four of participation."
Trombley recently joined

**A Health Podyssey** to discuss the paper and his findings

Today in Health Affairs Forefront, Rebecca Haffajee from the US
Department of Health and Human Services (HHS) discusses HHS' Overdose
Prevention Strategy
,
which includes evidence-based activities in four priority areas: primary
prevention, harm reduction, evidence-based treatment, and recovery
support.

Katherine LeMasters and coauthors argue prisons and jails

should release as many individuals as possible to preserve the health of
people behind the walls and staff.

Michael Chernew and J. Michael McWilliams argue that population-based
payment models

are a better way to promote efficiency and equity than the dominant
fee-for-service system.

Enjoying our newsletter but not yet a Health Affairs subscriber? Sign up
today .

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Daily Digest

Coverage Denials: Government And Private Insurer Policies For Medical
Necessity In Medicare

Aaron Schwartz et al.

ACO Investment Model Produced Savings, But The Majority Of Participants
Exited When Faced With Downside Risk

Matthew Trombley et al.

Podcast: Matthew Trombley on Why Many Providers Run From Downside Risk
In ACOs

Alan Weil and Matthew Trombley

Tackling The Drug Overdose Crisis: A Novel Health And Human Services
Strategy

Rebecca Haffajee

Staff Shortages In Prisons And Jails Highlight Opportunities For
Decarceration

Katherine LeMasters et al.

The Case For ACOs: Why Payment Reform Remains Necessary

Michael Chernew and J. Michael McWilliams

HHAeXchange's Homecare Predictions for 2022

Greg Strobel
Sponsored by HHAeXchange

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New Podcast: Health Affairs Pathways

Health Affairs is launching a new podcast next week!

Health Affairs Pathways explores the avenues and alleyways of the health
care system through varied storytelling. Our first season is a six-part
series from Lalita Abhyankar, a physician based in San Francisco,
California.

Her series, titled Piecemeal, examines how consolidation in health care
is affecting independent primary care.

Subscribe today on Apple Podcasts
,
Spotify
,
or wherever you listen.

 

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