CMS Releases Week Two Enrollment Snapshot
By Katie Keith (11/14/19)

So far, total plan selections for 2020 are down from the nearly 1.2 million consumers who selected a plan last year between November 1 and November 10 in the 39 states that used HealthCare.gov. Read More >>

ACA Round-Up: First Enrollment Report, SBC Updates, And More
By Katie Keith (11/12/19)

This post covers the first weekly enrollment report, updates to the Summary of Benefits and Coverage (SBC), a new enforcement safe harbor for direct enrollment (DE) entities on quality rating requirements, an extension of relief for dual enrollees in Medicare and marketplace coverage, and data submission requirements for the risk adjustment program for 2019.
Read More >>

CONSIDERING HEALTH SPENDING

To Succeed, MIPS Value Pathways Need More Episodic Cost Measures
By Joshua M. Liao, Sophie C. Miller, and Amol S. Navathe (11/14/19)

In proposing new Merit-based Incentive Payment System value pathways, CMS intends to increase the program’s salience to clinicians and increase alignment among different MIPS domains. Read More >>

SYSTEMS OF CARE

Bernard Tyson Is Gone Way Too Soon
By George C. Halvorson (11/14/19)

We need to make sure that people understand what Bernard did and who he was, because we need role models for our country and our people at this point in our history. Bernard provided that role model with joy, grace, integrity, and skill, and with core levels of truth, commitment, and positive energy every day. Read More >>

PUBLIC HEALTH

Using The County Health Rankings To Assess County Performance At A National Scale
By Jessica Athens (11/14/19)

Is there a way to see how the counties in one state are faring on health outcomes measures, compared to counties nationwide? Yes, says a policy and research officer at the New York State Health Foundation, who describes a September 2019 report it issued on this subject. Read More >>

MEDICARE

Treat ACOs And MA Plans Equally? By All Means
By Joseph R. Antos and James C. Capretta (11/13/19)

Medicare should establish policies to ensure that accountable care organizations and Medicare Advantage plans are treated fairly, but such policies must account for the substantial differences in the way those alternatives operate. Read More >>

HIV/AIDS

Ending An Epidemic Requires Multiple Interventions: Considerations For Developing And Harmonizing HIV Preventive Recommendations
By Richard Hughes IV, Chris Sloan, Alisa Vidulich, Chloé Chepigin, and Manny Aviña (11/13/19)

The specter of overlapping or competing Advisory Committee on Immunization Practices and US Preventive Services Task Force recommendations that could undermine efforts to reduce HIV transmissions underscores the need for a collaborative recommendation development process between the recommending bodies. Read More >>

HEALTH INFORMATION TECHNOLOGY

Time For A Health Information Agency
By Julie Barnes and Mattie Quinn (11/12/19)

It’s time to step into this brave new world, one that we’ve always hoped for in health care: where patients are empowered, health data are in real time, and the whole system no longer feels like a handful of people making decisions behind a curtain. Read More >>

SYSTEMS OF CARE

Stop Blaming The Victim: The Case For Systemic Health System Transparency
By Niall Brennan and Katie Martin (11/12/19)

Decision makers and policy makers—federal, state, local, and private sector—need more and better information to consider and implement changes that can alter the trajectory of health care spending. Greater transparency, by which we mean a comprehensive view of where and how health care dollars flow and what is driving them, is a key tool in enabling those changes. Read More >>

ELDER CARE

Mobilizing Public Health To Support Elders’ Longevity And Thriving
By John Auerbach and Joanne Lynn (11/15/19)

The situation for frail elders, families, and governments will be dire within a dozen years if leadership and resources do not shift to meet population needs. Read More >>

MEDICAID

Improper Medicaid Enrollment Following ACA Expansion
By Aaron Yelowitz (11/15/19)

The evidence—whether broad survey data from the Census Bureau’s ACS or highly detailed audits from the OIG—suggests serious problems with program integrity related to the ACA’s Medicaid expansion. Read More >>

IN THE JOURNAL

AHEAD OF PRINT: EYE ON HEALTH REFORM

Health Reform On The Campaign Trail
By Katie Keith

In this primer, Katie Keith summarizes the range of Democratic candidates’ proposals, from improving the ACA to Medicare for All, noting the different plans’ costs, impacts, and trade-offs. She observes that some candidates have shifted their positions, which may "be in reaction to the public debate, which has thus far focused on simple answers to complex questions such as whether each candidate supports banning private health insurance or not, how each will pay for their plan, and whether coverage options should be extended to undocumented people." Read More >>

AFFORDABLE CARE ACT

As Insurers Exit Affordable Care Act Marketplaces, So Do Consumers
By Daniel Crespin and Thomas DeLeire

Much has been written about the stability of the ACA Marketplaces. Daniel Crespin and Thomas DeLeire analyze the relationship between insurer exits from the Marketplaces and consumer decisions to reenroll in policy years 2015–18. Read More >>

California’s New Gold Rush: Marketplace Enrollees Switch To Gold-Tier Plans In Response To Insurance Premium Changes
By Petra W. Rasmussen, Thomas Rice, and Gerald F. Kominski

"Silver loading" occurred when the Trump administration discontinued cost-sharing reduction payments to health plans, and some states permitted insurers to place the entire cost of these subsidies on silver-tier plans. Petra Rasmussen and coauthors examine Marketplace enrollees’ behavior in California between the 2014–15 and 2017–18 open enrollment periods in response to silver loading. Read More >>

ENTRY POINT: AGING & HEALTH

Age-Friendly Care At The Emergency Department
By Michele Cohen Marill

Mount Sinai Hospital in New York City is at the forefront of an innovative approach to geriatric emergency care. Read More >>

LEADING TO HEALTH: DETERMINANTS OF HEALTH

Integrating Pediatric Care And Taking On Risk To Improve Health
By Rebecca Gale

In Delaware, Nemours Children’s Health System wants to get paid for keeping children healthy. Read More >>

PATIENT-CENTERED CARE

Frequent Emergency Department Users: Focusing Solely On Medical Utilization Misses The Whole Person
By Hemal K. Kanzaria, Matthew Niedzwiecki, Caroline L. Cawley, Carol Chapman, Sarah H. Sabbagh, Emily Riggs, Alice Hm Chen, Maria X. Martinez, and Maria C. Raven

To better understand the wide-ranging problems of frequent and superfrequent ED users (defined as four or more and 18 or more ED visits per year respectively), Hemal Kanzaria and coauthors examined Medicaid claims data in the years 2013–15 linked to records from San Francisco County’s Coordinated Care Management System (CCMS). Read More >>

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.

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