Telemedicine, pharmaceuticals, and more.
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John,

The June 2022 issue of Health Affairs covers a range of topics including
drug pricing, hospice care, telehealth, and more.

We are also pleased to announce the launch of Health Affairs Insider
,
a membership offering exclusive access to content beyond the journal.

Learn More

Costs

William Feldman and coauthors analyze how manufacturers limit generic
competition

through the use of patents and other exclusivities granted to inhalers
approved by the Food and Drug Administration.

Of the sixty-two inhalers for asthma and chronic obstructive pulmonary
disease that were approved during 1986-2020, only one contained an
active ingredient with a new mechanism of action, and more than half of
all patents were on the devices themselves, not the active ingredients.

In a companion Perspective, Scott Hemphill and Bhaven Sampat argue for
updating the system for competition between brand-name and generic drugs
,
with a focus on challenging invalid or irrelevant patents.

In another Perspective, Robin Feldman suggests that we consider the
social value of extending market protection

for minor modifications of existing innovations.

Care provided by nurse practitioners (NPs) and physician assistants
(PAs) can be billed to Medicare either directly or under the name of a
supervising physician-a practice referred to as indirect billing.
Using indirect billing obfuscates the amount of care delivered by these
providers.

Sadiq Patel and coauthors determine that the number of indirectly billed
visits by NPs and PAs

in fee-for-service Medicare grew from 10.9 million in 2010 to 30.6
million in 2018.

Two decades after implementation of tax-favored health savings accounts
(HSAs), Sherry Glied and coauthors conclude that HSAs no longer serve
their original purpose
.

With the growth in cost sharing in traditional insurance, HSAs provide a
tax benefit to higher-income people without increasing cost-conscious
behavior.

Read More

Care Delivery

Using nationally representative data from 2011-17, Krista Harrison and
coauthors determine that the proxies of hospice-enrolled people living
with dementia are more likely to rate last-month-of-life care as
excellent

compared with the proxies of people living with dementia who did not
enroll with hospice.

As the COVID-19 pandemic has revealed, nursing home residents are
particularly vulnerable to harm.

Michael Wasserman and Tamara Konetzka argue that effective responses to
pandemics or natural disasters

are rooted not only in providers' compliance with regulations but also
in broader system preparedness, which arises from stronger nursing home
administration, managerial accountability, and integration into
community disaster planning.

In October 2015 the Centers for Medicare and Medicaid Services launched
the Comprehensive End-Stage Renal Disease Care Model, the first
specialty-oriented accountable care organization (ACO) model designed to
serve a specific Medicare subpopulation.

Darin Ullman and coauthors find that, relative to a fee-for-service
Medicare comparison group and a traditional ACO group, beneficiaries
participating in the model had reduced Medicare payments
,
hospitalizations, and likelihood of hospital re-admission after one
year.

Buprenorphine is highly effective at preventing overdoses and treating
opioid use disorder.

Mark Meiselbach and coauthors report that in 2019, 50 percent of
Medicaid managed care enrollees in states with high overdose death rates

had access to fewer than 1.9 buprenorphine prescribers per 100,000
population, with variation across states.

Juan Andino and coauthors assess trends in interstate telehealth uptake
by Medicare beneficiaries

during 2017-20 in light of COVID-19-related
regulatory changes.

The volume of interstate telehealth use increased from about 17,000
services in the first quarter of 2020 to almost 100,000 services in the
fourth, but this mode of care delivery remained a relatively small share
of all outpatient and telehealth visits.

Read More

COVID-19

Riley Shearer and coauthors report that as of the end of 2021, people
incarcerated in Minnesota state prisons

had a COVID-19 vaccination completion rate of 70.9 percent compared with
64.0 percent of the general population and 33.7 percent among those
experiencing homelessness.

Those experiencing homelessness or incarceration were less likely to
have received booster shots than the general population.

Neil Sehgal and coauthors find that after factors such as age, access to
health care, and chronic disease burden are controlled for, counties in
which a majority of presidential votes cast were for the Republican
presidential candidate in 2020

experienced 72.9 additional COVID-19 deaths per 100,000 people relative
to majority Democratic counties.

The province of Ontario, Canada, closed its schools because of COVID-
19 on December 26, 2020.

Tiffany Fitzpatrick and coauthors find very low rates of additional
cases subsequent to gradual reopening

and conclude "that any increases in case growth after the reopening of
schools may be manageable with appropriate mitigation policies."

Read More

Order The Issue

Join Health Affairs Unlimited to access our current and past issues
.

Health Affairs Branded Post:
Improving Maternal And Newborn Health And Improving Health Equity With
Doula Care

Nicole Truhe

Sponsored by United Healthcare .

In case you missed it, we launched Health Affairs Insider
,
a membership offering exclusive access to content beyond the journal.

Health Affairs Insider is a membership community that includes exclusive
news from Health Affairs, entry to our growing portfolio of virtual
events, and curated email newsletters on priority health policy topics.

Use discount code HAInsider10 for $10 off your Health Affairs Insider
membership before June 15 to secure your access to Insider-only
exclusive events.

Join Insider

Attend These Events

This month, Health Affairs will host events
featuring Admiral
Rachel Levine, HHS Assistant Secretary for Health, Rabih Torbay,
president and CEO of Project HOPE, Sadiq Patel of Harvard University,
and Health Affairs' Don Metz.

Beginning this month, exclusive access to our virtual Lunch and Learn,
Professional Development, and Journal Club events will be limited to
Health Affairs Insider and Unlimited

members only.

Theme issue briefings, which are held alongside the launch of a monthly
issue on a dedicated topic, and Policy Spotlights will continue to be
free for all to attend.

June events include a Journal Club on June 16 featuring Sadiq Patel from
Harvard's Blavatnik Institute for Health Care Policy on indirect
billing
.

On June 21, Health Affairs Executive Editor Don Metz will lead a
Professional Development to discuss the journal's manuscript
submission and selection processes
.

On June 24, Admiral Rachel L. Levine, Assistant Secretary for Health at
the US Department of Health and Human Services, will join a free Policy
Spotlight event
.

Finally, there will be a free Professional Development event on June 28
featuring Rabih Torbay, president and CEO of Project HOPE
.

To become an Insider and attend all virtual events, visit our membership
page
.

View Full Event Schedule

Listen to These Podcasts

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A Health Podyssey goes beyond the pages of Health Affairs to tell
stories behind the research and share policy implications.

This month, upcoming guests will include Ateev Mehrotra, Krista
Harrison, and Sherry Glied to discuss topics such as hospice care
quality for older adults with dementia and the frequency of indirect
billing to Medicare.

On a recent episode, Christine Ritchie from Massachusetts General
Hospital and Harvard Medical School joins A Health Podyssey to discuss
what a reimagined health system designed around the needs of older
patients could look like and what it would take to get there.

Listen

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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
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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.

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