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The Commonwealth Fund Connection

A roundup of recent Fund publications, charts, multimedia, and other timely content.




June 10, 2022

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A Strong Public Health System Depends on Making the Invisible Visible
Success in public health is often invisible — we don’t notice problems until the system breaks down during a crisis. While the U.S. public health system has taken a drubbing from COVID-19, the pandemic also has driven home just how critical it is to invest in this key component of national infrastructure. On The Dose podcast, Dave Chokshi, M.D., who led New York’s pandemic response as the city’s health commissioner, talks about how we can apply the lessons of the past two years in rebuilding the U.S. public health system.

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New York City Bridges Public Health and Health Care to Advance Equity
A major challenge for municipal health departments everywhere is how to build bridges between the worlds of public health and health care so we are better prepared for emergencies as well as able to tackle longstanding health inequities. To meet the challenge, New York City’s Department of Health and Mental Hygiene in 2021 established its new Office of the Chief Medical Officer, led by Michelle Morse, M.D. New York has created a plan for partnering with the city’s hospitals to institute two-way communication, prioritize health equity, build accountability, and promote antiracism in health care. Writing on To the Point, Morse and colleague Adriana Joseph explain the plan and what it aims to accomplish.

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How Can Health Insurance Marketplaces Improve Collection of Race and Ethnicity Data?
Without accurate data on patients’ race and ethnicity, efforts to make health care more equitable can achieve only limited success. Information on race and ethnicity is missing for a quarter or more of people who signed up for a health plan during the 2022 open enrollment period for Affordable Care Act coverage. Georgetown University’s Dania Palanker and colleagues explore how state-based insurance marketplaces can improve data collection by making changes to their application processes and by working with insurers to fill gaps.

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Racism in Health Care “Matters Profoundly” to Black and Latino Patients
As many as 55 percent of Black patients and 35 percent of Hispanic/Latino patients in the United States say they’ve experienced racism in a health care setting, according to a new study in the journal Healthcare. The analysis, coauthored by the Commonwealth Fund’s Laurie Zephyrin, M.D., and colleagues from Harvard University, also finds that patients who’ve experienced racism tend to have worse views of the quality of care they’ve received and lower trust in their doctors. Health professionals, health care organizations, and payers, the authors say, need to “hold themselves accountable for understanding how racism manifests within their institutions” and examine the policies and procedures that perpetuate it.

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Public Good Versus Private Gain in Drug Innovation and Pricing
Policymakers have long debated whether the federal government’s “march in” authority to take patent licenses for themselves, or grant them to competitors, can or should be used to address the high cost of prescription drugs. Since 1980, federal agencies like the National Institutes of Health (NIH) have had a right to do just that in cases where they had funded a drug’s development and a specific health or safety concern was not being met. Recently, a group of cancer patients petitioned the NIH to exercise its march-in rights over concerns about the high price of the prostate cancer treatment Xtandi. Bobby Clark and Jeff Callis dive deeper into the debate around Xtandi and broader issues around march-in rights.

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Will the Supreme Court Deprive Protection to Millions of Federal Program Beneficiaries?
Under civil rights law, people enrolled in Medicaid, nutrition, housing, and other programs are protected if public officials threaten to unlawfully deny or terminate their benefits. A pending Supreme Court decision, however, could change that. Read why health law experts Timothy S. Jost and Sara Rosenbaum believe the outcome of the case, Health and Hospital Corp. v. Talevski, could have an impact that is “breathtaking, resulting in the disentitlement of tens of millions of children and adults, disproportionately poor and people of color.”

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Making Value-Based Payment Work for Health Centers
A
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recent commentary in the Journal of the American Medical Association argues that a key to advancing health equity in the U.S. is enabling federally qualified health centers to participate in — and profit from — value-based payment approaches. In the January issue of
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Transforming Care , the Commonwealth Fund’s Martha Hostetter and Sarah Klein reported on the experiences of health centers that have been early adopters of value-based contracts.





Affordable, quality health care. For everyone.

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