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The Commonwealth Fund Connection

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




July 22, 2022

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What Can Congress Do to Protect Coverage Gains Made During the Pandemic?
During the COVID-19 pandemic, millions of Americans gained health insurance in marketplace and Medicaid plans, thanks to protections included in the American Rescue Plan Act (ARPA) and other legislation. But those measures will most likely expire within months. Without action, this is certain to trigger coverage losses and spikes in premiums. On To the Point, the Commonwealth Fund’s Sara Collins discusses options for protecting coverage gains, like extending ARPA premium subsidies and making it easier for adults to maintain Medicaid eligibility.

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New International Study: U.S. Men Far More Likely to Die from Avoidable Causes
Compared to men in 10 other high-income countries, men in the United States are more likely to have serious health conditions, die from avoidable causes, and be dissatisfied with the health care system, according to a new Commonwealth Fund study. On nearly every health care measure studied, American men experiencing income insecurity fared the worst. These findings track with previous Commonwealth Fund research documenting poor health care access and outcomes for U.S. women of reproductive age.

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Older Black and Latinx Patients Say They Regularly Encounter Discrimination and Disrespect
An ideal health care system is one that respects people’s identities, health needs, and preferences — something the current system fails to do, according to older Black and Latinx Medicare beneficiaries participating in focus group research supported by the Commonwealth Fund. Focus group members varied in their health status and income level but recounted similar experiences with medical discrimination based on race and ethnicity as well as language, age, gender, and income.

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Innovating to Meet Youth Mental Health Needs
During the pandemic, rates of depression, anxiety, and other mental health problems skyrocketed among young Americans. Perhaps most distressing: nearly 20 percent of U.S. high school students surveyed in 2021 said they’d considered suicide during the prior 12 months. A new Transforming Care feature looks at ways to promote resilience and connect young people in crisis to mental health treatment and other clinical and social supports through innovative care models and new therapeutic tools.

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HHS Approves Colorado’s Public Option–Style Health Care Plan
The U.S. Department of Health and Human Services authorized Colorado to implement a public option–style health care plan that is expected to reduce premiums costs, increase enrollment in coverage, and decrease federal spending over time. Georgetown University’s Christine H. Monahan, Justin Giovannelli, and Kevin Lucia explain that the Colorado waiver marks the first time the federal government has approved a state action to introduce more heavily regulated plans in the Affordable Care Act’s marketplaces.

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Bolstering the Health Care Safety Net in a Post-Dobbs World
Experts predict that the Supreme Court’s decision overturning Roe v. Wade will have grave health impacts, including more pregnancy complications, more preterm births, and higher rates of infant and maternal mortality. These impacts will be felt most among lower-income families. George Washington University’s Sara Rosenbaum and colleagues outline several policies that could strengthen the health care safety net, including greater federal investments and expanding Medicaid coverage for 12 months postpartum.

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Hospitalized Medicare Patients Transferred to Home Health Care at Varying Rates During COVID-19
As the COVID-19 pandemic disrupted traditional health care patterns and overwhelmed health systems, hospitals freed up capacity by discharging patients to postacute care settings, including home health agencies. A new Commonwealth Fund report by Lane Koenig and colleagues examines home health use by Black beneficiaries, people dually eligible for Medicare and Medicaid, and those who are disabled, frail, or chronically ill. It describes how patterns in hospital transfer rates varied, and how the findings can influence policies to support access to high-quality, cost-effective postacute care.

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How to Improve Medicare’s Home Health Benefit
Many older adults and people with disabilities rely on Medicare’s home health benefit to access postacute care or help in managing their chronic conditions. The benefit covers skilled care as well as home health aide services. But it can be difficult to access and restrictions limit its potential to improve people’s health and well-being. On To the Point, health policy experts Barbara Lyons and Diane Rowland discuss insights from interviews with a diverse group of Medicare home health users to
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better understand their experiences and the challenges they face . In another post, Lyons, Rowland, and colleague Molly O’Malley Watts highlight
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lessons for Medicare from state Medicaid programs .
Unmet Social Needs Linked to Higher Hospital Use Among MA Beneficiaries
A study published in JAMA Health Forum found Medicare Advantage beneficiaries who reported having health-related social needs, such as food insecurity or unreliable transportation,
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also had higher rates of hospital use . Earlier this year, the Commonwealth Fund and Arnold Ventures asked more than 25 experts
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how the Medicare Advantage program could be strengthened , including whether quality measurement should be adjusted to account for the fact that some enrollees face more social and economic barriers in adhering to treatment recommendations.

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Are Big Medicare Advantage Plans Profiting by Gaming the Medical Loss Ratio?
As Medicare Advantage (MA) continues to attract more beneficiaries, it has become a source of significant earnings growth for several large insurers, including UnitedHealthcare and Humana. A new analysis from health economist Richard Frank and research analyst Conrad Milhaupt explains that some of these insurers can get around the rule limiting MA plan profit margins by making profits generated from their related businesses appear as costs.

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FDA Accelerated Approval: What It Is, How It Works, and Why It’s Under Scrutiny
A year ago, the U.S. Food and Drug Administration (FDA) approved the Alzheimer’s drug Aduhelm through the agency’s Accelerated Approval Program. But controversy surrounding Aduhelm’s extremely high cost, along with questions over its clinical benefit and health risks to patients, has placed the accelerated approval pathway under scrutiny. In our new explainer, we shine a light on the FDA’s program to reveal how the accelerated approval process works, key controversies and proposed reforms, issues around insurance coverage and reimbursement, and what lies ahead.

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How Wholesalers Affect Prescription Drug Availability and Cost
In the United States, most prescription drugs are distributed through wholesalers — companies that buy drugs from manufacturers and then distribute them to pharmacies and health care providers. How do these intermediaries affect the affordability and availability of medications? In a new Commonwealth Fund issue brief, health policy analyst Elizabeth Seeley finds that the wholesaler industry has important but often unheeded effects on pharmaceutical markets, influencing the prices as well as the availability of drugs.

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The Dose Podcast Encore: One Health System Fights Climate Change
The Dose podcast is taking a short break this summer to plan for the season ahead. While we’re away, we’re revisiting some of the most-listened-to episodes. Tune in to host Shanoor Seervai’s
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conversation with Nick Watts, Chief Sustainability Officer of the U.K.’s National Health Service. Watts talks about what health systems can do to combat climate change — from switching to medications that have a smaller carbon footprint to using electric and hybrid vehicles. If there’s a health care topic you want to learn more about, or an expert you think we should feature on the podcast, please send us an email at
mailto:[email protected]
[email protected] .





Affordable, quality health care. For everyone.

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