Preview

MATERNAL & CHILD HEALTH

Out-Of-Pocket Spending For Maternity Care Among Women With Employer-Based Insurance, 2008–15
By Michelle H. Moniz, A. Mark Fendrick, Giselle E. Kolenic, Anca Tilea, Lindsay K. Admon, and Vanessa K. Dalton

While maternity care is a required benefit under the ACA, women with employer-based insurance still face deductibles and copayments when obtaining care. Michelle Moniz and coauthors find that between 2008 and 2015, mean out-of-pocket spending for maternity care for these women increased from $3,069 to $4,569, driven mostly by increases in deductibles. Read More >>

PAYMENT

Differences Between Public And Private Hospital Payment Rates Narrowed, 2012–16
By Thomas M. Selden

In an earlier study Tom Selden and coauthors used data from the Medical Expenditure Panel Survey (MEPS) to show that the average difference in payment rates for inpatient hospital stays between private insurance and Medicare grew from under 10 percent in 2000 to about 75 percent in 2012. This DataWatch updates those results through 2016, revealing a slowing in and even a reversal of the divergence between private and public (Medicare and Medicaid) payment rates. Read More >>

AFFORDABLE CARE ACT

Terminating Cost-Sharing Reduction Subsidy Payments: The Impact Of Marketplace Zero-Dollar Premium Plans On Enrollment
By Coleman Drake and David M. Anderson

The termination of cost-sharing reduction subsidy payments to insurers in 2017 resulted in a proliferation of Marketplace plans having zero-dollar premiums in 2018 and 2019. In this study Coleman Drake and David Anderson examined whether a zero-price effect exists in potential enrollees’ decisions to become insured in the Marketplaces. Read More >>

HEALTH REFORM

Medicare For All: An Analysis Of Key Policy Issues
By Micah Johnson, Sanjay Kishore, and Donald M. Berwick

Micah Johnson and coauthors identify key policy design issues for a Medicare for All system: comprehensiveness of coverage, the private sector’s role, the payment approach, and financing. Read More >>

Challenges To Medicare For All Remain Daunting
By Austin B. Frakt and Jonathan Oberlander

Medicare for All will not become viable unless it can meet the daunting political, economic, and administrative realities that govern US health care. Austin Frakt and Jonathan Oberlander explore several key issues. Read More >>

MEDICAID

Medicaid Expansion Slowed Rates Of Health Decline For Low-Income Adults In Southern States
By John A. Graves, Laura A. Hatfield, William Blot, Nancy L. Keating, and J. Michael McWilliams

John Graves and coauthors draw upon survey data collected from health center patients in southern states to compare outcomes in four states that expanded Medicaid with those in eight states that did not. Read More >>

THIS WEEK ON THE BLOG

FOLLOWING THE ACA

Will The Supreme Court Take Up The Contraceptive Mandate (Again)?
By Katie Keith (1/7/20)

We may learn the Supreme Court’s decision on January 13, 2020. This is because Pennsylvania has been scheduled for the Court’s conference on January 10. If the Court accepts the appeal, it could affirm or reverse the Third Circuit’s decision. If not, the case would be over, and the Third Circuit’s decision would be allowed to stand. The Trump-era rules on the contraceptive mandate would be permanently vacated and unenforceable.
Read More >>

Democratic AGs, House Ask Supreme Court For Expedited Review Of Texas
By Katie Keith (1/6/20)

Expedited review and a resolution of the case in 2020 is necessary, the House and Democratic attorneys general maintain, to address the uncertainty that Texas creates about the future of the ACA and the potential for devastating consequences for the health care system if a lower court decision is upheld. Read More >>

ACCOUNTABLE CARE

Number Of ACOs Taking Downside Risk Doubles Under ‘Pathways To Success’
By Seema Verma (1/10/20)

Our redesign of the Medicare Shared Savings Program, “Pathways to Success,” puts accountable care organizations (ACOs) on a quicker path to taking on real risk, with accountability for spending increases generally required after two years for new ACOs, while closely monitoring the quality of care provided. Read More >>

How Are ACOs Prioritizing Palliative Care And Other Serious Illness Strategies?
By Rachel Roiland, William K. Bleser, David Muhlestein, Robert S. Saunders (1/7/20)

Given their breadth and their incentives for care coordination, accountable care organizations could be a powerful vehicle for improving palliative and serious illness care. Read More >>

PHARMACEUTICALS AND MEDICAL INNOVATION

Prescription Drug Policy: The Year in Review, And the Year Ahead
By Rachel Sachs (1/6/20)

This past year, prescription drug policy issues remained at the forefront of the national health policy conversation. In this post, I review five of the biggest prescription drug policy developments of 2019 (and revisit my predictions from my January 3, 2019, post) and offer five issues to watch for in 2020. Read More >>

LEGAL AND REGULATORY ISSUES

The New State Medical Board: Life In The Antitrust Shadow
By Eli Y. Adashi, Barak D. Richman, and Reuben C. Baker (1/6/20)

The new State Medical Board could be one that abandons its role as an ossified gatekeeper and crafts a visionary role for expanding consumer welfare and professional dynamism. Read More >>

MEDICARE

Will Medicare For All Get Us To Value?
By David Lansky (1/10/20)

Let’s begin the debate on how we want our health care system to look, what we hold it accountable for, and the value we place on improved health outcomes and affordability versus industry and professional economic interests. Read More >>

SYSTEMS OF CARE

Moving To A Learning Measurement System
By Somava Stout, Christine Petrin, and Karen DeSalvo (1/8/20)

We need a national measurement system that can bridge sectors to advance health, well-being, and equity. Read More >>

PAYMENT

Patient Influencers, Paid By Pharmaceutical Companies, Should Be Required To Disclose Industry Ties
By Judy Butler and Adriane Fugh-Berman (1/10/20)

Transparency is a minimum standard for assessing whose views should carry most weight in public health debates. Read More >>

MEDICAID

Proposed Rules On Medicaid Financing Miss Mark And Threaten Access
By Cindy Mann and Anne O'Hagen Karl (1/8/20)

If finalized, the rules would have a profound impact on state financing and payment policies that, in turn, could dramatically reduce beneficiary access to care. Read More >>

ACCESS TO CARE

Resolving Wait Times With Cross-Specialty Collaboration
By Benjamin F. Chong (1/9/20)

Dermatology intersects with many other specialties because the skin is the body’s largest organ and can serve as a window into internal conditions. Read More >>

MATERNAL & CHILD HEALTH

The Next Steps To Advance Maternal And Child Health In Medicaid: Filling Gaps In Postpartum Coverage And Newborn Enrollment
By Kay Johnson, Sara Rosenbaum, and Morgan Handley (1/9/20)

Medicaid policy changes at the federal level and action by states to support maternal and infant health could make a tremendous difference in the lives of half of all infants and their mothers throughout the nation. Read More >>

COSTS & SPENDING

Disappointing Randomized Controlled Trial Results Show A Way Forward On Complex Care In Camden And Beyond
By Kathleen Noonan (1/9/20)

Like medicine itself, the work of caring for our nation’s most vulnerable people is neither simple to do nor easy to measure. Read More >>

QUALITY OF CARE

What Is The Status Of Research On Low-Value Care?
By Elizabeth L. Cope and Paul Armstrong (1/8/20)

Using the HSRProj database (which includes projects funded by federal and private grants and contracts), researchers at AcademyHealth looked at recent trends in health services research on low-value care (LVC). The authors explain that LVC can include "overuse, underuse, inappropriate use, and unnecessary care." They found that LVC research increased between 2014 and 2017. They also learned which study topics were popular during their search period (January 1, 2014–March 31, 2019). Read More >>

HEALTH AFFAIRS BRANDED POST

The Value Of Medicare Advantage: Understanding What's At Stake
By Allyson Y. Schwartz (1/7/20)
Supported by the Better Medicare Alliance

Like the election before it, the 2020 presidential election is already proving to be a referendum on health care—and the stakes for consumers couldn’t be higher. 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.

Copyright © Project HOPE: The People-to-People Health Foundation, Inc.
Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, United States

Privacy Policy

To unsubscribe from this email, click here. I