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The Connection

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




January 13, 2023

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Medicare Private Plan Enrollment Is Skyrocketing.
So Are the Ads.
As more and more Medicare beneficiaries enroll in private plans, marketing for them has caused confusion for some consumers. A new explainer from the Commonwealth Fund details the rules governing how insurers can sell their plans, how marketing and sales tactics impact beneficiaries, and what efforts are being made to ensure beneficiaries get the information they need.

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Health Equity and Medicaid Managed Care Contracts
Managed care contracts can be a valuable tool for state Medicaid programs looking to promote racial equity, write Shilpa Patel of the Center for Health Care Strategies and the Commonwealth Fund’s Laurie Zephyrin, M.D. States can use provisions in these contracts to require plans to collect, classify, and report data by race and ethnicity and design interventions to address structural racism.

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FEATURED CHART




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Millions Could Lose Access to Free Preventive Care

Last year, a federal court judge in Texas threw into jeopardy a popular Affordable Care Act provision that guarantees millions of people access to preventive health care without copayments or other cost sharing. On To the Point, Commonwealth Fund experts explain why getting timely preventive care is so important — and what might be lost if the Texas decision is upheld by the Supreme Court.

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Webinar: The Year Ahead in Health Policy

What do 2023 and the 118th Congress hold for health policy? Join the Commonwealth Fund and leading policy experts on Wednesday, January 18, at 12:00 p.m. EST for a virtual discussion on the major policy milestones of 2022, their implications for the year ahead, and other health-related issues to watch.

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REGISTER HERE

Supporting U.S. Women’s Health as Some States Limit Abortion

Restrictive abortion policies in the U.S. are limiting access to reproductive care and threatening to compound existing racial, ethnic, and socioeconomic health inequities. A research team at the Commonwealth Fund describes how reproductive health care in the U.S. compares with other high-income countries to draw lessons for how U.S. policymakers could work to improve women’s health.

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Updating Essential Health Benefits to Meet New Challenges

The Biden administration is taking steps to update the essential health benefit (EHB) requirements under the Affordable Care Act, starting with a request for public comment. Health law expert Timothy Jost explains how the EHB helps ensure comprehensiveness of health care coverage and why the request for information is significant.

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New Waiver Policies for State Medicaid Programs

Through new Medicaid demonstration waivers, the Centers for Medicare and Medicaid Services has established a framework that “enables states to . . . address health disparities and focus on underserved populations,” write Cindy Mann and Mindy Lipson on To the Point. The authors investigate the new waiver policies, which that they say impose “guardrails” to prevent new investments from crowding out basic Medicaid coverage.

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Q&A: Expanding Access to Behavioral Health Care

Demand for behavioral health services is high. In a new Transforming Care Q&A, Rocky Mountain Health Plans CEO Patrick Gordon talks about how his organization, through its broader efforts to strengthen primary care, expanded access for Medicaid beneficiaries by paying primary care providers substantially more to hire behavioral health staff and offer routine screenings and brief interventions.

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Personal Care Aides: Gap Between Supply and Need

Researchers recently found that states in the south and southeast U.S. have the
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highest percentage of adults with disabilities who need help with daily activities and the lowest numbers of personal care aides per 1,000 residents. They recommend several strategies for building the supply of personal care aides and other direct care workers. A recent Transforming Care issue describes employers and states that are
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recognizing and rewarding direct care workers by creating pathways for promotions and giving them a greater say in management.

Evolving Requirements for State Telemedicine Coverage

The COVID-19 pandemic compelled states to act quickly to encourage greater use of telehealth; since then, many have worked to adopt more permanent changes. JoAnn Volk, from Georgetown University’s Center on Health Insurance Reforms, and colleagues reviewed legislation and regulation enacted since March 2021, including coverage of audio-only telephone visits and adopting protections to preserve patients’ access to providers.

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Where Is Medicare Hospital Spending Most Concentrated?

In many parts of the United States, just two or three hospital systems account for most Medicare inpatient spending. This has critical implications for beneficiaries. On To the Point, experts from the Commonwealth Fund and CareJourney show where in the nation Medicare inpatient spending is most and least concentrated, and which policy solutions could help avoid the negative outcomes associated with hospital concentration.

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The Right Way to Update Medicare’s Physician Fee Schedule

Medicare’s physician fee schedule is a highly influential, yet flawed, tool used by public and private insurers alike to set payment rates. The Urban Institute’s Robert Berenson and Adele Shartzer recommend updates to the schedule to more accurately reflect the time and resources providers need to deliver patient care, as well as to encourage the provision of high-value services that are currently underreimbursed, such as primary care.

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Bolstering Health Systems for the Climate Crisis

On the other side of the world, the Pacific islands are taking a comprehensive approach to adapting their health systems to climate change. As the Commonwealth Fund’s Evan Gumas reports in our International Insights newsletter, the U.S. can learn from our neighbors on the front lines of the climate crisis.

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Affordable, quality health care. For everyone.

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