Health Affairs This Week

President Joe Biden's administration this week published a notice of proposed rulemaking to amend the "family glitch" in the Affordable Care Act. In essence, the rule would revise the eligibility for premium tax credits for families. It's a wonky but important policy measure. In today's episode of Health Affairs This Week, Health Affairs' Leslie Erdelack and Georgetown University's Katie Keith break down the proposed rule, what the "family glitch" is, how the Biden administration seeks to amend it, and what impact that may have on families including access to affordable care.Sign up for Katie Keith's Health Reform newsletter.Related Links:New Biden Executive Order Aims To Build On Coverage Gains (Health Affairs Forefront)Biden Administration Proposes To Fix The Family Glitch (Health Affairs Forefront)President Biden Moves To Fix a 'Glitch' in the Affordable Care Act (TIME)Health Policy Brief on The Family Glitch (Health Affairs)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast

A new ahead-of-print from Health Affairs features the Centers for Medicare and Medicaid Services (CMS) annual projections of national health expenditures. John Poisal and colleagues estimate national health spending growth will moderate from 9.7 percent in 2020 to 4.2 percent in 2021 as COVID-19 impacts wane.Listen to Health Affairs' Ellen Bayer and Chris Fleming dissect the latest national health spending projections on today's Health Affairs This Week.Pre-order the April 2022 issue where the CMS report will be published in the Health Affairs journal.Related Links:National Health Expenditure Projections, 2021–30: Growth To Moderate As COVID-19 Impacts Wane (Health Affairs)National Health Expenditures Post COVID: Hints Of A New Normal? (Health Affairs Forefront)National Health Expenditure Projections And A Few Ways We Might Avoid Our Fate (Health Affairs Forefront)National Health Care Spending In 2020: Growth Driven By Federal Spending In Response To The COVID-19 Pandemic (Health Affairs)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast

This month, three US credit reporting agencies - Equifax, Experian and TransUnion - announced changes to medical collection debt reporting, which will remove nearly 70% of medical collection debt tradelines from consumer credit reports.As financial security is a major social determinant of health, Health Affairs' Leslie Erdelack and Chris Fleming join Health Affairs This Week to discuss medical debt changes and their potential impact of the changes on health.Related Links:No Surprises Act: Known Impacts on Surprise Medical Bills & What's Next (Health Affairs This Week)Medical Debt Burden In The United States (Consumer Financial Protection Bureau)Charity Care Needs To Be Better Than This (Health Affairs)The Burden of Medical Debt in the United States (Peterson-KFF Health System Tracker)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast

Late last month, the White House called out private equity firms in a fact sheet on the safety and quality of nursing homes."Private equity firms have been buying up struggling nursing homes, and research shows that private equity-owned nursing homes tend to have significantly worse outcomes for residents," the fact sheet reads, adding that "Private equity firms’ investment in nursing homes has ballooned from $5 billion in 2000 to more than $100 billion in 2018, with about 5% of all nursing homes now owned by private equity firms." Listen to Health Affairs' Kathleen Haddad and Rob Lott discuss the role of private equity in health care service lines.Related Links:FACT SHEET: Protecting Seniors by Improving Safety and Quality of Care in the Nation’s Nursing Homes (White House)Private Equity Investments In Health Care: An Overview Of Hospital And Health System Leveraged Buyouts, 2003–17 (Health Affairs)Hospital Service Offerings Still Differ Substantially By Ownership Type (Health Affairs)Private Equity Acquisition And Responsiveness To Service-Line Profitability At Short-Term Acute Care Hospitals (Health Affairs)Podcast: Jill Horwitz Questions the Role of Nonprofit Hospitals (A Health Podyssey)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast

Late last month, the Centers for Medicare & Medicaid Services (CMS) announced its redesign of its Global and Professional Direct Contracting Model to its now-branded Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health (REACH) Model. The agency stated the redesign is meant to advance health equity and was in response to stakeholder feedback and participant experience.On today's episode of Health Affairs This Week, Harvard Medical School's Michael Chernew joins Health Affairs Forefront Editor Chris Fleming to talk about the new CMS model for ACOs, and where Medicare Advantage could improve.Related Links:Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health (REACH) Model (CMS)The Case For ACOs: Why Payment Reform Remains Necessary (Health Affairs Forefront)Podcast: Michael Chernew Makes The Case for Payment Reform (Health Affairs This Week)Medicare Advantage, Direct Contracting, And The Medicare 'Money Machine,' Part 2: Building On The ACO Model (Health Affairs Forefront)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast

Listen to Health Affairs' Leslie Erdelack and Rob Lott outline President Joe Biden's health care aspirations outlined in his State of the Union Address, which includes information on COVID-19, health care costs, nursing homes, opioid epidemic, the cancer moonshot, and mental health.Related Links:President Biden's State of the Union Address (White House)Fact Sheet: President Biden to Announce Strategy To Address Our National Mental Health Crisis, As Part of Unity Agenda in his First State of the Union (White House)Fact Sheet: Addressing Addiction and the Overdose Epidemic (White House)Fact Sheet: Protecting Seniors and People with Disabilities by Improving Safety and Quality of Care in the Nation's Nursing Homes (White House)The Speech That Mentioned It All (Politico Pulse)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast

Listen to Health Affairs' Ellen Bayer and Rob Lott discuss possible implications for health policies related to Medicaid and telehealth when the COVID-19 public health emergency sunsets.Related Links:Is It Fair? How To Approach Professional Scope-Of-Practice Policy After The COVID-19 Pandemic (Health Affairs Forefront)Medicare Beneficiaries' Use of Telehealth in 2020: Trends By Beneficiary Characteristics and Location (ASPE)Opinion: In This Next Phase of the Pandemic, Beware of the Extremes (The Washington Post)2/15/22: Extending the Public Health Emergency Remains Complicated (Politico Pulse)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast

Last week, the Kaiser Family Foundation released a report showing that outpatient telehealth use has decreased after an initial spike in use during the COVID-19 pandemic's early months. This week, a new Stat News report examines whether telehealth services actually lowers health care costs and spending.It's known that telehealth use was low before the COVID-19 pandemic. Historically, it has been challenging to scale and integrate telemedicine and virtual care models within the broader health care system. Dr. Thomas Lee, founder and CEO of Galileo Health, joins Health Affairs This Week host Leslie Erdelack to discuss the state of telehealth, access to care, and health equity. Before starting Galileo, Dr. Lee founded One Medical, a primary care company. Related Links:Outpatient telehealth use soared early in the COVID-19 pandemic but has since receded (Kaiser Family Foundation)What we know - and still don't know - about whether telehealth can cut costs (Stat News)Variation In Telemedicine Use and Outpatient Care During the COVID-19 Pandemic in the United States (Health Affairs)Seizing The Moment For Telehealth Policy and Equity (Health Affairs Forefront)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast

“Racism is an uncomfortable subject for a lot of people in academia and academic publishing itself is part of the problem, in that a lot of journals including Health Affairs have neglected to name racism and publish research about how racism harms health.” - Leslie Erdelack. In February, Health Affairs published a theme issue dedicated to racism and health. Understanding and addressing the impact of racism, particularly structural racism, on health is essential to building equity in health. As Health Affairs Editor-in-Chief Alan Weil wrote on Health Affairs Forefront in June 2020, the legacy of racism “is baked into our institutions, our thinking, and our policies.” Racism must be explored as a key driver of health outcomes and health disparities.  In today's episode, Health Affairs' Jessica Bylander and Leslie Erdelack discuss the publication process, main findings, and research insights from the Health Affairs February 2022 theme issue on racism and health.Health Affairs thanks Rachel Hardeman of the University of Minnesota and José Figueroa of Harvard University, who served as theme issue advisers. Health Affairs also thanks the Robert Wood Johnson Foundation, the California Wellness Foundation, the Episcopal Health Foundation, the New York State Health Foundation, and the W.K. Kellogg Foundation for their generous support of this issue.Order the February 2022 Health Affairs Racism and Health theme issue.Related Links:Health Affairs Racism and Health Theme IssueHealth Affairs' Interview with Harriet Washington, author of Medical Apartheid Systemic and Structural Racism: Definitions, Examples, Health Damages, And Approaches To Dismantling (Health Affairs)Sick And Tired Of Being Excluded: Structural Racism In Disenfranchisement As A Threat To Population Health Equity (Health Affairs)The Mutually Reinforcing Cycle Of Poor Data Quality And Racialized Stereotypes That Shapes Asian American Health (Health Affairs)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast

This week, a major development in health care reform occurred in California.Listen to Health Affairs' Leslie Erdelack and Rob Lott talk about the headlines in health policy news (including President Joe Biden's revived Cancer Moonshot initiative) and the latest in California's fight for single-payer health insurance where they ask, as California goes, so goes the country?Related Links:Single-Payer Healthcare Proposal Fizzles in California Assembly (Los Angeles Times)California Theme Issue - September 2018 (Health Affairs)What We Talk About When We Talk About Single Payer (Health Affairs Forefront)Could States Do Single-Payer Health Care? (Health Affairs Forefront)Single Payer Or Not: Matching Problems With Solutions (Health Affairs Forefront)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast