Health Affairs This Week

Subscribe to UnitedHealthcare's Community & State newsletter.Last week, the Biden administration issued an interim final rule to implement critical components of the No Surprises Act (NSA).Building on the Affordable Care Act, the NSA includes new patient protections against surprise medical bills. About one in five insured adults had an unexpected medical bill from an out-of-network provider, according to a 2020 Kaiser Family Foundation survey. A study released this week found that about one in five newborn hospitalizations or childbirth deliveries result in receiving a surprise medical bill. These surprise medical bills can cause financial stress to patients and their families.Listen to Health Affairs' Senior Editors Leslie Erdelack and Chris Fleming break down the interim final rule, how it will impact surprise medical bills or "balance billing," and what we can expect regarding what's next.Check out the July issue on Borders, Immigrants & Health. Register for the July 12 Event on Border Health.Related Links:Banning Surprise Bills: Biden Administration Issues First Rule on No Surprises Act (Health Affairs Blog)Unpacking The No Surprises Act: An Opportunity To Protect Millions (Health Affairs Blog)Emergency Physicians Recover A Higher Share Of Charges From Out-Of-Network Care Than From In-Network Care (Health Affairs)Timing Out-of-Pocket Spending In Health Care Is Challenging (A Health Podyssey)Surprise Billing Protections Are One Step Closer To Becoming Reality (The Washington Post)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.President Joe Biden has been making negotiations to get his massive infrastructure plan over the finish line. Some funding related to health care that was originally in the plan ended up on the cutting room floor.In particular, $400 billion in federal Medicaid funding for home and community-based long term care services were removed from the plan. The earmarked funds for Medicaid still could be passed through a budget reconciliation act but that remains to be seen. This has implications for the health and well-being of many Americans including low-income individuals 65 and older, people with disabilities, and home-based care workers. Listen to Health Affairs' Senior Editors Ellen Bayer and Jessica Bylander go beyond recent headlines on President Biden's infrastructure plan and discuss important provisions to improve home-based care.Order your copy of the July 2021 issue of Health Affairs.Related Links:Biden's Pledge To Boost Home Caregiver Funding Excluded From Infrastructure Deal (CNBC)Making Care Work Pay: How A Living Wage For LTSS Workers Benefits All (Health Affairs Blog)Home And Community-Based Workforce For Patients With Serious Illness Requires Support To Meet Growing Needs (Health Affairs)Modernizing Long-Term Services And Supports And Valuing The Caregiver Workforce (Health Affairs Blog)Direct Care Workers In The United States: Key Facts (PHI)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Tech giants like Apple and Alphabet, the parent company of Google, have been trying to push into health care for some time now. But pursuing health care as a business is hard. Recent news of Google reorganizing its health team and Apple struggling to create primary care services illuminate how difficult it can be for companies - even those with deep pockets and resources - to break into the health care industry.To discuss the recent Apple news as well as the maturity of the digital health industry, Health Affairs' Jeff Byers welcomes Brian Dolan, founder of digital health news and market research publication Exits & Outcomes, to Health Affairs This Week. Dolan is a veteran journalist in the health tech space and shares his insights from his reporting on Crossover Health's partnership with Apple.Related Links:Apple Struggles In Push To Make Healthcare Its Greatest Legacy (The Wall Street Journal)The Crossover Health Report (Exits & Outcomes)Apple Explored Buying A Medical-Clinic Start-Up As Part Of A Bigger Push Into Health Care (CNBC)Google Is Downsizing Its Health Team And Moving Employees To Fitbit As Part Of A Major Reorganization (Insider)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.June is shaping to be a busy month in the health policy space. Two major events happened this week alone.First, the Affordable Care Act (ACA) survived its latest legal challenge in the Supreme Court. After facing many court challenges, the 2010 policy is still the law of the land.Also, the Medicare Payment Advisory Commission (MedPAC) sent a report to Congress on Tuesday making many recommendations to revamp Medicare payments. It's recommendations are not binding but the group is influential in the health policy community. In the report, the advisory group called for streamlining alternative payment models (APMs) and changing how Medicare Advantage benchmarks are calculated.On this episode of Health Affairs This Week, Senior Editors Leslie Erdelack and Jessica Bylander discuss the recent Supreme Court decision and try and demystify what MedPAC is and highlight some of the agency's recommendations from the recent report. Related Links:MedPAC June 2021 ReportAffordable Care Act Survives Latest Supreme Court Challenge (The New York Times)LIVE with Liz Fowler, Director Of The Center for Medicare & Medicaid Innovation (A Health Podyssey)Private Equity Investments In Health Care: An Overview Of Hospital And Health System Leveraged Buyouts, 2003-17 (Health Affairs)Understanding Private Equity Investment In Hospitals (A Health Podyssey)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.This week, the US Food and Drug Administration approved Aduhelm (aducanumab) to treat patients with Alzheimer's disease using an accelerated approval pathway.The drug was approved on June 7, 2021, and the decision was quick to spark controversy. At least two members of a panel of outside advisors to the FDA from Mayo Clinic and Washington University resigned in protest over the drug's approval.Clinical trials for the drug, which is manufactured by Biogen, showed a reduction in amyloid beta plaques. According to the FDA, that is "a hallmark finding in the brain of patients with Alzheimer's" and "is expected to lead to a reduction in the clinical decline of this...form of dementia."But there remain concerns about the drug's side effects in addition to its price tag.Health Affairs' Senior Editor Leslie Erdelack joins Deputy Editor for Special Content Rob Lott on this episode of Health Affairs This Week to discuss the approval and review outstanding questions, drug pricing, and whether pharmaceutical companies might look to old data for new drug approvals.  Related Links:The FDA's Approval of Aduhelm: Potential Implications Across A Wide Range Of Health Policy Issues and Stakeholders (Health Affairs Blog)Limiting Coverage Based On Efficacy And Safety: A Path For Medicare Regarding The Alzheimer's Treatment Aducanumab (Health Affairs Blog)The Search For Effective Alzheimer's Therapies: A Work In Progress (Health Affairs)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.President Joe Biden included the public health insurance option, commonly referred to as the "public option," as a major pillar of his health care platform during the 2020 presidential campaign.To date, the public option hasn't been included in the discourse for the Biden administration. Instead the administration has focused on supporting the Affordable Care Act, among other agenda items.Now states are leading the charge and considering the adoption of public option policies. Nevada's Governor stated earlier this month that they would sign a public option bill while Colorado is also considering a public option. Washington adopted similar legislation in 2019.On today's episode, Georgetown University's Katie Keith joins Health Affairs Blog Editor Chris Fleming to discuss the latest on how states are leading the way on the public option. In addition, Katie shares her insights on where the major Affordable Care Act case - California v. Texas - currently stands in the Supreme Court. Related Links:The Origins And Demise Of The Public Option (Health Affairs)Hill Democrats Ask For Input On Public Option As CO, NV Consider Adoption (Health Affairs Blog)Letter from Frank Pallone, Jr. and Patty Murray on Public Health Insurance Option (May 26, 2021)Sisolak Pledges To Sign Public Option Health Care Bill (Las Vegas Review-Journal)Public Option(al): What Happened To Biden's Big Idea? (Tradeoffs)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Last week, Representative Katie Porter took AbbVie CEO Richard Gonzalez to task on drug pricing during a House Oversight and Reform Committee hearing. Porter highlighted the CEO's high salary while pointing to increases in drug prices in the pharmaceutical industry.The narrative casts pharmaceutical companies as villains but it's more complicated than that. It's true that pharmaceutical companies provide life-saving medicines and it's also true that some drugs simply aren't affordable for individuals that would benefit from them. On this episode of Health Affairs This Week, Senior Editor Jessica Bylander joins Deputy Editor Rob Lott to discuss the inherent tensions in drug innovation and pricing. Related Links:Beyond The High Prices Of Prescription Drugs: A Framework To Assess Costs, Resource Allocation, And Public Funding (Health Affairs)New Players Join The Drug Development Game (Health Affairs)Lawmakers Pitch A Bill To Create $30 Billion In 'Biobonds' To Jumpstart Drug Development (Stat News)Drug Pricing Conversations Must Take The Cost Of Innovation Into Consideration (Stat News)Nonprofits, Federal Government Surpass Pharma To Lead Alzheimer's Drug Development (Medical Xpress)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Last week, the CDC updated its guidance on mask-wearing in public for individuals that are fully vaccinated against COVID-19. The agency stated, "if you are fully vaccinated, you can resume activities that you did prior to the pandemic." That means fully vaccinated individuals can wear masks indoors or outdoors if they choose to.Unsurprisingly, this guidance was met with controversy. Some critics felt the guidelines were too abrupt while others questioned if the guidelines hold up principles of health equity. On today's episode of Health Affairs This Week, Health Affairs' Blog Editor Chris Fleming and Director of Equity Vabren Watts review the CDC guidelines and discuss the criticism and remaining questions surrounding the agency's decision.Related Links:When You've Been Fully Vaccinated (CDC)Fauci Says Public Is 'Misinterpreting' Latest CDC Mask Guidance (CNBC)The CDC's Mask Guidance Is A Mess. Biden Needs To Clean It Up (Washington Post)Community Use Of face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US (Health Affairs)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.The COVID-19 pandemic reshaped the telehealth landscape. Many physicians and patients had their first experience with a telehealth visit as lockdown measures limited in-person physician offices. Many questions remain whether the telehealth explosion is a flash-in-the-pan success or if it will have long-lasting changes in patient visit behaviors. Health Affairs' Chris Fleming and Rob Lott join Health Affairs This Week to discuss a recently published series of blog articles on the topic and unpack the biggest questions regarding the future of telehealth, including: Should Medicare continue payment parity?Where does payment reform stand on telehealth?What are current barriers affecting implementation of telehealth? Related Links:The Coming Conflict Over Tele-Visits: The Need For Innovation In Payment And Information Sharing (Health Affairs Blog)Understanding The Case For Telehealth Payment Parity (Health Affairs Blog)Congress: Act Now To Ensure Telehealth Access For Medicare Benefits (Health Affairs Blog)Mutual Recognition Of Physician Licensure By States Would Provide For Better Patient Care (Health Affairs Blog)How Telehealth Can Enable New Care Management Strategies In Alternative Payment Models (Health Affairs Blog)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast Subscribe to UnitedHealthcare's Community & State newsletter.

Subscribe to UnitedHealthcare's Community & State newsletter.Last month, the Biden administration unveiled the $1.8 trillion American Families Plan, which includes $45 billion to enrich federal nutrition programs for families and children. The plan builds on the expansion of the Pandemic-EBT program from March 2021.Research has shown that summer EBT programs decrease food insecurity among children but some children have yet to benefit from the COVID-19 pandemic food aid program due to administrative challenges.Listen to Health Affairs' Leslie Erdelack and Jessica Bylander discuss food insecurity and President Biden's latest efforts on federal food aid.Related Links:How COVID-19 Threatens The Safety Net For US Children (Health Affairs)Biden Proposal Will Make Free School Lunch Available To 29 Million Children Every Summer (CNBC)Low-Income Families Left Waiting For Billions In Food Aid As Children Go Hungry (Politico)The Effect Of Pandemic EBY On Measures Of Food Hardship (Brookings)Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast Subscribe to UnitedHealthcare's Community & State newsletter.