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Coronavirus (COVID-19)
Government Response
While states continue to enforce stay-at-home orders across the country, the Trump administration has taken additional steps to slow the spread of COVID-19. This past week, the administration announced that it will require health insurers to provide free antibody tests to help determine the number of people who were infected and experienced minimal symptoms. In addition, the administration announced that hospitals receiving funds from the $2 trillion stimulus bill passed on March 27 must agree not to send surprise medical bills to patients treated for COVID-19.

Meanwhile, Congress continues to work on the development of a third stimulus package . A Senate bill allocating $250 billion for small businesses did not garner enough votes for passage, with those in opposition indicating that additional funding will be needed for hospitals, small businesses, and essential workers. At the state level, governors on the East and West Coasts have formed coalitions to develop strategies to begin reopening their respective states. The East Coast governors plan to form a council that will review how to restore “business as usual.” On the West Coast, the governors of California, Washington, and Oregon released plans that included an incremental release of stay-at-home orders over the next few months. President Trump plans to announce his administration’s strategy for reopening the country in the near future. As part of this strategy, the CDC and FEMA have been working together to develop a three-phased approach to reopen the United States.
Here are some resources for following the latest coronavirus news:
  • Johns Hopkins developed a frequently updated worldwide map of confirmed COVID-19 cases and deaths.

  • The CDC provides guidelines and resources on an ongoing basis to help the public prepare and protect themselves and their families.

  • Statista is creating interesting data visualizations related to COVID-19, using data reported by countries around the world.

  • Vox answers the most frequently asked questions about social distancing. They also have other coronavirus-related FAQs available on prevention recommendations and guidance.

  • The New York Times is tracking the implementation of stay-at-home guidelines for states and counties.

  • Unacast developed a dashboard to show how people adhering to social distancing at the county-level.
Over the past two weeks, CMS has released a number of press releases detailing emergency actions they are taking to address the COVID-19 outbreak, including:
COVID-19 Amplifies Racial and Ethnic Health Inequities across the Country
Data released by a number of southern states show that African Americans are disproportionately becoming infected, and dying from, COVID-19. Studies indicate that because black Americans living in this region are more likely to live in poverty and have underlying health conditions, they are more susceptible to contracting the illness. In Louisiana, a major southern hotspot for the disease, the Governor announced that 70 percent of deaths were among African Americans, even though they only make up 33 percent of the population in the state. The Guardian (4/8)
Over the past few weeks, the number of COVID-19 cases has expanded rapidly in Detroit, highlighting once again that communities of color continue to be at a higher risk for contracting COVID-19 due to underlying health factors. However, many suggest that this could be the beginning of the second phase of the pandemic. As one public health official noted, once the disease seeds, the most vulnerable will be those with higher levels of underlying disease and those who are disconnected from institutions. The New Yorker (4/7)
In Milwaukee, African Americans now comprise 44 of the 67 deaths (roughly two thirds) that have occurred in the city, with most located in the northernmost parts of the city. Local officials are not surprised at these numbers, given the health and economic disparities this community faces. Nearly 34 percent of black people in Milwaukee live below the poverty line, and 9 percent were uninsured in 2018. The Guardian (4/14)
As disparities in health equity become more apparent during the COVID-19 crisis, states have begun collecting more comprehensive data about COVID-19 in minority communities. In response, some states and cities have implemented task forces aimed at addressing these disparities. As the funding from the CARES Act is made available to more states and hospitals, these leaders will have the opportunity to use these funds to support communities disproportionately impacted by COVID-19. National Academy for State Health Policy (4/13)

  • In a similar article, the Kaiser Family Foundation conducted an analysis on underlying health conditions, health coverage, and social/economic factors by race and ethnicity to understand how the health and financial impacts of COVID-19 may affect different racial and ethnic groups. (4/7)
Beyond the Headlines
CMS has taken steps to alleviate pressure on providers participating in Alternative Payment Models (APMs), such as granting exceptions from reporting requirements and extensions for data reporting and submission deadlines. However, some researchers argue that additional relief will be needed to mitigate potentially significant losses to advanced APMs, which involve downside risk components. A recent Health Affairs article recommends that CMS should suspend downside risk recoupment for providers in advanced APMs for the duration of the COVID-19 crisis. Health Affairs (4/6)

  • Modern Healthcare published a similar article, highlighting that most accountable care organizations (ACOs) are considering exiting out of Medicare Shared Savings Programs due to concerns of suffering financial losses as a result of the COVID-19 pandemic. ACOs have until May 31 to make a decision about participation. (4/13)
It is a question that is on every American’s mind. However, the question is not just when, but how? It is very likely that some states, cities, and towns will recover from the virus faster than others. What is certain is that public health workers will be essential to reopening schools and businesses, and having a strong workforce to deploy contact tracing will be key. Kaiser Health News (4/13)

  • NPR published a similar article on the role of contact tracing and its importance in mitigating COVID-19. (4/10)
As COVID-19 continues to spread, companies and research facilities are racing to start clinical trials on possible drug treatment therapies and vaccines for the virus. Currently, three drugs undergoing clinical trials (two in the United States, and one in China) are showing promising results. Commenting on the two vaccines currently in trials in the United States, Dr. Anthony Fauci indicates that there have been no red flags yet and hopes the next round of testing can begin in June. The LA Times (4/15)
For the millions of Americans who have lost their jobs over the past few weeks, many also lost their employer-sponsored health plans. While some uninsured individuals will be able to turn to Medicaid and health insurance exchanges, their insurance options largely depend on the state in which they live. For example, while most states that run their own health insurance exchanges have created a new open enrollment period in light of the pandemic, the federal government has decided not to follow suit for the federal health exchange, leaving individuals in states that rely on with fewer insurance options. Eligibility for Medicaid also varies by state, depending on whether the state has expanded Medicaid eligibility or not. These differences create roadblocks for unemployed Americans trying to access health insurance. PEW (4/14)
Feel-Good News Stories
Below are a few feel-good stories to remind us that no matter what, people always find a way to help one another, even in times of crisis.
  • “Golden Girls” Become Celebrities for Coronavirus Isolation Plans. The Washington Post (4/6) 

  • Hospitals Open Grocery Stores for Providers Treating COVID-19 Patients. Modern Healthcare (4/9)
Additional Eye-Catching Headlines
A key aspect of value-based care models is avoiding unnecessary hospitalizations. As a result, many studies have been undertaken to identify creative solutions to keep patients out the hospital when possible. In one such study, doctors at Brigham and Women’s Hospital conducted a randomized control trial utilizing home hospitals. Results from the study show that acutely ill patients in home hospitals saw a 38 percent lower cost of care and decreased 30-day hospital readmission rates. RevCycle Intelligence (4/6)
The Supreme Court will determine if a 2015 Arkansas law violates components of the Employee Retirement Income Security Act (ERISA), which prevents states from regulating self-insured employer health plans. The Arkansas law in question requires pharmacy benefit managers (PBMs) to pay pharmacies enough to cover their acquisition price for generic drugs. If the Supreme Court strikes down the Arkansas law, it could negate laws in at least 40 other states that regulate PBMs in multiple ways. This, in turn, could make it more difficult for states to implement group purchasing initiatives, price caps, public option plans, or single-payer models. Modern Healthcare (4/9)
Before the virus arrived in the United States, fatal opioid overdose rates were on the decline for the first time in years. In addition to social distancing mandates disrupting typical treatment activities, the NIH has frozen funding for non-coronavirus research. Vital drug research and data collection efforts, including a large project studying pain management alternatives and treatment options, have been stalled. Drug experts warn that the pandemic could lead to more addiction in society and also derail many who are in treatment. Politico (4/10)
Spotlight on IMPAQ
US Capitol Building reflected in an ambulance on March 24. Photo: Brendan Smialowski, AFP
In the context of COVID-19, IMPAQ leaders and health policy experts reflect on how policymakers in Washington and the Senate have addressed past public health crises such as Ebola, Zika, the opioid epidemic, and others.

Published in The Globe Post , this article is authored by:

  • Dr. Adam Block, Assistant Professor of Public Health at New York Medical College

  • Kevin Van Dyke, Managing Director, IMPAQ Health

  • Dr. Adaeze Enekwechi, IMPAQ President
Graphic of the Week
The CDC recommends covering your nose and mouth when around others. Learn how to make your own face mask at home.
Upcoming Events, Trainings, Tools, & Webinars
This webinar, hosted by America’s Health Insurance Plans (AHIP), will explore the relationship between addressing patients’ health-related social needs and achieving quality improvement through virtual delivery of post-acute services. Register here .
The Bipartisan Policy Center’s (BPC’s) Rural Health Task Force will host a webinar highlighting findings from their recent report on the current healthcare crisis in rural communities. The task force will discuss proposals to promote the uptake of value-based care, provide incentives for clinicians to stay in rural areas, and remove barriers to telehealth. Register here .
In this webinar, facilitated by the eHealth Initiative, learn how three leading Health Information Exchanges (HIEs) are confronting various data challenges, including aggregation, patient identification, and interoperability for accurate reporting and tracking of COVID-19. The panelists will also share emergency response efforts, lessons learned, and best practices. Register here .
Led by healthcare leaders and data experts, this webinar will address how to use data analytics to address and help solve the global health crisis, how to communicate data effectively, and how to implement effective analytics strategies. Register here .
This webinar, hosted by the National Academy of Medicine and the U.S. Government Accountability Office, will discuss the opportunities and challenges with implementing AI in the healthcare sector. Register here .
NOTE: The information, analyses, and opinions expressed in the articles, publications, or comments contained therein are those of the authors and should not be considered verified or endorsed by IMPAQ or any of our partners or clients.