IMPAQ Health News
From our experts to your inbox. Every two weeks.
In this edition, learn about racial and ethnic health disparities, the expansion of telehealth, and the impact of COVID-19 on the start of the school year. Don’t miss IMPAQ’s presentations at the NAHDO Annual Conference and our AIR colleagues’ insights on patient-centered measure development.
IMPAQ was recently awarded a grant from Arnold Ventures to study the care integration challenges of individuals who receive both Medicare and Medicaid benefits (often referred to as “dual eligibles”). Although dual eligibles are especially likely to benefit from coordinated care, the current delivery of services across these programs continues to be fragmented. This project will use a human-centered design approach to uncover insights on care integration by describing how these individuals navigate the two different healthcare programs.
This week, the United States surpassed 5 million total cases of COVID-19 nationwide. However, the average number of cases reported has declined by 16 percent over the past week, a promising sign after a steep spike in cases over the past two months.

  • Congressional talks over additional COVID-19 funding have stalled and will most likely continue into September. Unemployment benefits and additional funding for state and local governments are key points of contention.

  • President Trump signed an executive order on August 13 to enhance unemployment benefits for Americans, though benefits may now need to be paid by states rather than the federal government. If states are required to pay, they may look to cut Medicaid provider reimbursement rates to offset the burden.

  • The Trump administration floated new immigration rules that would block American citizens and legal permanent residents from re-entering the United States if believed to be infected with COVID-19.

  • The Trump administration plans to issue new guidelines for how state and local governments report public health data to the government. However, experts question why this overhaul is happening during a pandemic, when state and local health departments are already under pressure.

  • As the school year approaches and is already underway in some states, health experts are issuing warnings about reopening too quickly. Dr. Anthony Fauci indicated that the combined impact of COVID-19 and the upcoming flu season in the United States could lead to the worst fall season on public health record if social distancing guidelines are not followed.

  • As reported in a new CDC survey, one in four young adults have considered suicide in the past month because of the pandemic. The mental health toll of the pandemic is also greatly impacting essential workers, due to their experiences on the front lines, and minority respondents, who are disproportionately affected by the virus.
Here are some resources for following the latest efforts to address COVID-19:
  • IMPAQ researchers have developed a dashboard to provide a comprehensive overview of COVID-19 clinical trial data. This dashboard is updated with new data and infographics every two weeks.

  • A Kansas school teacher constructed a Google Doc that tracks K–12 school closures, quarantines, confirmed cases, and deaths by school across the country. It has grown to over 700 entries.

  • The Atlantic’s COVID Tracking Project, which provides data to both Johns Hopkins and the White House, collaborated with the Boston University Center for Antiracist Research to create a COVID Racial Data Tracker.

COVID-19 Amplifies Racial
& Ethnic Health Inequities
In one of the most segregated counties in California, Latinos account for 90 percent of COVID-19 cases. Many are immigrants who work essential jobs and live in apartments with other families to afford rent, creating an environment where the virus can spread easily. Kaiser Health News (8/12)
HHS distributed COVID-19 provider relief grants in roughly equal amounts among communities of color with high disease burdens and other communities with less need. Modern Healthcare (8/10)
Research has shown that racial disparities exist in COVID-19 clinical trials. For example, in trials for remdesivir, data supporting the drug’s efficacy and safety in minority groups was limited, and data on race and ethnicity were not recorded for the 53 patients treated under the “compassionate use” program. New England Journal of Medicine (8/11)
COVID-19 & Telehealth
A bipartisan group of lawmakers requested that Congress include $200 million in funding for the Federal Communications Commission’s (FCC) COVID-19 Telehealth Program to provide better health care support to Medicare beneficiaries. Of the 5,200 providers that applied for program, the FCC could only fund 500. Lawmakers hope the increased funding would allow for more providers to participate. The Well News (8/10)
Telehealth use has increased exponentially because of COVID-19, but experts wonder if its popularity will remain. Many believe that some telemedicine restrictions will return and some doctors may be apprehensive to permanently practice telemedicine. This raises the question of where telehealth fits in the context of the broader healthcare sector. Associated Press (8/10)

Back to School Amid the Pandemic
Many students will attend school virtually in the fall. This disruption of regular school schedules could widen the opportunity gap for minority and disadvantaged students. Roughly 30 percent of all K-12 public school children live in homes that don’t have an internet connection or adequate devices for at-home learning. Additionally, many low-income families rely on schools for services and support, such as providing two meals a day. According to recent research, this lack of access for these communities could exacerbate achievement gaps by 15 to 20 percent. MSNBC (8/12)
According to a report published by the American Academy of Pediatrics and the Children’s Hospital Association, the number of COVID-19 cases in children increased by 90 percent between July and August. This data is a warning sign that reopening schools, even with social distancing measures, could exacerbate the spread of COVID-19 among children this fall. Time (8/10)
COVID-19 Vaccines & Treatments
In response to Russia’s claim that it has developed the world’s first COVID-19 vaccine, Alex Azar, Secretary of HHS, stressed that the US is prioritizing vaccine safety and effectiveness. The Hill (8/11)

  • Dr. Anthony Fauci, the top infectious disease expert in the US, stated that he had serious doubts about Russia’s COVID-19 vaccine and that “having a vaccine and proving that a vaccine is safe and effective are two different things.” The Hill (8/11)
Gilead Science is now facing complaints from state leaders and a government watchdog group over its rollout of remdesivir, an antiviral drug that could assist COVID-19 patients in fighting the virus. Both groups assert that Gilead is taking advantage of the current situation by setting artificially high prices for remdesivir and not moving quickly enough to pursue a potentially cheaper option. ABC News (8/13)
Spotlight on IMPAQ
IMPAQ experts will deliver four presentations at the National Association of Health Data Organizations (NAHDO) Annual Conference, which will be held August 17–18 and 25–26, 2020.
IMPAQ presentation topics include:

  • Building a Broader Vision of Healthcare Data: A Multi-Disciplinary Approach to Understanding and Leveraging SDOH Data, Jennifer Pooler

  • Challenges and Opportunities around Mental Health Parity Data, Charles Patton, Elizabeth Schoyer

  • Visualizing Opportunities and Disparities with the Social Determinants of Health Dashboard Action Tool, Alberto Ortega Hinojosa, Sydney Lufsey

  • Showcase of the Massachusetts Healthcare and Health Data System, Craig Schneider
In the brief Transforming Measurement for Better Care: Lessons Learned From Patient-Centered Measurement Pilots, our colleagues at the American Institutes for Research (AIR) explain how four pilot projects on patient-centered measurement created partnerships among measure developers, patients, caregivers, researchers, and clinicians to improve care. The team behind this effort, including Hala Durrah, Karen Frazier, Stephen Hoy, Mary Lavelle, Dilani Logan, and Ellen Schultz, also authored a related blog post published by Health Affairs, titled Transforming Health Care Measurement by Partnering with Patients and Caregivers.
On August 18, IMPAQ President Dr. Adaeze Enekwechi was a guest panelist on the Ernst & Young health equity webcast titled The Business Case for Achieving Health Equity: Actionable Steps for Systemic Change. Dr. Enekwechi, along with fellow health experts from the Henry Ford Health System and Cambia Health, explored how organizations can eliminate barriers to achieving health equity and how addressing social determinants of health can benefit the economy. Register to watch the on-demand recording.
Dr. Enekwechi was also recently quoted in a Chicago Tribune article on implicit bias in health care, saying “In the health care setting, just because someone is a doctor, and a very good doctor, and a wonderful or decent person, doesn’t mean they don’t have biases.”
Other Health News
The Trump administration announced new funding opportunities aimed at increasing health care access and quality for rural health systems. The Community Health Access and Rural Transformation (CHART) Model offers rural hospitals the opportunity to participate in either a $75 million seed funding program that would empower communities to implement care delivery reforms, or an ACO Transformation Track that is part of the Medicare Shared Savings Program (MSSP). CMS (8/11)
CMS plans to end its national coverage determinations for artificial hearts. Under the plan, Medicare Administrative Contractors would determine if Medicare should pay for a beneficiary’s artificial heart. This proposed change could increase the number of people that receive artificial hearts covered by Medicare, because eligibility would be based on medical necessity, rather than requiring beneficiaries to participate in a clinical study to receive a transplant. Modern Healthcare (8/12)
A federal appeals court ruled that the Trump administration must pay insurers for subsidies from an ACA program that the President ended abruptly three years ago. However, the court also ruled that insurers are not entitled to all of the unpaid money. The case will now be reheard by the Court of Federal Claims. Health Affairs (8/17)
Feel-Good News Stories
During a routine ultrasound, veterinarians at the Smithsonian National Zoo announced that one of their giant pandas is pregnant and could give birth any day. The chief veterinarian stated, “in the middle of a pandemic, this is a joyful moment we can all get excited about.” NPR (8/15)
Graphic of the Week
As many schools make plans to reopen this fall, the National Institute for Health Care Management analyzed concern sentiments by race. The majority of parents surveyed view returning to school as a risk.
Upcoming Events, Trainings, & Webinars
IMPAQ President Adaeze Enekwechi will join Revel Health’s discussion about how to humanize SDoH, address hidden barriers, and create solutions to drive change. Register here.
Researchers in the US have suggested outdoor air pollution, which was killing around 4.2 million people worldwide each year before the pandemic began, has significantly worsened during the pandemic, and even led to more deaths. NIHCM will explore environmental injustice and how it affects communities’ short- and long-term health outcomes. Register here.
Systematic racial bias in the US healthcare system is well documented, raising concerns that minority communities may not receive the same level of care as white patients once they contract COVID-19. Duke University convenes a panel of experts to discuss the extent to which racial biases in healthcare result in poorer outcomes for minority COVID-19 patients and how to correct the issue. Register here.
In this webinar, three provider organizations will detail how they are using population health management approaches to care for people with complex needs amid the COVID-19 pandemic. 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.