In an effort to reduce opioid-related overdose deaths, states across the US are implementing new laws to increase access to naloxone—a drug that reverses opioid overdose. In a
new report published in the journal
Substance Abuse
, IMPAQ researchers, Dr. Guido Cataife and Dr. Jing Dong, with co-author Corey Davis, share findings from their study on the causal impact of Naloxone Access Laws on state-level opioid-related mortality rates.
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The Trump Administration revealed its fiscal 2021 budget last week, providing insight into its legislative priorities ahead of the 2020 presidential election. The budget advocates for imposing work requirements for SNAP and Medicaid beneficiaries, providing congressional funding to lower prescription drug costs, funding increases for oversight of the Medicaid 340B drug discount program, and reducing Medicaid Disproportionate Share Hospital (DSH) payments, among other initiatives. The
budget
proposes significant spending cuts to HHS (including Medicaid, Medicare, and the ACA), NIH, and the CDC. It does not provide specific details on large-scale health reform initiatives.
Modern Healthcare
(2/10)
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A
recent study in JAMA
reports that more than 20 percent of privately insured patients experienced an out-of-network charge after an elective (i.e. planned) surgery. On average, this resulted in more than $2,000 in charges that were not covered by insurance companies. The surprise bills were most often from anesthesiologists or surgical assistants, who are not typically selected by patients.
NPR
(2/11)
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The National Center for Health Statistics (NCHS)
released new data
on maternal mortality in the United States for the first time in over ten years. Analyses confirm that the maternal mortality rate in the United States has large racial and ethnic disparities and is the highest among developed countries.
The Commonwealth Fund
(2/6)
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Health Insurance Marketplaces and Medicaid
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On February 14, a U.S. Court of Appeals ruled that HHS acted in an “arbitrary and capricious manner” when approving Arkansas’ plan to require lower-income residents to work in exchange for Medicaid coverage. HHS has approved ten states to adopt work requirements for Medicaid, but Michigan is the only state implementing their plan (despite a pending lawsuit).
The Wall Street Journal
(2/14)
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Though federal officials paused Georgia’s 1332 waiver plan, they are still interested in allowing flexibilities for the state’s implementation of the ACA. Through the 1332 waiver, Georgia seeks to create a reinsurance program, send consumers directly to private insurers’ websites instead of Healthcare.gov, replace federal premium tax credits with state premium subsidies, and cap spending on these state premium subsidies. Georgia’s plan would also promote cheaper, non-ACA compliant policies (with higher cost sharing)
and allow state premium subsidies
to be applied to them. States using 1332 waivers must still meet certain guidelines set by the ACA, and it is questionable if Georgia’s plan is adherent.
Kaiser Health News
(2/7)
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Enrollment in California’s ACA marketplace
i
ncreased by 1.6 percent
from last year due to new state policies, including a state penalty on uninsured individuals and new consumer subsidies to help make the required coverage affordable. This growth includes a 41 percent jump in new sign-ups. The state is also offering a special enrollment period through April for residents who were not aware of the new penalty and subsidies.
California Healthline
(2/18)
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Quality Measurement & Value-Based Care
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In response to CMS’ proposed price transparency rule, the Alliance of Community Health Plans (ACHP) offers a framework for health plans to expand and certify voluntary price estimator tools. ACHP prefers a voluntary approach to reporting out-of-pocket costs, rather than disclosing negotiated rates with providers as required in the proposed rule.
Modern Healthcare
(2/11)
- Confused by the proposed price transparency rule? IMPAQ’s health policy experts break it down in this blog post.
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Accountable care organizations (ACOs) were initially formed to improve patient outcomes and lower spending through care coordination and shared savings. According to the report, the challenges of hospital inclusion, constantly growing standards to earn savings, and shifting benchmarks from unstable quality metrics make the ACO model difficult for providers to navigate, resulting in less progress in cost savings and care quality.
Revcycle Intelligence
(2/17)
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Pharmaceuticals, the Opioid Crisis, and Behavioral Health
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A
new report by the Schaeffer Center
found that on average, a $1 increase in the rebates negotiated by pharmaceutical benefit managers (PBMs) is associated with a $1.17 increase in the list price of drugs. Rebates are passed from PBMs to privately insured consumers as lower premiums, leaving the uninsured and privately insured consumers whose coinsurance is based on the drug list price to shoulder the burden of the higher costs.
University of Southern California
(2/11)
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The Commonwealth of Massachusetts is suing Juul Labs for allegedly targeting children in its initial advertising campaign by using young-looking models on the Nickelodeon website and other websites that assist with schoolwork. Three other states have also sued, but Massachusetts is the first to include Juul’s internal documents discussing its marketing strategy to target the “cool crowd.”
CNN
(2/13)
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Missouri offered pain management alternatives to its Medicaid populations to diminish the reliance on opioids for those with chronic pain. Only roughly 500 adult Medicaid recipients accessed these services within the first nine months, though 109,610 Medicaid recipients of all ages received an opioid prescription in 2019. Barriers to adopting these alternatives include the treatments requiring more time to alleviate pain than taking a pill, limited numbers of providers for Medicaid beneficiaries, and inconsistencies among therapy outcomes for individuals.
Kaiser Health News
(2/13)
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Social Determinants of Health
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The acceptance of social determinants of health (SDoH) as key factors that can improve health outcomes has sparked debate over which stakeholders are best suited to oversee services. Large insurers and hospitals have begun investing billions in SDoH programs, though smaller grant-funded Community Benefit Organizations (CBOs) have managed this care for years. Despite the discrepancies in resources, proponents of CBOs argue that they should still manage SDoH programs given their unique, local experience in the field.
Healthcare Dive
(2/12)
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The Donaghue Foundation, a health research organization, identified ways in which research funders can improve their methods to dismantle barriers to health equity. These include ensuring protocols to address potential internal and external biases are in place within research algorithms, data collection methods, and grant application processes.
Health Affairs
(2/5)
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Additional Eye-Catching Headlines
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Experts believe that thousands of cases may be unreported due to the relatively mild symptoms of the virus. Currently, the virus is thought to be fatal in about two percent of people infected, with risks increasing for older and immunocompromised patients. This mortality rate may actually be lower if infectious disease experts are correct that there are thousands of undetected cases, with many of them having mild symptoms.
CBS News
(2/18)
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The Kaiser Family Foundation developed state-level briefings that compile data across a variety of health policy topics such as costs, coverage, access to care, and women’s health, for all 50 states and the District of Columbia. The snapshots document the different health care landscapes across the country heading into the upcoming 2020 elections.
Kaiser Family Foundation
(2/13)
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Spotlight on IMPAQ Health
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IMPAQ Addresses Social Determinants of Health at AcademyHealth Conferences
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During AcademyHealth’s recent National Health Policy Conference (NHPC) and Health Datapalooza, IMPAQ fueled conversations among industry leaders on challenges and solutions related to social determinants of health (SDoH).
- IMPAQ President Dr. Adaeze Enekwechi led a panel discussion that explored innovations in public-private partnerships to address SDoH with nationally recognized leaders from providers, insurers, consumer advocacy, and the public sector.
- Several IMPAQ Health experts presented work addressing SDoH, including Ann-Marie Akiwumi’s rapid-fire presentation on IMPAQ’s award-winning SDoH Dashboard Action Tool.
- IMPAQ convened health policy, equity, and data analytics leaders and experts from across the country over dinner to discuss strategies for advancing industry discourse and action on SDoH issues.
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IMPAQ has been named a phase two
Research, Measurement, Assessment, Design, & Analysis (RMADA2) contractor
by CMS. Through the Indefinite Delivery Indefinite Quantity (IDIQ) five-year contract, we will continue providing full-cycle services for CMS and driving innovation in programs supporting health reform legislation, including the ACA and the Medicare Access and CHIP Reauthorization Act (MACRA).
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Upcoming Events, Trainings, Tools, & Webinars
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States are increasingly exploring “standard plan designs” or policies that set standard benefit and/or cost-sharing requirements across plans sold in their markets to ease consumers’ shopping experiences and provide better coverage value. During this webinar, multiple state insurance marketplace officials will discuss the evolution of standard plans, including their impact on the markets and consumers.
Register here.
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The first webinar will introduce public health practitioners to broad concepts and principles that form the foundation of administrative law. Participants will learn about the scope of administrative law and why it is important for public health.
Register here.
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March 10, 2020
Washington, D.C.
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The March 2020 issue of Health Affairs, “The Affordable Care Act Turns 10,” offers must-read analyses of the ACA. Authors explain the law’s effects on coverage, cost, health status, and more. They also review the political and legal issues that have shaped implementation and consider what should come next. On Tuesday, March 10, Health Affairs will host a special event to amplify the work.
Register here.
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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.
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