Health Affairs This Week

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The Public Transit-Health Connection Aug 13, 2021

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This episode is brought to you by Semafor Healthcare.

Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free.

This week, the US Senate approved the sweeping Bipartisan Infrastructure Plan. The bill includes a $39 billion investment in public transit to report aging infrastructure across the US.

Public transportation in the US is an important aspect of American Life, including health care. Health Affairs recently published a Health Policy Brief on the connection between public transportation and health.

On this episode of Health Affairs This Week, Health Affairs' Rob Lott and Jeff Byers discuss what to expect next for the infrastructure bill and dive into the insights from the health policy brief.

Related Links:

Public Transportation In the US: A Driver Of Health And Equity (Health Affairs)
Senate Approves The $1 Trillion Bipartisan Infrastructure Bill In A Historic Vote (NPR)
Podcast: The Bipartisan Infrastructure Bill - What's in it for Health Care (Health Affairs This Week)

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The Bipartisan Infrastructure Bill - What's in it for Health Care Aug 06, 2021

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This episode is brought to you by Semafor Healthcare.

Last week, President Joe Biden and his administration released more detail on the Bipartisan Infrastructure Investment and Jobs Act.

While a lot of focus has been given to provisions, such as the $66 billion investment in passenger rail since the creation of Amtrak 50 years ago, there are many areas which will affect the health care sector.

Health Affairs' Senior Editors Ellen Bayer and Chris Fleming share the latest on the bipartisan infrastructure deal and how health care will be affected, including policies on telehealth, clean drinking water, climate change, broadband internet, and other social determinants of health.

Related Links:

Bipartisan Infrastructure and Investment Jobs Act (White House Fact Sheet)
A Lead Poisoning Crisis Enters Its Second Century (Health Affairs)
Climate & Health Theme Issue (Health Affairs)
Health Risks Due to Climate Change: Inequity In Causes and Consequences (Health Affairs)
Ensuring the Growth of Telehealth During COVID-19 Does Not Exacerbate Disparities In Care (Health Affairs Blog)

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COVID-19: The Latest on Federal Mask Guidance and Vaccine Mandates Jul 30, 2021

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This episode is brought to you by Semafor Healthcare.

This week has seen considerable movement in the effort to curb the COVID-19 pandemic from the federal level.

On Tuesday, the Centers for Disease Control and Prevention (CDC) updated its mask guidance, recommending that fully vaccinated individuals wear mask indoors in areas with high COVID-19 transmission rates to reduce the spread of COVID-19. At the time of this recording on Thursday July 29, 2021, President Joe Biden is expected to announce a COVID-19 vaccine requirement for federal employees.

On this episode of Health Affairs This Week, editors Rob Lott and Leslie Erdelack discuss the latest on COVID-19, the Delta variant, CDC's updated mask guidance, and President Joe Biden's expected vaccine requirement for federal government employees.

Related Links:

Assessing The Legality Of Mandates For Vaccines Authorized Via An Emergency Use Authorization (Health Affairs Blog)
Community User Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US (Health Affairs)
President Biden To Announce New Actions To Get More Americans Vaccinated And Slow the Spread Of the Delta Variant (White House)
COVID-19 Data Tracker: Integrated County View (CDC)
When You've Been Fully Vaccinated (CDC)

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Behind the Pages: July 2021 Issue on Borders, Immigrants & Health Jul 23, 2021

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This episode is brought to you by Semafor Healthcare.

In July, Health Affairs published an issue dedicated to borders, immigrants, and health.
A public health crisis is unfolding along and inside the US-Mexico border. Immigrants arriving at the US border are likely to have experienced political, economic, or interpersonal violence prior to their arrival, leading to unmet mental health and physical health needs. Immigrants detained at the border may face crime and violence in border towns as they await trial in the US, or prolonged stays in detention centers and family separations if they are able to cross the border. Immigrants in the US face health challenges that extend well beyond the border.

Health policy issues are impacted by the continuously shifting demography of US immigrants. The July 2021 journal issue of Health Affairs and related content focuses on immigrants and borders and the impact on health policy. The issue examines recent trends in immigrant health and health care after the Great Recession and the nationwide implementation of the Affordable Care Act (ACA).

In today's episode of Health Affairs This Week, Senior Editors Leslie Erdelack and Jessica Bylander discuss the publication process and highlight research insights from the issue.

Order your copy of the July 2021 issue of Health Affairs.

Related Links:

Borders, Immigrants & Health July 2021 Issue (Health Affairs)
Health Policy Challenges Posed By Shifting Demographics And Health Trends Among Immigrants To The United States (Health Affairs)
Immigrant Essential Workers Likely Avoided Medicaid And SNAP Because Of A Change To The Public Charge Rule (Health Affairs)
Podcast: Many US Immigrants May Defer Health Care to Avoid ICE (A Health Podyssey)
Health Care Has Few Plans To Address The Aging Immigrant Population (Axios)

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New Biden Executive Order Targets Hospital Mergers & Drug Pricing, Renews Antitrust Focus Jul 16, 2021

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This episode is brought to you by Semafor Healthcare.

Last week, the Biden Administration unveiled a sweeping executive order, focused on promoting competition in the US economy.

With Lina Khan as the new chairperson of the Federal Trade Commission, the administration is looking to increase its antitrust focus and potentially break up monopolies.

The new executive order contains 72 provisions, giving direction to multiple agencies on sectors such as agriculture, transportation, labor, and health care. In health care, the executive order focuses on drug pricing, hospital mergers and acquisitions, hospital pricing transparency, biosimilars, and comparison shopping for health plans.

Listen to Health Affairs' Deputy Editor Rob Lott and Senior Content Marketing Manager Jeff Byers go over the health care sections in the Biden administration's executive order on promoting competition in the US economy. They also discuss the hipster antitrust movement, the cost of hearing aids, and hospital deal trends since the implementation of the Affordable Care Act.

Related Links:

Fact Sheet: Executive Order On Promoting Competition In The American Economy (White House)
Hospital M&A Down From Pre-Pandemic Highs, Though Deal Size Growing, Kaufman Hall Says (Healthcare Dive)
Biden Administration's First Marketplace Rule Promotes Coverage and Reverse Trump-Era Changes (Health Affairs Blog)
How Biosimilars Are Affecting The Drug Markets (A Health Podyssey)
Lina Khan And the "Hipster Antitrust" Movement (The Atlantic)
The End of Friedmanomics (The New Republic)

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No Surprises Act: Known Impacts on Surprise Medical Bills & What's Next Jul 09, 2021

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This episode is brought to you by Semafor Healthcare.

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.

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)

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Home-based Care Left Out of Bipartisan Infrastructure Plan Jul 02, 2021

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This episode is brought to you by Semafor Healthcare.

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)

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Unpacking Apple's health care efforts and digital health's overall maturity Jun 25, 2021

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This episode is brought to you by Semafor Healthcare.

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)

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Peering into the MedPAC crystal ball for the future of Medicare payments Jun 17, 2021

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This episode is brought to you by Semafor Healthcare.

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 Report
Affordable 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)

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Insights into FDA's controversial decision to approve a new Alzheimer's treatment drug Jun 11, 2021

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This episode is brought to you by Semafor Healthcare.

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)

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