IMPAQ Health News
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This edition of IMPAQ Health News highlights stories on racial and ethnic health disparities, the impact of COVID-19 on the ACA, and other insights, including two new posts in our COVID-19 blog series exploring the implications of telehealth expansion. Don’t miss the invite to our free webinar on telehealth access and equity !
In this post on the IMPAQ blog , health experts from IMPAQ and the American Institutes for Research (AIR) explore how telehealth policies are shifting during the pandemic and how effective and equitable telehealth policies can and should be designed going forward.

Authors include Stevland Sonnier, Dr. Brandy Farrar, and Kevin Van Dyke of IMPAQ Health, as well as Dr. Yael Harris, Vice President of Research and Evaluation at AIR.
How will CMS’ expansion of telehealth impact Medicare’s Quality Payment Program (QPP)? In this blog post , IMPAQ Health experts Leah Nash and Sarah Pedersen review Medicare telehealth payment rules prior to COVID-19, summarize temporary changes, and explore how these changes may influence the QPP.
COVID-19
As COVID-19 infections spike around the nation, Americans celebrated the Fourth of July last weekend in a variety of ways including staying at home , exercising their rights through protest , and joining packed crowds at BBQs and beaches . Experts believe that the rising rates are due to young people disregarding social distancing mandates, rather than the protests for racial justice . Wearing masks is the key difference between the transmission rates at these large gatherings. Though face coverings have been controversial among the public, GOP leaders like Vice President Pence and Senate Majority Leader Mitch McConnell have made statements in support of wearing masks. A coalition of 239 scientists are now pressing the World Health Organization (WHO) to update guidance to reflect that COVID-19 is airborne , meaning that viral particles lingering indoors are infectious. At the same time, the Trump administration officially began proceedings to withdraw the United States from the WHO , effective July 2021. Meanwhile, HHS is expected to renew the COVID-19 public health emergency that is set to expire on July 25, and Congress began a two-week recess on July 6 after extending the Paycheck Protection Program (PPP) for another two months. In addition, CMS released telehealth guidance for eligible providers using CMS quality reporting programs for 2020 and 2021.
Here are some resources for following the latest COVID-19 containment efforts:
  • COVID Exit Strategy is tracking each state's progress in combatting the virus using easy-to-read data visualization techniques.

  • Johns Hopkins developed a frequently updated worldwide map of confirmed COVID-19 cases and deaths.

  • The New York Times has compiled a tracker outlining the progress of more than 140 COVID-19 vaccines currently in development around the world.
COVID-19 Amplifies Racial and Ethnic Health Inequities across the Country
Relatively comprehensive data on nearly 1.5 million COVID-positive patients reinforces what many already knew: the Latino and Black populations are three times as likely to be infected as compared to the white population in the United States. It is worth noting that demographic data is missing for a large percentage of cases. The New York Times (7/5)
Use of telehealth services has quickly accelerated in recent months as a means to safely interact with patients during a pandemic. Experts warn that without a mindful approach to implementation after the pandemic, a consumer-driven version of telehealth could isolate marginalized racial and ethnic minorities, who are already more likely to experience discrimination in health care. STAT (6/26)
On June 26, an order was made to release all children held in ICE custody by July 17, citing that family detention facilities failed to provide basic health protections for detained children and their families amid the pandemic. NPR (6/26)
It has been well established that those living in US jails and prisons are at high risk of contracting COVID-19 due to cramped conditions and an overall lack of sanitary supplies. New research shows that the virus can significantly spread outside prison walls through released inmates that carry the virus into communities, similar to other infectious diseases. PEW (7/1)
COVID-19 and the Affordable Care Act
Narrowly passing with 50.5 percent of the vote, Oklahoma will expand Medicaid by July 1, 2021. Approximately 200,000 residents will be newly eligible for Medicaid benefits, though this number will likely grow due to COVID-19 as unemployment increases. Missouri will vote on a similar provision in August. Politico (7/1)
According to a Kaiser Family Foundation analysis , almost 80 percent of people who lost their health coverage through work were eligible for expanded Medicaid benefits or government-subsidized private insurance. Additionally, younger jobless Americans could join their parents’ plans. These provisions were made possible through the ACA. However, millions are still without coverage in states that did not expand Medicaid or if they cannot afford the high costs of insurance through the individual market. The New York Times (6/27)

Amid a sinking economy and public health crisis, the Trump administration maintains that the entire ACA is illegal due to the eliminated individual mandate. Various ACA provisions are currently providing health insurance to over 20 million Americans. NPR (6/26)

  • In the latest knock against the ACA, the Supreme Court sided with the Trump administration to grant employers with religious objections the ability to deny employees free birth control coverage–a benefit made available through the ACA. The New York Times (7/8)
COVID-19 Vaccine and Treatments
The drug manufacturer Gilead’s novel drug is shown to decrease the recovery period for individuals with COVID-19. This treatment course, however, is being criticized for its high price tag of $2,340. The Associated Press (6/29)
Inovio Pharmaceuticals claims to have developed a potential COVID-19 vaccine. However, the company did not provide critical detail on whether the trial patients produced any neutralizing antibodies in response to the virus. STAT (6/30)

  • The current COVID-19 vaccine trials provide an opportunity to demonstrate equitable representation for high-risk populations such as the Black and Latino communities. STAT (6/26)
COVID-19 and Substance Use Disorders
The stressors of COVID-19 have affected the mental health of many Americans and increased substance use disorder across the nation. In fact, Jim Carroll, the Director of National Drug Control Policy, revealed a 57 percent increase in drugs seized by the US Customs and Border Protection between March and May of 2020 in comparison to the same months in previous years. Politico (6/29)

COVID-19 has resulted in numerous flexibilities for telehealth and prescriptions . These relaxed regulations have helped maintain access to opioid use disorder treatments through various means such as online training for buprenorphine prescribing and telehealth opioid treatments. Health Affairs (6/12)
Spotlight on IMPAQ
Free webinar: July 16, 1-2pm ET
How can we ensure the growing use of telehealth enhances access for all patients and does not exacerbate existing disparities for vulnerable populations? Join IMPAQ President Dr. Adaeze Enekwechi and nationally recognized telehealth experts for a free webinar on July 16, 1-2pm ET. Brought to you by IMPAQ in partnership with the American Telemedicine Association , the webinar will offer a solutions-oriented discussion on how payers, providers, and policymakers can use telehealth to advance health equity.
IMPAQ has joined the Core Quality Measures Collaborative (CQMC), convened by America’s Health Insurance Plans in partnership with the National Quality Forum and CMS. The Collaborative is a broad-based coalition of health care thought leaders who work to recommend measures in priority clinical areas to assess the quality of American health care. Jensen Chiu, IMPAQ Health Quality Measurement Lead, will represent IMPAQ in this initiative and serve as the ambassador for the Collaborative.
Beyond the Headlines
The US public health system is unable to provide a robust response during the current pandemic due to decades of budgetary reductions. Underfunded state and local health departments need increased funding on a regular basis in order to build a strong system to protect and maintain the nation’s health. Kaiser Health News (7/1)
LGBTQ youth are generally at high risk for anxiety, depression, and homelessness. COVID-19 has increased these challenges faced by the LGBTQ community as there is limited access to counseling and community support. The New York Times (6/29)
Similar to urban hospitals, rural hospitals in the United States have been struggling financially due to a decrease in elective services and an increase in personal protective equipment purchases. Rural hospitals are particularly financially vulnerable due to their normally low margins even prior to the pandemic. One potential policy option to aid rural hospitals is to expand eligibility for Medicaid. Health Affairs (7/1)
Many patients delayed seeking care for their heart issues during the early months of COVID-19 , resulting in an increase of deaths related to heart conditions. In fact, New York City shows a 27 percent increase in heart condition related deaths during the months of March, April, and May 2020 compared to past years’ averages. The Washington Post (7/2)
Feel-Good News Stories
While treating COVID patients, some frontline workers quarantined away from their families to protect them. Some are finally reuniting with their families after months saving lives. ABC News (6/29)
One year ahead of schedule, the “Hamilton” movie was released last weekend on a major streaming platform due to the pandemic. The film contains the original cast and has received high praise from fans. Insider (7/3)
Beyond the Pandemic: Other Health News
The 5-4 decision ruled that a Louisiana law requiring doctors who perform abortions to have admitting privileges at a nearby hospital was unconstitutional. However, Justice Roberts’ vote in this case does not indicate he will vote with abortion-rights supporters in future cases. Kaiser Health News (6/29)

  • Later that week, the Supreme Court declined to hear several abortion cases. Politico (7/2)
A report released by the House’s Energy and Commerce Committee concluded that enrollment in short-term health plans, which do not comply with ACA requirements, grew in 2019 after the Trump administration extended their maximum duration from three months to a year. Modern Healthcare (6/26)
A 2012 study of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey found that those most satisfied with their hospital care were 26 percent more likely to die within six months than patients with lower satisfaction ratings. More recent research suggests that patients’ hospital recommendations are not associated with quality of care or patient survival rates, rather they are based on hospital amenities and bedside manner. The Washington Post (7/4)
Graphic of the Week
Nebraska Medicine demonstrates the importance of wearing a mask when in public. Wearing one properly can help reduce the odds of transmission to fight the spike!
Upcoming Events, Trainings, and Webinars
California’s public hospitals and health systems, a vital part of the health care safety net, are on the front lines of responding to the COVID-19 pandemic and treating those with the most acute cases. How are they adapting to meet the challenge? Are there lessons from this crisis that can help strengthen the safety net and improve care for patients going forward? Register here.
NOPREN is hosting its monthly webinar with a focus on social determinants of health for Medicaid beneficiaries. This webinar requires no registration and can be accessed here.
Virtual care and digital health have become increasingly popular as a result of COVID-19. This webinar, sponsored by Stat News, will discuss the benefits and challenges of the increased use of virtual and digital care, as well as how virtual care will shift in a post-pandemic world. 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.
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