IMPAQ Health News
From our experts to your inbox. Every two weeks.
In this edition, learn about the race between the national COVID-19 vaccination effort and the delta variant, new CMS and state rules to combat consumer medical costs, and more.
Prescription drug prices have been rising over the last several years, potentially preventing consumers from obtaining necessary medications. Two new IMPAQ Health resources provide insights into this issue. In an issue brief, IMPAQ Health experts explore rising prices, efforts to slow the increases, and resources for tracking this issue. In a blog post, IMPAQ Health experts take a closer look at federal efforts under the Trump and Biden administrations to address Medicare prescription drug prices, plus preview potential congressional action.
The COVID-19 global pandemic has put increased pressure on an already stressed physician community, with certain specialties, such as critical care and infectious diseases, experiencing more burnout than others. In a new blog post, IMPAQ Health experts explain how community health workers—trained public health workers who serve as a bridge between communities, health care systems, and state health departments—may be able to alleviate some of physicians’ burdens. For instance, these workers are uniquely positioned to connect members of their communities to resources and also can identify needs within the health care delivery system.
COVID-19
COVID-19 Cases and the Delta Variant. Nearly half of U.S. states report increases in COVID-19 cases, and CDC Director Rochelle Walensky warns that the delta variant is a growing threat to those who are unvaccinated. However, Walensky maintains that vaccinated people are ‘safe’ from the delta variant.

  • In response to rising cases, localities like Los Angeles County have recommended that residents take stricter COVID-19 precautions, such as wearing face masks indoors, regardless of their vaccination status.

 
COVID-19 Vaccine Updates. By July 4, 20 states and Washington, D.C., met the Biden administration’s goal of having 70 percent of adults vaccinated with at least one dose of a COVID-19 vaccine. Despite this positive trend, gaps are growing in vaccination rates throughout the United States, leaving certain regions of the country at higher risk for severe COVID-19 cases. In June, nearly 100 percent of COVID-19 deaths were among unvaccinated adults.



The Health Care Workforce After COVID-19. Accelerated by the COVID-19 pandemic, over 48,000 physicians quit private practice, resulting in nearly 70 percent of U.S. physicians now being employed by hospitals or other companies, according to research from Avalere. At the same time, medical offices and facilities are having difficulty hiring entry-level health care employees, such as medical assistants and pharmacy technicians, raising concerns about the ability of the health care workforce to meet an expected increase in demand for services.
ACA & Medicaid Expansion
On 6/28, the Biden administration announced a proposal to add 30 days to the annual ACA open enrollment period, starting with the 2022 plan year. This extension, from Dec. 15 to Jan. 15, is intended to provide individuals with more time to research their coverage options, and it could boost Medicaid enrollment, as some individuals learn they qualify for Medicaid benefits when they search for coverage on HealthCare.gov. The proposal also includes a plan to open a month-long special enrollment period offering low-cost plans for individuals with annual incomes lower than 150 percent of the federal poverty level. Modern Healthcare (6/30)
A new study indicates that Medicaid expansion has not resulted in low-income or non-white patients seeking care at facilities other than safety-net hospitals. According to the study, by the Boston Medical Center and published in the Journal of the American Medical Association, these patients may be satisfied with their safety-net hospitals’ services, are reluctant to leave providers they have relationships with, or face discrimination in their attempts to transfer to other facilities. Fierce Healthcare (7/1)

  • Democratic policymakers are divided on how to expand Medicaid eligibility in the remaining 12 holdout states, with some pushing for the federal government to intervene. New York Times (6/28)
New Rules & Payment Models
On 7/1, CMS released an interim final rule, “Requirements Related to Surprise Billing; Part I.,” the first regulation to follow the No Surprises Act and the beginning of what is expected to be numerous regulations that will prevent consumers from receiving large, unexpected medical bills from their health insurance. Provisions of this new rule include the removal of prior authorization requirements for emergency services and that an issuer may not charge more than the in-network amount for emergency and air ambulance services regardless of if the provider is in-network. Wall Street Journal (7/1)
The Biden administration on 6/28 released the calendar year 2022 Home Health Prospective Payment System proposed rule, which proposes an expansion of the existing value-based home health purchasing model starting 1/1/22. This rule is in response to an evaluation of the model from 2016 to 2018, which found an average 4.6% improvement in quality scores and an annual average of $141 million in Medicare savings. The rule aims to reduce Medicare spending, while rewarding Medicare-certified home health agencies for efficient, high-quality care. Fierce Healthcare (6/28)
In 2021 alone, 42 states have introduced 108 bills to regulate pharmacy benefit managers (PBMs) after the Supreme Court upheld Arkansas’ right to enforce them last year, according to the National Academy for State Health Policy. The goals of many of these regulations are to decrease drug costs for consumers and increase transparency in the price negotiation process between insurance companies, drug manufacturers, and pharmacies. Kaiser Health News (6/30)
Graphic of the Week
In a new infographic, the National Institute for Health Care Management examines how the COVID-19 pandemic has affected people of color, what drives disparities among these groups, and proposes solutions to improve health equity.
Upcoming Events, Trainings, & Webinars
Monday, July 12, 2021, 1:30 pm – 3:00 pm ET
Join Health Affairs for a discussion of the health disparities among the 15 million people that live along the US-Mexican border. Authors in the Health Affairs issue of the same topic will present research on topics including insurance coverage statistics for adults and children and the effects of COVID-19 on immigrants and asylum seekers. Register here.
This webinar, hosted by the Center for Health Care Strategies and sponsored by the Commonwealth Fund, will cover how states can advance health equity through Medicaid managed care and primary care models. This webinar will also walk through case examples of how Michigan and the Southern Jamaica Plain Health Center have successfully implemented initiatives to advance health equity. 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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