Health Affairs This Week

Last week, the CDC updated its guidance on mask-wearing in public for individuals that are fully vaccinated against COVID-19. The agency stated, "if you are fully vaccinated, you can resume activities that you did prior to the pandemic." That means fully vaccinated individuals can wear masks indoors or outdoors if they choose to.

Unsurprisingly, this guidance was met with controversy.

Some critics felt the guidelines were too abrupt while others questioned if the guidelines hold up principles of health equity. On today's episode of Health Affairs This Week, Health Affairs' Blog Editor Chris Fleming and Director of Equity Vabren Watts review the CDC guidelines and discuss the criticism and remaining questions surrounding the agency's decision.

Related Links:

• When You've Been Fully Vaccinated (CDC)
• Fauci Says Public Is 'Misinterpreting' Latest CDC Mask Guidance (CNBC)
• The CDC's Mask Guidance Is A Mess. Biden Needs To Clean It Up (Washington Post)
• Community Use Of face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US (Health Affairs)

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The COVID-19 pandemic reshaped the telehealth landscape. Many physicians and patients had their first experience with a telehealth visit as lockdown measures limited in-person physician offices.

Many questions remain whether the telehealth explosion is a flash-in-the-pan success or if it will have long-lasting changes in patient visit behaviors.

Health Affairs' Chris Fleming and Rob Lott join Health Affairs This Week to discuss a recently published series of blog articles on the topic and unpack the biggest questions regarding the future of telehealth, including:

• Should Medicare continue payment parity?
• Where does payment reform stand on telehealth?
• What are current barriers affecting implementation of telehealth?

Related Links:

• The Coming Conflict Over Tele-Visits: The Need For Innovation In Payment And Information Sharing (Health Affairs Blog)
• Understanding The Case For Telehealth Payment Parity (Health Affairs Blog)
• Congress: Act Now To Ensure Telehealth Access For Medicare Benefits (Health Affairs Blog)
• Mutual Recognition Of Physician Licensure By States Would Provide For Better Patient Care (Health Affairs Blog)
• How Telehealth Can Enable New Care Management Strategies In Alternative Payment Models (Health Affairs Blog)

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The American Rescue Plan was signed into law by President Joe Biden on Thursday March 11, 2021.
A lot of news has covered the inclusion of the $1,400 stimulus check, but there is a lot in the bill concerning health and health care policy. For example, the American Rescue Plan offers financial incentives to states that have yet to expand Medicaid. In addition, the bill expands the eligibility for health insurance subsidies and temporarily relieves premium tax credit claw backs for 2020. These changes are expected to extend coverage to about 2.5 million uninsured consumers from 2021 through 2023.

On today's episode of Health Affairs This Week, Georgetown University faculty member and Health Affairs Contributing Editor Katie Keith joins Health Affairs Blog Editor Chris Fleming to discuss what's in the American Rescue Plan for health care.

Related Links:

• Biden's $1.9 Trillion Rescue Plan Set To Turbocharge U.S. Economy (NPR)
• Final Coverage Provisions In The American Rescue Plan And What Comes Next (Health Affairs Blog)
• The Affordable Care Act's Insurance Marketplace Subsidies Were Associated With Reduced Financial Burden For US Adults (Health Affairs)
• Biden And New Congress Tackle COVID-19, ACA (Health Affairs)
• CBO Analyzes American Rescue Plan Coverage Expansions (Health Affairs Blog)
• New Incentive For States To Adopt The ACA Medicaid Expansion: Implications For State Spending (Kaiser Family Foundation)

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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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“Racism is an uncomfortable subject for a lot of people in academia and academic publishing itself is part of the problem, in that a lot of journals including Health Affairs have neglected to name racism and publish research about how racism harms health.” - Leslie Erdelack.

In February, Health Affairs published a theme issue dedicated to racism and health.

Understanding and addressing the impact of racism, particularly structural racism, on health is essential to building equity in health. As Health Affairs Editor-in-Chief Alan Weil wrote on Health Affairs Forefront in June 2020, the legacy of racism “is baked into our institutions, our thinking, and our policies.”

Racism must be explored as a key driver of health outcomes and health disparities.

In today's episode, Health Affairs' Jessica Bylander and Leslie Erdelack discuss the publication process, main findings, and research insights from the Health Affairs February 2022 theme issue on racism and health.

Health Affairs thanks Rachel Hardeman of the University of Minnesota and José Figueroa of Harvard University, who served as theme issue advisers. Health Affairs also thanks the Robert Wood Johnson Foundation, the California Wellness Foundation, the Episcopal Health Foundation, the New York State Health Foundation, and the W.K. Kellogg Foundation for their generous support of this issue.

Order the February 2022 Health Affairs Racism and Health theme issue.

Related Links:

• Health Affairs Racism and Health Theme Issue
• Health Affairs' Interview with Harriet Washington, author of Medical Apartheid
• Systemic and Structural Racism: Definitions, Examples, Health Damages, And Approaches To Dismantling (Health Affairs)
• Sick And Tired Of Being Excluded: Structural Racism In Disenfranchisement As A Threat To Population Health Equity (Health Affairs)
• The Mutually Reinforcing Cycle Of Poor Data Quality And Racialized Stereotypes That Shapes Asian American Health (Health Affairs)

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