We are in final weeks of the August Congressional recess and domestic policy discussions are focused on the infrastructure bills being considered in the House while we continue to grapple with the Delta variant, health systems at the point of fracture, and substantial anti-vaccine misinformation and sentiment.
Nursing home workers must get vaccinated against COVID-19
The Biden administration will require nursing homes to mandate that all of their workers be vaccinated against covid-19 as a condition for those facilities to receive federal funds. President Biden is directing the Department of Health and Human Services to develop the new regulations for long-term care workers who serve people enrolled in Medicare and Medicaid programs. The new regulations would apply to more than 15,000 nursing home facilities, which employ roughly 1.3 million workers, according to a person familiar with the announcement who requested anonymity to share details that were not yet public.
The Center for Medicare and Medicaid Innovation looks ahead
Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and other CMS leaders wrote in Health Affairs about their vision for the Center for Medicare and Medicaid Innovation (CMMI) in the next ten years. They called for five objectives for delivering equitable and high-value care: drive accountable care; advance health equity; support innovation; address affordability; and partner to achieve system transformation.
Congress is moving closer to allowing Medicare to negotiate with drug manufacturers
President Biden has called on Congress to pass legislation that would allow Medicare to negotiate drug prices and to cap drug price increases at the rate of inflation or require the companies to pay a fine. These remarks come at a time when Congressional Democrats are drafting a reconciliation bill for “soft infrastructure” funding, which would include policies to make health care more affordable and equitable. The Senate passed the budget resolution authorizing the drafting of the reconciliation bill on August 11, sending it to the House for passage.
The White House is continuing to develop ARPA-H proposals
The National Institutes of Health (NIH) and the White House Office of Science and Technology Policy (OSTP) have held 15 listening sessions with patient organizations and scientists over the last month to help optimize the proposed Advanced Research Projects Agency for Health (ARPA-H). AcademyHealth CEO and President Lisa Simpson was invited to discuss why supporting health services research is key to improve health equity. You can read more about her thoughts here.
More than 2.5 million Americans gained health coverage during the special enrollment period
More than 2.5 million people enrolled in health coverage on HealthCare.gov and state Marketplaces during the Biden Administration’s 2021 Special Enrollment Period (SEP). Additionally, the American Rescue Plan lowered premiums by an average of $40 per person per month.
What I’m reading
As we all experience growing anxiety over the toll of the delta variant and vaccine hesitancy, this article from Science provides a good summary of what we might expect in terms of future variants.
The Commonwealth Fund released a report comparing health care in the US with other high-income countries and found that the US ranks last on access to care, administrative efficiency, equity, and health care outcomes, but second on measures of care process. The authors point to four features that differentiate between the US and these other countries: 1) they provide for universal coverage and remove cost barriers; 2) they invest in primary care systems to ensure that high-value services are equitably available in all communities to all people; 3) they reduce administrative burdens that divert time, efforts, and spending from health improvement efforts; and 4) they invest in social services, especially for children and working-age adults.
The ongoing pandemic has been devastating to our nursing workforce, as turnover and burnout are leaving hospitals understaffed and patients receiving lower quality care than they otherwise would. Nurses and all other medical staff need to have access to mental and emotional support in order to stay safe.
One of the health systems challenges in the pandemic has been the breakdown of reporting COVID-19 data. Politico wrote about the challenges that state health agencies have had, from reporting data via fax machines to lab results being shared through the mail to outdated computer systems. While the CDC relies on states to identify and monitor outbreaks, the pandemic showed that this patchwork system based on outdated surveillance systems failed to allow for the collection and analysis of data in real time. Updating our public health data systems must be a priority as we continue to grapple with this pandemic and prepare for future crises.
Racial, ethnic, and socioeconomic health care disparities are unambiguously present in our health care system. Mahajan et al published in JAMA their study on almost 600,000 adults and found that while 6.3 percent of white individuals with middle to high income reported poor or fair health status, that number shoots up to 24.9 percent for Black individuals with low income. This article was just one of several in the special issue of JAMA on equity.
Finally, did you know that Altmetric introduced a significant change to their weighting system which cut the effect of Twitter by 75%? They also added an interpretation to the graphic.