President Biden is calling for Centers of Excellence at AHRQ for Long COVID
The President’s Budget called for the creation of Centers of Excellence at AHRQ that would specialize in treatment of Long COVID. The Administration has called for interim clinical guidance, so not only will these Centers of Excellence provide top-tier care, they will also disseminate their findings. Dr. Lisa Simpson was interviewed about these Centers, and noted that while AHRQ is the correct federal agency to lead in their creation, the currently budgeted $20 million is small down payment on what is actually needed.
The Friends of AHRQ have called for Congress to fully fund AHRQ at $500 million in FY23, with over 135 organizations representing patients, hospitals, doctors, nurses, universities, and more, signing a letter to House and Senate Appropriators. A fully funded AHRQ is critical for addressing a health system reeling from the pandemic, preexisting disparities, and poor health outcomes.
Additionally, the Friends had an exclusive opportunity to talk with the new AHRQ Director Bob Valdez to hear his goals for the agency and share their priorities. Director Valdez used this opportunity as a call to action, highlighting the role of AHRQ and HSR in responding to the pandemic, transforming the healthcare system, dismantling structural racism, improving maternal health outcomes, expanding access to high-value healthcare, and understanding the impact of climate change on health delivery. If you are interested in joining the voluntary Friends of AHRQ and attending future events, please send an email to Advocacy@AcademyHealth.org.
National Health Policy Conference and Health Datapalooza brought researchers, policymakers, and patients together
The joint Health Datapalooza and National Health Policy Conference continued to harness and strengthen the synergies that exist between the data and policy worlds. With healthcare spending making up 18 percent of domestic GDP, healthcare businesses thriving, and new technologies emerging, the conference allowed for participants to discuss why health outcomes “are going in the wrong direction” as stated by FDA Commissioner Robert Califf. Despite high-levels of spending, US health expectancy has been decreasing for years, with even worse outcomes among racial and ethnic groups. Speakers discussed the importance of including communities in question in designing research and implementing findings. You can learn more about what was discussed HERE.
You can register for access to 13 breakout sessions and all of the plenary speakers until May 6 HERE. You will be able to hear what CMS Administrator Chiquita Brooks-LaSure, ONC National Coordinator Micky Tripathi, congressional staffers, and dozens of the top experts in health systems have to say about the state of health data and health policy.
Congressional negotiators agree on a $10 billion COVID-19 supplemental
A bipartisan group of senators unveiled a $10 billion COVID-19 supplemental funding proposal to close the gap between existing funding for vaccinations and therapeutics and the end of the fiscal year. The bill would provide $9.25 billion for the Biomedical Advanced Research and Development Authority, of which at least $5 billion must be used to research, develop, manufacture, produce, purchase, and administer therapeutics. The remaining $750 million would be used for research and clinical trials on novel variants and vaccine manufacturing. Congress was unable to pass this legislation before a recess, but is expected to vote on it the week of April 25th.
Biden Administration announced new efforts to improve maternal health care
Congress and the Administration are considering and implementing legislation and regulatory changes to reduce poor maternal health outcomes, which has stark racial disparities as Black women face three times higher maternal mortality rates than white women. The American Rescue Plan provided funding to extend Medicaid and CHIP coverage for a full year after pregnancy. The Centers for Medicare and Medicaid Services have approved Louisiana, Virginia, New Jersey, and Illinois’ extension of Medicaid and CHIP coverage, and is working with another eleven states. In order to receive federal funds and to ensure consistency with federal standards, including those set by the American Rescue Plan, states must go through a formal process run by CMS. Medicaid covers more than 40 percent of births in the United States. Additionally, Vice President Kamala Harris convened a cabinet meeting on maternal health care, marking the first time any Administration held a meeting at that level on the issue. This meeting included agencies that may not have historically taken a leading role addressing the maternal health crisis.
CDC rolled out a new center for predicting disease outbreaks
The CDC announced the launch of the Center for Forecasting and Outbreak Analytics (CFA). CFA seeks to enhance the nation’s ability to use data, models, and analytics to enable timely, effective decision-making in response to public health threats for CDC and its public health partners. CFA’s goals are to improve outbreak response using infectious disease modeling and analytics and to provide support to leaders at the federal, state, and local levels. CFA will also develop a program to provide insights about infectious disease events to the public to inform individual decision making – the equivalent of the National Weather Service for infectious diseases.
Kindergarten vaccination rates continue to drop
Vaccination coverage for kindergartners dropped across the country in the 2020-2021 school year, according to data released by the Centers for Disease Control and Prevention, part of a worrying decline in childhood immunization since the start of the pandemic. Missed routine vaccinations can leave children and communities more vulnerable to preventable diseases like measles and whooping cough, which are highly contagious and serious for young children. Childhood immunization dropped dramatically at the start of the pandemic as families stayed at home and COVID-19 vaccine hesitancy spilled over, and have been slow to catch up.
Congressional Caucuses call for Congress to pass permanent health coverage provisions
The Congressional Black Caucus, Congressional Hispanic Caucus, and Congressional Asian Pacific American Caucus (together: Tri-Caucus) have called for Congress to pass measures that ensure that Americans keep health coverage when the public health emergency (PHE) officially ends. They propose requirements that states provide 12 months of continuous Medicaid and Children’s Health Insurance Program (CHIP) eligibility to children and 12 months of Medicaid and CHIP postpartum coverage; permanently fund CHIP and its associated policies that make it easier for kids to enroll in coverage; and permanently close the Medicaid coverage gap in states that have not elected to expand coverage. HHS has extended the current public health emergency authority until July 16, 2022.
What I’m reading
The pandemic has been a critical test for the NIH as the largest funder of biomedical research in the world, and it is worth reflecting on the lessons the agency and our field can take away. The NIH is currently waiting on a new director, further emphasizing the crossroads they are at. I read with great interest an article in Nature that identified four key lessons for the NIH: Fast innovation is possible and achievable; the biomedical workforce needs to be more diverse (a subject we have written recently to NIH on – here and here); a need to incorporate health services research and social sciences to increase buy-in; and the need for a director who understands the political and communication space.
Since the start of the pandemic, nursing home residents have accounted for one out of every six COVID-19 deaths. As we find ways to promote better health and safety among patients and the workforce, Dean et al wrote in Health Affairs about the role of unionized staff. They found that nursing facilities with unionized staff had 10.8 percent lower resident COVID-19 mortality rates and 6.8 percent lower worker infections. The authors suggested that labor unions worked more proactively to prevent worker COVID-19 infections, which led to less spread between staff and residents.
As government mask mandates are removed, it is important for us to remember that there are tens of millions of Americans who cannot get vaccinated, either because they are immunocompromised or are too young. Rumors have it that children under five may not be able to get vaccinated until mid-summer. We all have to make choices to protect ourselves, our loved ones and those who cannot protect themselves. Here is an excellent piece on how to weigh risks in Scientific American. Also, Bob Wachter recently had a good thread on his choices of when to wear a mask. But if you were wondering what to do on planes – well just follow lots of discussion on twitter with excellent data. Bottom line – YES.
The Human Rights Watch has a report out arguing that the high price for insulin in the US and its contribution to cost-based medicine rationing could constitute a violation of the right to health and a human rights abuse. The responsibility to protect human rights extends to all actors in the supply chain from manufacturers to purchasers to consumers.
As we grapple with dismantling structural racism, Kraus wrote in Psyche that over-optimism about the process of racial justice is both widespread and harmful. Although it is pleasing to think of change as being positive, preordained, linear, or automatic, yet in reality it can be the opposite. A predetermined belief in constant progress toward equity despite contrary evidence actually makes it more difficult to enact the kind of large, societal changes that are necessary to actually transform society into a more equitable version of itself. It assumes that time, rather than behavior, is the causal mechanism for producing racial equity. Success on racial equity is dependent on clear-eyed review of actual evidence, not assumptions of what we want the evidence to be.