Health Affairs

NEW A Health Podyssey Episode! LIVE from Aspen Ideas: Debra Whitman on Aging and "The Second Fifty" https://hubs.la/Q02FPk240

In their new Forefront article, Scott D. Landes, Bonnielin K. Swenor, Melissa A. Clark, Kelsey S. Goddard, Jean P. Hall, Amanda Hermans, Catherine Ipsen, Michael Karpman, Noelle K. Kurth, Andrew Myers, Susan J. Popkin, Maggie R. Salinger, and Nastassia Vaitsiakovich from the Aging Studies Institute, The Johns Hopkins University, Brown University, the Research & Training Center on Independent Living, the Urban Institute, the Research and Training Center on Disability in Rural Communities (RTC:Rural), and the Syracuse University - Maxwell School of Citizenship and Public Affairs argue that, to achieve an accurate, inclusive, and equitable form of justice, the processes through which we determine disability measures must also be equitable and inclusive. "There are currently two sets of questions commonly used to measure disability in US population surveys, both of which equate disability with limitations in “core functions.” One set of questions is derived from the American Community Survey (ACS-6) and involves six yes-no questions regarding functional limitations with vision, hearing, mobility, cognition, self-care, or independent activities of daily living. The other set of questions is the Washington Group Short Set (WG-SS), which also inquires about six functional limitations but uses a four-point Likert-type scale rather than a yes-no response. The WG-SS items ask respondents to quantify the degree of limitation (ranging from no difficulty, some difficulty, a lot of difficulty, to cannot do at all) in vision, hearing, mobility, cognition, self-care, and communication. Despite collecting data about the degree of limitation, responses from the WG-SS are subsequently dichotomized into “disabled” and “not disabled” categories, adding another layer of complexity and uncertainty about the most appropriate point where this cut-off should occur." Read the full article here: https://bit.ly/4cT3f5i

Health Affairs invites you to submit an abstract for an upcoming theme issue on Food, Nutrition, And Health. The issue is scheduled to publish in April 2025. Please see our full REQUEST FOR ABSTRACTS for more details: https://bit.ly/3xzaHn9 Abstracts are due via our online submission form on Monday, July 29, 2024. Please share with interested colleagues!

Check out Alan Weil on Don Berwick's podcast Turn on the Lights. In this episode‎, Alan explores ways to improve the US health care system and combat widespread misinformation. https://hubs.la/Q02Fzfwp0

In their new Forefront article, Carmel Shachar, Amy Killelea, and Sara Gerke from the Harvard Law School Center for Health Law and Policy Innovation and the University of Illinois College of Law discuss how AI is increasingly being used by health insurers to automate a host of functions, including processing prior authorization requests. There is also a growing need, they argue, for additional mechanisms for accountability and oversight of these algorithms. "Now the not-so-good news. Like all applications of AI in health care, improperly implemented AI for coverage decision making, including PA, can seriously harm patients. AI tools are only as accurate as the data and algorithm inputs going into them. As the old data saying goes, “garbage in, garbage out.” In the context of PA, we already have real-world examples of what happens when AI tools are used to make plan PA decisions without accurate clinical criteria and appropriate human review. Medicare Advantage plans sold by the insurance powerhouse have been in the spotlight for the company’s use of an AI tool that led to what patients and their doctors claim were inappropriate denials of postacute care. A federal class action lawsuit filed in Minnesota against UnitedHealthcare asserts that the AI tool had a 90 percent error rate, leading to thousands of elderly and disabled Medicare beneficiaries being denied medically necessary care." Read the full article here: https://bit.ly/4cxjVzC

LISTEN: Health Affairs' Meg Winchester and Kathleen Haddad share their scene report from AcademyHealth's latest Annual Research Meeting. They chat about private equity's effect on health care and a solutions-based approach to health care research. https://hubs.la/Q02FjdYd0

In their new Forefront Williams Walters and Richard Hughes IV from Epstein Becker & Green, P.C. argue that, once it reviews the available evidence on GLP-1s, the US Preventive Services Task Force should provide a recommendation for GLP-1s as a preventive service for those living with obesity. "The US Preventive Services Task Force (USPSTF or Task Force) is reportedly developing a draft research plan that will consider whether to grade anti-obesity medications (AOMs) as preventive medications for chronic weight management. Meanwhile, the Congressional Budget Office has laid out the new research it needs to assess the budgetary effects were Medicare to widely cover AOMs, specifically asking for data on near- and long-term clinical impacts, factors affecting use of the drugs and the expectations around the price and effectiveness as they are being developed." Read the full article here: https://bit.ly/4cnKAid

In their new Forefront article, Joshua M. Sharfstein and Nicole Lurie of the Johns Hopkins Bloomberg School of Public Health and the U.S. Department of Health and Human Services (HHS) argue that local public health is key to the fight against avian influenza, and they must have the resources they need to do their jobs well. "Avian influenza is making the case for local public health all over again. Even as farm owners express reluctance to permit federal officials to visit farms for testing, many appear open to local health staff doing the work. The Idaho state epidemiologist, Christine Hahn, recently explained to Politico that the state's dairies prefer the involvement of local public health over state and federal engagement. "The more local things can get done, the better," she said." Read the full article here: https://bit.ly/3XKGg8b

Managed care plans contract with state Medicaid programs to administer substance use disorder (SUD) treatments. In the July issue of Health Affairs, Lauren Peterson of the University of Chicago and her team of coauthors survey thirty-three states and Washington, DC to determine the role these states play in regulating the distribution of substance use disorder benefits across Medicaid managed care plans. The researchers find that of the fifty-one “state programs” examined, “high percentages of state programs mandated coverage for each of the SUD treatments and medications assessed.” Despite this, only sixteen of the thirty-two state programs that “contracted with managed care plans to administer SUD treatment services required coverage of all clinically necessary services…” Peterson and coauthors conclude that while many state Medicaid programs require managed care plans to cover the most common SUD treatment services, limits on comprehensive coverage remain, which might restrict access to lifesaving SUD services. Read the full paper: https://bit.ly/3zun1pn