In their new Forefront article, Suhas Gondi, Benjamin Rome, and William Shrank from Brigham and Women's Hospital and Humana argue that, as regulators consider how mergers involving pharmacy benefit mangers (PBMs) affect competition, they should also consider the clinical and financial benefits for patients of merging pharmacy and medical benefits through integration between PBMs and health insurers. "Health insurers traditionally outsourced their pharmaceutical benefits to PBMs. On behalf of their health plan clients, PBMs build formularies that steer patients toward lower-cost drugs, negotiate prices with drug manufacturers, and manage contracts with networks of pharmacies that dispense medications to patients. PBMs also implement prior authorization and cost-sharing policies to limit use of high-cost drugs, similar to the tools used by health plans to manage other health care services such as emergency department visits or elective surgeries." Read the full article here: https://bit.ly/4dacYVi
Health Affairs
Book and Periodical Publishing
Washington, District of Columbia 22,549 followers
Since 1981, Health Affairs has been the leading journal of health policy thought and research.
About us
Health Affairs is the leading peer-reviewed journal at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online. Its mission is to serve as a high-level, nonpartisan forum to promote analysis and discussion on improving health and health care, and to address such issues as cost, quality, and access. The journal reaches a broad audience that includes: government and health industry leaders; health care advocates; scholars of health, health care and health policy; and others concerned with health and health care issues in the United States and worldwide. Health Affairs offers a variety of content, including: Health Affairs Journal Health Affairs Forefront (Formerly Health Affairs Blog) Health Policy Briefs Podcasts Events More information can be found here: https://www.healthaffairs.org/about
- Website
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http://www.healthaffairs.org
External link for Health Affairs
- Industry
- Book and Periodical Publishing
- Company size
- 51-200 employees
- Headquarters
- Washington, District of Columbia
- Type
- Nonprofit
- Founded
- 1981
Locations
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Primary
1220 19th St NW
800
Washington, District of Columbia 20036, US
Employees at Health Affairs
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Emily Zeigenfuse
Sr. Director, Marketing and Digital
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Kathryn Phillips
Professor & Founder UCSF Center for Translational & Policy Research on Precision Medicine at UCSF; Editor-in-Chief Health Affairs Scholar
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Sue Ducat
Senior Communications Director at Health Affairs
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Julia Nalitz Vivalo
Design Director at Health Affairs
Updates
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In their new Forefront article, Daniel Eisenkraft Klein and Aaron Kesselheim from Harvard Medical School and Brigham and Women's Hospital argue that it is time to revisit the potential of "money blinds," a method that involves using an intermediary agency to handle the funding and selection of investigators, ensuring that the pharmaceutical companies cannot directly influence the outcomes of the studies. "The Lykos case exemplifies the broader issues that often emerge when pharmaceutical companies run and fund their own clinical trials. Blinding participants is integral to clinical trial research. But many other decisions in a clinical trial, such as participant selection, dosing, outcome measurement, data analysis, and result reporting, also remain susceptible to bias because researchers may have incentives to favorably influence results." Read the full article here: https://bit.ly/4c6qmbz
Revisiting The Potential Of "Money Blinds": Lessons From Lykos's MDMA Research | Health Affairs Forefront
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In the July issue of Health Affairs, Richard Hughes IV of Epstein Becker & Green, P.C. and The George Washington University documents his efforts as a vaccine law and policy expert to implement evidence-based health policies within heavily political contexts. Hughes documents his unsuccessful attempt to make the human papillomavirus (HPV) vaccine a requirement for school entry for children in Arkansas. He argues that moral judgment, rather than scientific evidence, likely contributed to this defeat. Following his time in Arkansas, Hughes moved to Washington, DC., where he realized that his goal of implementing a law to strengthen federal authority to combat measles was political infeasible. He also documents his later experiences with pandemic fatigue and vaccine misinformation during the COVID-19 pandemic. Hughes concludes by arguing that “misinformation and politics have gotten in the way of sound health policy.” He recommends that public health officials should ground their decisions in science and work to make vaccine science more accessible. Read the full paper: https://bit.ly/3LOF3W8
Vaccine Politics | Health Affairs Journal
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In their new Forefront article, Lekshmi Santhosh, Carolyn Rennels, Jessica Lee, and Christina Mangurian from the University of California, San Francisco and UCLA propose a framework for medical education systems to support medical trainees who want to build families, highlighting three critical phases: before birth, during parental leave, and during return to work. "Academic medicine was not built with women in mind. Since most women have children in their twenties and thirties, many trainees become pregnant during medical school and residency. As described in detail below, because of limited systematic support before birth, during parental leave, and after return to work, people who give birth during training are a vulnerable population prone to mental health challenges. For example, in one study in an academic medical center, female residents were four times as likely to report symptoms of postpartum depression than the general population." Read the full article here: https://bit.ly/3WsQS9h
Supporting Perinatal Mental Health For Medical Trainees | Health Affairs Forefront
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Join us August 19 for a virtual event on the implications of recent nursing home developments for residents, their families, and the future of long-term care: https://bit.ly/3A6bU6n With support from the The John A. Hartford Foundation.
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On Health Affairs This Week, Jeff Byers welcomes Senior Editor Marianne Amoss to the program to explore the state of maternal health in health care and what a recent policy proposal from CMS could do to reduce maternal mortality and advance health equity.
Podcast: HHS Proposes Requirements To Advance Maternal Quality Improvement Efforts | Health Affairs Podcast
healthaffairs.org
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In their new Forefront article, Annabelle Ng, Teresa Janevic, Ashley M. Fox, Frances M. Howell, Heeun Kim, and Ellerie Weber from Icahn School of Medicine at Mount Sinai, Columbia University, University at Albany, the VIBE Research Lab, and UCLA argue that, while Medicaid postpartum extensions mark significant progress toward improved access to maternal health care in the United States, these extensions currently ring hollow for millions of pregnant immigrants who are ineligible because of nuances in state pregnancy-related Medicaid policy. "However, just because a state has adopted postpartum extensions under the American Rescue Plan does not mean the extensions automatically apply to all pregnant Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries (also true for the de facto FFCRA extensions). Rather, due to vagaries in how states have elected to pay for—or extend eligibility for—births to immigrants, extensions will only apply to specific Medicaid and CHIP programs. Fundamentally, because of historic Medicaid policies, noncitizens are significantly more likely than their citizen peers to be categorically excluded from postpartum extensions." Read the full article here: https://bit.ly/3WwTX8B
Twelve-Month Medicaid Postpartum Extensions Ring Hollow For Immigrant Communities | Health Affairs Forefront
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In their new Forefront article, Erin Weir Lakhmani and Diane Beaver from Mathematica argue that, to improve care for people who are dually eligible for Medicare and Medicaid, policy makers should modify the often-overlooked Medicare Savings Programs. "Established under the Medicare Prescription Drug, Improvement and Modernization Act of 2003, the LIS program reduces Medicare Part D prescription drug plan premiums and cost sharing for Medicare beneficiaries with limited income and resources. While the purpose and benefits of the LIS program for prescription drug coverage largely mimic those of MSPs for inpatient and outpatient care, the LIS program and MSPs are administered separately and differently. The Social Security Administration (SSA) handles LIS program eligibility and enrollment, while states are responsible for administering MSPs, and certain rules for LIS program eligibility are less stringent than those typically used by states for MSP eligibility. Fortunately, Congress and state Medicaid agencies both have the power to create alignment between these two important programs to ensure that low-income older adults and people with disabilities can afford both prescription drugs and medical care." Read the full article here: https://bit.ly/4d2qGJE
Medicare Savings Program Benefits Are Hard To Access. Congress And States Can Make It Easier | Health Affairs Forefront
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In their new Forefront article, Yuvaram N.V. Reddy, Sri Lekha Tummalapalli, Gaurav Jain, Amol S. Navathe, Sumit Mohan, and Mallika L. Mendu from the Penn State College of Medicine, Weill Cornell Medicine, The University of Alabama, Columbia University, and Mass General Brigham discuss how the Increasing Organ Transplant Access (IOTA) model may be a promising opportunity to increase kidney transplantation rates and narrow disparities while also focusing on improving quality of care, living donation, allocation efficiency, and organ use. "CMS has frequently leveraged kidney payment models to test new policies that were subsequently integrated into non-kidney payment models. For example, the ESRD Treatment Choices (ETC) model was the first CMS model to include a health-equity incentive to address health disparities. As such, CMS’s new considerations for health equity within the IOTA model may inform future changes that may occur in other CMS non-kidney payment models. Additionally, as both models have been intentionally designed to improve health equity, the models provide an opportunity to evaluate whether health-equity incentives embedded within payment policy can address health disparities nationally." Read the full article here: https://bit.ly/3SS2xxJ
Advancing Equity In Kidney Transplantation Through The Increasing Organ Transplant Access Model | Health Affairs Forefront
healthaffairs.org
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In their new Forefront article, Gregory Curfman and Nicole Huberfeld from JAMA and the Boston University School of Public Health discuss how, fifteen years after the passage of the Tobacco Control Act, the fact that the FDA has finally prevailed in mandating graphic warning labels for cigarette packaging and advertising signals a victory for the public’s health. "Since 2011, the FDA has attempted to comply with the law but has been blocked by challenges from the tobacco industry. The basis for the industry’s legal actions is the free speech clause of the First Amendment, which protects commercial speech, such as advertising. This litigation has pushed federal courts to reconsider how commercial speech by the tobacco industry is protected and whether government-required, image-based warnings should receive heightened scrutiny. But a recent appellate court decision indicates the industry may be fighting a losing battle." Read the full article here: https://bit.ly/46pUzRM
Federal Appeals Court Upholds Graphic Warning Labels For Cigarettes | Health Affairs Forefront
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