IMPAQ Health News
From our experts to your inbox. Every two weeks.
In this edition, learn about racial and ethnic health disparities, the expansion of telehealth, surprise billing related to COVID-19, and coverage of AcademyHealth presentations by experts from IMPAQ and the American Institutes for Research (AIR).
As hospital systems experience their worst quarter in decades, profits are soaring for large, for-profit, publicly traded health plans. This article in Managed Healthcare Executive, co-authored by Kevin Van Dyke and Leah Dillard with Dr. Adam Block of the New York Medical College, examines hospitals’ current struggles, recent government emergency aid, and for-profit insurers’ recent requests for rate increases despite record earnings in the first half of 2020.
Over four million Americans have contracted COVID-19, which is now surging in the Midwest. In July, there were multiple days with over 1,000 COVID-19 deaths, which has pushed the national COVID-19 death count past 150,000. However, the country reported its lowest number of new cases in the last month on August 2.

  • Experts push for greater adoption of pooled testing, a popular testing method internationally that could increase state testing capacity by as much as 318 percent, while states join forces to request rapid response test kits.

  • Congress is slowly moving toward another virus relief package as it discusses issues such as direct payments, unemployment benefits, eviction prevention, and food security.

  • CMS announced that health plans in the ACA’s individual and small group markets may temporarily reduce premiums, if consistent with state law, until 2021.
Here are some resources for following the latest efforts to address COVID-19:

  • Georgia Tech created a tool that estimates the risk of attending an event by US county.

  • The Atlantic’s COVID Tracking Project, which provides data to both Johns Hopkins and the White House, collaborated with the Boston University Center for Antiracist Research to create a COVID Racial Data Tracker.

  • is tracking each US state’s progress against the pandemic, including status on key measures, testing activity, and health system sustainability.
COVID-19 Amplifies Racial
and Ethnic Health Inequities
Millions of volunteers are joining large-scale clinical trials for COVID-19 vaccines this summer, but Black Americans (13 percent of the US population) and Hispanic Americans (18 percent of the US population) typically constitute only five percent and one percent of clinical trial participants, respectively. Minority and elder participation in the trials is crucial if scientists are to take appropriate stock of populations who, for months now, have died at higher rates from the virus. Kaiser Health News (7/27)
Historically Black colleges and universities (HBCUs) face unique socioeconomic caveats in their decision to reopen. This article explores the health, financial, educational, and emotional considerations that HBCUs around the country are weighing as they prepare for this fall and how these factors may contribute to a growing racial divide on the decision to reopen schools. Politico (7/27)
Americans with diabetes, who make up 10 percent of the population, are 12 times more likely to die from COVID-19 than Americans without diabetes. These odds worsen if those individuals are minorities who face food insecurity, work “essential” jobs, live in multi-generational homes, or lack health insurance. USA Today (7/27)
COVID-19 and Telehealth
As a part of the Trump administration’s executive order to improve rural health and telehealth access, the White House and CMS are moving to expand the number and type of telehealth services available to Medicare beneficiaries and make permanent some of the temporary changes to payment policy instituted during the pandemic. This will require Congress to modify the Social Security Act to expand where telehealth services can be provided and who can provide them. The executive order also introduces a model to test new payment mechanisms that would give rural healthcare providers more flexibility with Medicare rules, more predictable financial support, and increased incentives and support as they move to value-based care. CMS (8/3)
Two studies published this week in JAMA Internal Medicine found disparities in Americans’ ability to take advantage of the recent telehealth boom due to age and financial constraints. Healthcare Dive (8/3)

  • The first study examined US seniors’ readiness to use telehealth services. The researchers found that due to physical factors, inexperience with modern technology, or both, approximately 13 million seniors, or 38 percent of all older adults, were not prepared for video calls with their physician.

  • The second study looked at seniors’ access to telehealth services. It found that more than 41 percent of Medicare beneficiaries lacked access to a computer with adequate internet access at home and about 41 percent lacked a smartphone with wireless data.
COVID-19 and Surprise Billing
Patients face harmful care gaps and unexpected fees as providers leave their insurance networks during COVID-19. Surprise bills lower patients’ ability to financially withstand the pandemic and ultimately their willingness to seek care when needed. Kaiser Health News (7/27)
Even within the same city, those who have received COVID-related testing and treatment have seen noteworthy variations in their medical bills. Complicated differences between provider and insurer policies have led patients to be billed anywhere from $0 to $6,408 for a COVID-19 test. The New York Times (8/3)
COVID-19 Vaccines and Treatments
An analysis of 1,551 studies published in JAMA Internal Medicine found that less than one-third of clinical COVID-19 studies had enough substantial evidence to change clinical practice. Center for Infectious Disease Research and Policy (7/27)
In a report published by the Center for American Progress, two Democratic health policy experts cautioned against shortages and disconnects in the United States’ current vaccine production infrastructure. STAT News (7/28)

  • This Politico article explains how communities of color are especially at risk in the nation’s eventual vaccine rollout, given they have traditionally faced greater barriers to getting vaccinated and have greater distrust in the health care system. Politico (8/3)
Spotlight on IMPAQ
IMPAQ President Dr. Adaeze Enekwechi to Address Health Equity & Social Determinants of Health at Upcoming Virtual Events
On August 18, Dr. Adaeze Enekwechi will be a featured panelist on the free Ernst & Young webcast, The Business Case for Achieving Health Equity. Dr. Enekwechi will join other national health care leaders to discuss how achieving health equity ultimately strengthens the US economy. Learn more and register.

On August 25, Dr. Enekwechi will discuss how we can humanize the social determinants of health during the “Social Determinants Up Close and Personal” session of Revel Health’s free Rev Up 2020 Virtual Healthcare Innovation Series. Learn more and register.
Other Health News
The White House released four executive orders aiming to lower pharmaceutical prices, but likelihood is low that the administration will finalize all four, if any, by Election Day. If passed, these rules would require drug manufacturers to propose plans to reduce their drug prices, allow personal importation of drugs from other countries, and force select health centers to negotiate discounts on insulin and EpiPens, among other provisions. STAT News (7/24)
Missouri voters narrowly approved Medicaid expansion via ballot measure on Tuesday (8/4), securing health insurance for approximately 230,000 low-income residents. The measure forbids restrictions, work requirements, or premiums for eligible enrollees. Forbes (8/5)
OSCAR unveiled its new $0 Virtual Primary Care program, which will offer unlimited virtual visits to its individual and family plan members at no cost in select markets. In addition, the program will offer vitals monitoring kits and in-home lab draws at no cost. Fierce Healthcare (7/30)
Due to COVID-19, CMS limited its annual changes in the proposed rule, including continuing a gradual implementation of the Merit-based Incentive Payment System (MIPS) Value Pathways. CMS will host a webinar next week to explain the proposed policies. CMS (8/4)
Feel-Good News Stories
Neighbors in New York City and across the world are assisting each other with groceries, emergency funds, essential supplies, and a support network to help survive the pandemic both physically and emotionally. Kaiser Health News (7/27)
Graphic of the Week
The CDC has some new tips for people attending gatherings this summer. These include reminding people to stay at home if they feel sick, arrange seating to maintain six feet of spacing, and bring their own food and drink.
Upcoming Events, Trainings, and Webinars
The COVID-19 pandemic has placed a spotlight on the impact of long-standing systemic racism on the health of Black Americans, including from the social determinants of health that increase the risk of acquiring or dying from COVID-19. This webinar will discuss how systemic racism harms health and how solutions-based approaches at the state and community level are making a difference. Register here.
Researchers in the US have suggested outdoor air pollution, which was killing around 4.2 million people worldwide each year before the pandemic began, has significantly worsened during the pandemic, and even led to more deaths. NIHCM will explore environmental injustice and how it affects communities’ short- and long-term health outcomes. Register here.
Revel Health will facilitate a discussion with speakers, including IMPAQ President Adaeze Enekwechi, about how to humanize SDoH through personal experiences and insights, address hidden barriers, and create solutions that are driving change. Register here.
NOTE: The information, analyses, and opinions expressed in the articles, publications, or comments contained therein are those of the authors and should not be considered verified or endorsed by IMPAQ or any of our partners or clients.