Health care workers in personal protective equipment attend to a patient.

Value-Based Reimbursement Can Decrease Spending on Medicare During COVID-19

By Sravya Chary

Since the start of the COVID-19 pandemic, the virus’ disproportionate threat to the Medicare patient population has been widely discussed and acknowledged. In light of the public health crisis and an increasing financial burden placed on entities involved in Medicare cost sharing, a value-based Medicare system would not only reduce costs, but also better protect the elderly and chronically ill during the pandemic.

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Main Entrance Of Modern Hospital Building With Signs.

To Address COVID-19 Disparities, 340B Hospitals Need More Flexibility

By Sravya Chary

Many racial minorities and low-income individuals rely on 340B hospitals and associated child sites for access to discounted drugs and charity care.

In 1992, Congress enacted the 340B program as an avenue of access to prescription medication for “the nation’s most vulnerable patient populations.” Hospital savings incurred from purchasing 340B drugs at a steep discount are invested in charity care programs to enhance patient services and access to care.

The 340B program is an essential component of the COVID-19 response. Increased flexibility for 340B covered entities is necessary to address disparities faced by marginalized communities.

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Health care workers in personal protective equipment attend to a patient.

How Much Help Do Health Care Systems Need to Survive Coronavirus?

By Michael Simkovic and Laleh Jalilian

Coronavirus has caused health care institutions’ precariously balanced finances to deteriorate by requiring the suspension of elective procedures in order to mitigate the spread of disease.

One of us has previously noted that less than 8% of the CARES Act stimulus package may reach the health care system, although there are options available to state governments and the U.S. Secretary of the Treasury to increase this amount. How much additional funding would it actually take to enable the health care system to continue functioning at close to normal capacity?

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Busy Nurse's Station In Modern Hospital

Hospital Administration and the COVID-19 Pandemic (Part II)

By Chloe Reichel

This post is the second in a series of question and answer pieces with Rina Spence about hospital administration and the COVID-19 pandemic.

The COVID-19 pandemic has brought numerous challenges to hospitals and hospital administrators: equipment shortages for both patients and health care workers; steep declines in revenue; and attendant staffing concerns.

Rina K. Spence served as the president and CEO of Emerson Hospital in Concord, MA from 1984 through 1994. Currently, Spence is an advisor to the Precision Medicine, Artificial Intelligence, and the Law Project at the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School.

Spence spoke with the Petrie-Flom Center to offer her perspective on the challenges hospitals are facing amid the COVID-19 pandemic. The conversation touched on: the basics of hospital administration; the business-like model by which many hospitals are run; unpopular decisions hospitals are making during the pandemic, like furloughing some staff and slashing retirement benefits; and steps forward in addressing the COVID-19 crisis at the hospital-level.

We’ve lightly edited and condensed the interview, which is running as a series of question and answer pieces. This second installment provides an overview of the administrative decisions hospitals are making during the COVID-19 pandemic, including cutting benefits for employees and furloughing staff.

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Main Entrance Of Modern Hospital Building With Signs.

Hospital Administration and the COVID-19 Pandemic (Part I)

By Chloe Reichel

This post is the first in a series of question and answer pieces with Rina Spence about hospital administration and the COVID-19 pandemic.

The COVID-19 pandemic has brought numerous challenges to hospitals and hospital administrators: equipment shortages for both patients and health care workers; steep declines in revenue; and attendant staffing concerns.

Rina K. Spence served as the president and CEO of Emerson Hospital in Concord, MA from 1984 through 1994. Currently, Spence is an advisor to the Precision Medicine, Artificial Intelligence, and the Law Project at the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School.

Spence spoke with the Petrie-Flom Center to offer her perspective on the challenges hospitals are facing amid the COVID-19 pandemic. The conversation touched on: the basics of hospital administration; the business-like model by which many hospitals are run; unpopular decisions hospitals are making during the pandemic, like furloughing some staff and slashing retirement benefits; and steps forward in addressing the COVID-19 crisis at the hospital-level.

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A calculator, a stethoscope, and a stack of money rest on a table.

Why Our Health Care Is Incomplete: Review of “Exposed” (Part II)

By: Daniel Aaron

Just last month, Professor Christopher T. Robertson, at the University of Arizona College of Law, released his new book about health care, entitled Exposed: Why Our Health Insurance Is Incomplete and What Can Be Done About It. Part II of this book review offers an analytical discussion of “cost exposure,” the main subject of his book with a focus on solutions. Read Part I here.

Baby solutions

Prof. Robertson writes two chapters on solutions. In the first, titled “Fixes We Could Try,” he offers reforms, from mild to moderate, that would make cost exposure less harmful. The chapter largely retains the analytical nature of the prior chapters, but it comes across like a chapter he might have rather not written. This is evident in the following chapter’s title, “What We Must Do.” It’s also evident because some of the proposals do not seem fully considered, and in some ways appear more controversial than the more comprehensive solution offered later. Read More

A calculator, a stethoscope, and a stack of money rest on a table.

Why Our Health Care Is Incomplete: Review of “Exposed” (Part I)

By: Daniel Aaron

Just last month, Professor Christopher T. Robertson, at the University of Arizona College of Law, released his new book about health care, entitled Exposed: Why Our Health Insurance Is Incomplete and What Can Be Done About It. This book review will offer an analytical discussion of “cost exposure,” the main subject of his book.

What is cost exposure in health care?

Cost exposure is payments people make related to their medical care. There are many ways patients pay – here are a few common ones.

  • Deductible – Patient is responsible for the first, say, $5,000 of their medical care; after this point, the health insurance kicks in. Resets each year.
  • Copay – Patient pays a specific amount, say $25, when having an episode of care.
  • Coinsurance – Patient pays a specified percentage, say 20%, of care.

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Large pile of amber prescription pill bottles

Recent Litigation Developments Regarding Drug Pricing and Access

This post originally appeared on SLS Blogs and is reposted with permission of the author. You can read the piece in its entirety here.

By Rebecca Wolitz

With multi-million dollar treatments entering the market, prescription drug costs accounting for between 15-17% of healthcare expenditures, and nearly 1 in 4 Americans unable to afford a prescription medication in the past 12 months, it is no wonder that prescription drug costs remain an important topic of national discussion. There has been a flurry of legislative proposals at both the federal and state levels this year, with Nancy Pelosi’s H.R. 3 recently passing the House. And, within the executive branch, HHS just issued its drug importation proposal. Both of these developments have been within the past few weeks; there is a lot going on. Not to mention we are heading into an election year. Read More

Ambassador-at-Large Deborah Birx giving a speech from a podium with an American flag and PEPFAR banner in the background

One of the Biggest Public Health Initiatives in History: PEPFAR and HIV

By Daniel Aaron

In October, the Petrie-Flom Center hosted a conference of world-leading experts in HIV/AIDS to discuss one of the biggest public health successes in history: PEPFAR, the President’s Emergency Plan for AIDS Relief. PEPFAR was launched in 2003 in response to a burgeoning global epidemic of HIV. The program offered $2 billion annually, rising to about $7 billion in 2019, to surveil, diagnose, treat, and reduce transmission of HIV around the world.

PEPFAR prevented what could have become an exponentially growing epidemic. It is estimated to have saved more than 17 million lives and avoided millions of new HIV infections. As a result, the speakers at the conference were quick to extol the virtues of the program. Professor Ashish Jha called it an “unmitigated success”; Professor Marc C. Elliott named it a “historic effort”; Dr. Ingrid Katz described PEPFAR as “nothing short of miraculous.”

However, several undercurrents within the conference, as well as more explicit points made by several panelists, suggested the importance of enlarging the discussion beyond PEPFAR itself to include other policies that impact HIV and AIDS, and even other diseases.

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U.S. Supreme Court building

Health Law Cases in the Upcoming Supreme Court Term

By Alexa Richardson

The next Supreme Court term is shaping up to include a number of critical cases that will impact health law. From insurance, the Affordable Care Act, abortion access, and mental health, the decisions made this term could have significant impacts on public health moving forward. Here are some of the key health law cases upcoming this term to keep an eye on:

June Medical Services, LLC v. Gee

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