As the new year begins, Health Affairs compiles their annual top ten lists, citing the previous year’s most influential contributions. This year, three articles and one podcast from faculty at the Harvard Department of Health Care Policy (HCP) feature among the journal’s picks.
Among the top ten articles selected by Health Affairs Editor-in-Chief Alan Weil is "Differences in Nursing Home Staff COVID-19 Testing Rates and Odds of Vaccination Across Work Shifts" co-authored by David Grabowski.
In this study, the authors expand on the study of COVID-19 vaccination and testing among nursing home staff by investigating disparities within this workforce. The study reveals a concerning gap between day and night-shift staff; day-shift workers had the highest rates of COVID-19 testing and vaccination, while those on night shifts had the lowest. These findings identify the structural barriers affecting access and emphasize the need for targeted interventions to ensure uniform testing and vaccination across all nursing home staff.
Highlighted as one of the year's most-read articles is "Risk Adjustment and Promoting Health Equity in Population-Based Payment: Concepts and Evidence" byJ. Michael McWilliams, Gabe Weinreb, Lin Ding, Chima D. Ndumele, and Jacob Wallace. This study examines the role of accounting for “social risk” as part of risk adjustment in population-based payment systems such as Medicare Advantage or accountable care organization programs. The authors lay out conceptually why using social factors as predictors to improve “accuracy” of payment can have a limited or detrimental impact on equity. They then provide empirical evidence documenting this and demonstrating that existing payment models go further to set payment above historical spending for some underserved groups, thereby supporting levels of spending that are more commensurate with meeting unmet needs and encouraging health plans and providers to attract underserved patients with enhanced care.
Also, among the most-read articles is "Adult Primary Care Physician Visits Increasingly Address Mental Health Concerns," an article by Lisa S. Rotenstein, Samuel T. Edwards, and Bruce E. Landon. This paper, based on nationwide data from 2006 to 2018, reveals a significant rise in primary care physicians addressing mental health concerns of their patients. The study also reveals concerning disparities, with Black and Hispanic patients less likely to have their mental health needs addressed. The authors advocate for payment models and billing codes supporting integrated behavioral health, alongside organizational designs that promote longer visits and collocated therapy services.
Rounding off HCP's contributions is "A Health Podyssey: Michael Chernew on Medicare Advantage Benchmarks," a podcast featuring insights from the Professor of Health Care Policy. In this episode, Chernew discusses the potential consequences of reducing Medicare Advantage (MA) benchmarks, reflecting on recent studies which suggest that cutting MA plan payments could lead to some increases in costs and reductions in benefits. While such adjustments might make MA plans less attractive, the overall impact is projected to be modest. The podcast emphasizes the need for policymakers to carefully consider the potential effects on beneficiaries when contemplating changes to MA payments.
Health Affairs is a prominent peer-reviewed journal of health policy research, investigating critical domestic and international healthcare issues. With a global reach including government officials, health industry leaders, advocates, and scholars, the journal is a pivotal platform, shaping conversations around health, healthcare, and policy.
We thank Health Affairs for spreading the word and sparking conversations about current healthcare research and look forward to the new year in groundbreaking publications!