Chartis Top Reads – Week of December 6 - December 12, 2020

Our research team breaks down this week’s top healthcare news.


Top Reads Overview

In an age of unprecedented change, staying current has never been more important. Our team at Chartis is curating news most relevant to the healthcare industry and tracking the topics that are trending on seven key issues: high reliability care, digital and advanced technology, financial sustainability, health disparities, the health ecosystem of the future, partnerships, and the provider enterprise. Each week, we break down what’s happening and why it matters.

The Next Administration

The Buzz This Week

President-elect Joe Biden this week continued to announce choices for many senior administration and advisor appointments and nominees, including healthcare leadership. He has chosen:

  • Jeff Zients, an Obama Administration economist, as the White House’s COVID-19 coordinator;
  • Xavier Becerra, a former congressman and current Attorney General of California, to serve as the Department of Health and Human Services Secretary;
  • Vivek Murthy to return to the surgeon general role, a position he held during the Obama Administration;
  • Marcella Nunez-Smith to lead the COVID advisory board with a focus on health equity;
  • Rochelle Walensky, Chief of Infectious Diseases at Massachusetts General Hospital, to lead the Centers for Disease Control and Prevention (CDC); and
  • Anthony Fauci, MD, to join his administration as senior medical advisor and serve on the COVID advisory team.

Positions that have not been named yet include CDC Director, Assistant Health Secretary for Preparedness, and nominees to lead the Food and Drug Administration and the Centers for Medicare & Medicaid Services.

Meanwhile, momentum is building to pass another relief bill prior to the end of the year. The proposed $908 billion bill includes an additional $35 billion for the health care provider relief fund.

Why It Matters

Biden’s nominees and appointees represent both those who have significant policy experience though no direct healthcare expertise, like Becerra and Zients, and renowned physicians with little political experience, like Walensky and Nunez-Smith. In addition to the leadership roles named, the Biden Administration pandemic response is likely to rely heavily on health agency deputies, like top scientists at the CDC.

Biden has emphasized that his response to the pandemic will be driven by science in other ways as well. He has called for 100 days of mask wearing throughout the country to start his presidency. He is also focused on building confidence around the vaccine and the distribution process. In order to assure the public of the safety of the vaccine, Former Presidents Bill Clinton, George W. Bush, and Barack Obama all have agreed to get vaccinated publicly.

Much like confidence building around the vaccine is taking a bipartisan effort, passing another relief bill this year will also require bipartisan collaboration. While many elements of the bill have broad agreement, Democrats want liability protection for businesses removed from the bill, and Republicans want to see less funding go to state and local governments. Another sticking point for some is that the current proposal does not include individual stimulus checks. Congress could pass the relief bill as early as next week.

Health Ecosystem of the Future

The Buzz This Week

The U.S. health system was already experiencing high costs, variability in quality, and broad inequities prior to COVID-19. The pandemic worsened many of these impacts. As we look to a post-COVID health system, one of the imperatives we must have is building a strong and comprehensive primary care system. Primary and preventative care are associated with improved cost, quality, and health equity, yet people in rural and lower income areas often lack access to providers. Additionally, many clinicians in the primary care field are experiencing significant burnout from being overworked and not adequately compensated.

Why It Matters

Strengthening the nation’s primary care foundation can help set a new path towards health equity, stabilized costs, and improved quality. To achieve this, it will likely take a mix of digital solutions, policy imperatives, and system change. Digital solutions like telemedicine and remote monitoring should be utilized to lessen the burden of unnecessary in-person visits, reducing no-show rates, and allowing access for those in rural areas or without transport. Increased telemedicine usage will likely require congressional legislation to clarify practice and licensure rules as well as government funding to expand broadband services to those communities that are currently lacking them.

To reduce the administrative burden on clinicians, we should consider how to diminish arduous provider tasks, especially those that inhibit care delivery. This may include consolidating technologies, streamlining quality and performance metrics, and developing uniform standards for billing.

Expanding and diversifying the pool of primary care clinicians can help solve for access gaps and lead to higher quality care for people of color. In 2020, academic medical centers are seeing an 18 percent spike in applications to medical school. While it remains to be seen if that will lead to any increase in matriculating medical students, residency slots, or eventually physicians, the increased interest is an opportunity to consider how we ensure a diverse and well-supplied primary care workforce in the future.

Health Disparities

The Buzz This Week

When COVID-19 arrived, many elements of the world economy came to an abrupt halt. Negative impact resulted across the globe, but there was an upside too: the reduction in carbon emissions and other damaging factors to the earth. Maps emerged showing dramatic reductions in traffic, fine particulate matter in the air, and emissions — as Bloomberg aptly put it, “Now we know that clear skies and silent streets can come about with shocking speed.” Unfortunately, this good news is mostly temporary. Climate experts have pointed out that carbon emissions, which have been steadily rising for decades, can stay in our atmosphere for 100 years, which means a short-term drop would have little to no effect on the trend.

In addition to the interesting connection between the pandemic and climate change, climate and health in general have a strong connection that is not always appreciated. Direct connections, such as emissions and particulate matter in the air leading to or exacerbating respiratory diseases such as asthma (or COVID-19) are evident. However, longer-term climate change and resulting phenomena, such as extreme weather, can contribute to injury, illness, or death, and do so unequally across populations — increasing health disparities on a national and global level. Health Affairs has dedicated an entire issue to “Climate and Health” this month. One overview piece states that vulnerable populations, such as the elderly Black and Indigenous populations, certain occupational groups, and women and girls “will suffer a disproportionate share of the impacts because of heightened physiological sensitivities, greater exposures, or less capacity to take protective actions.”

Why It Matters

While COVID-19 has rightfully occupied much of the world’s attention this past year, climate change should not be forgotten. The connection between climate, health, and health disparities should be further studied to better understand how health outcomes are affected and the best ways to mitigate negative impact. The economic effect of climate-sensitive health outcomes, such as the long-term cost for people with pollution-induced or exacerbated conditions, must be better understood. It will inform public policy that could impact how we reduce the speed of climate change and mitigate the fallout from what has already occurred.

These topics should be taught to and explored by medical students, healthcare executives, and government representatives. Health professionals and the institutions with which they are aligned can and should help advance efforts to address the climate crisis. As authors Jay Lemery, et al., propose in their Health Affairs piece on training clinical and public health leaders, health professionals must: (1) protect individual and community health from severe climate-related health threats; (2) ensure that healthcare and public health systems become resilient against the effects of climate change while also seeking to become carbon-neutral or sustainable; and (3) contribute their knowledge and expertise to advocacy efforts around the climate crisis. In the meantime, the nation’s health systems should prepare today for climate-related health challenges for the populations they serve, partnering with “health-determining sectors” and the government to establish a more resilient health system in the face of growing natural disasters and other effects from climate change. Unsurprisingly, a fairly consistent theme throughout articles on this topic is that additional funding is required to study the impact of climate on health and to implement related initiatives.


Contributors

Roger A. Ray. MD
Chief Physician Executive
[email protected]

Alexandra Schumm
Principal, Vice President of Research
[email protected]

Abigail Arnold
Senior Research Manager
[email protected]


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Past Top Reads

DECEMBER 2020
Week 1

NOVEMBER 2020
Week 3
Week 2
Week 1

OCTOBER 2020
Week 5
Week 4
Week 3
Week 2
Week 1

SEPTEMBER 2020
Week 4
Week 3
Week 2
Week 1

AUGUST 2020
Week 4

Chartis Top Reads - Week of December 6 - 12 | The Chartis Group