A New Nonprofit for Our New Era of Journalism

As part of an ongoing series, we are exploring the reform landscape of 2022 in all the areas where we work. AV’s health care team is excited about an array of opportunities to improve care delivery and lower costs. Here are the key developments getting their attention:

• In commercial sector pricing, there is momentum to address health care consolidation and anticompetitive behaviors, which drive up health care prices without improvements in quality and result in higher costs for everyone. Policies such as strengthening merger notification and review, allowing FTC oversight over nonprofit hospitals, and banning anti-tiering and anti-steering clauses in plan-provider contracts have bipartisan interest and are supported by consumer and employer groups.
   
• In drug pricing, the Prescription Drug User Fee Act is up for renewal this year and offers a chance for Congress to right-size drug approval standards so our health care system only pays for drugs with an established clinical benefit. Congress also has a critical opportunity to limit the cost of prescription drugs via the House-passed version of the Build Back Better Act, which empowers Medicare to negotiate lower prices, penalizes manufacturers for raising prices faster than inflation, and reforms Medicare Part D to ensure life-saving medications don’t bankrupt Americans. 
   
• In the provider payment incentives space, there is renewed momentum to transform the way we pay for care at both the state and federal level. The Center for Medicare and Medicaid Innovation’s future strategic direction for payment reform signals an interest in focusing on fewer, more effective models, advancing health equity, exploring more mandatory models for providers, improving multi-payer alignment, and engaging a broader range of provider types.
   
• Medicare sustainability is also an area to watch. The program faces significant fiscal challenges as rising per capita health care costs and the aging of the baby boomer generation strain the federal budget. Congress can make progress toward improving Medicare’s financial status, including by considering policies that reduce overpayments and enhance competition among Medicare Advantage plans, ensure efficient payments to traditional Medicare providers, and strengthen Medicare financing.
   
• And finally, complex care: For low-income older adults and people with disabilities who are dually eligible for Medicare and Medicaid coverage — one of the hardest hit populations in the pandemic — it is imperative to reduce the fragmentation in care delivery by expanding the availability of integrated Medicare-Medicaid models. 

By Torie Ludwin, communications manager

Return on investment is buzzing in higher education right now. Students want to know they’re getting more than a mountain of debt from their education. Taxpayers want to see their dollars go toward quality degrees, not predatory institutions. And what about schools — what can they do to be accountable for supporting return on investment? A lot, it turns out. 

What’s Happening: Andrew Kelly, senior vice president for strategy and policy at the University of North Carolina (UNC) System Office, has studied the connection between student support and return on investment. The UNC system has put into place robust data gathering to learn in near-real time how students are doing and what can be changed on the ground to better support them on their path to graduation.

Dive Deeper: AV’s Director for Higher Education Kelly McManus sat down with Kelly to talk about the UNC Student Success Innovation Lab, which pairs researchers and those working directly with students to identify and scale what’s working; a new effort to help transfer students graduate on time; and why we need more rigorous inquiry to help older students to be successful. 

Read the story >

Related: The Postsecondary Economics and Equity Research Project (PEER) just released a paper identifying optimal debt-to-earnings thresholds and repayment rates. It offers an excellent debrief on return on investment and accountability in higher education.

5.3 million
The number of Medicare beneficiaries who struggled to afford their prescription drugs in 2019

1.5 to 2x
Black and Latino adults 64 and older were 1.5 to 2 times more likely to have a hard time affording prescription drugs than white adults.

26.2%
The percentage of Medicare beneficiaries under 65 with diabetes who experienced problems affording their medications. The rates were even higher for people with common conditions like asthma and COPD.
 

A new federal report that spotlights the impact of high prescription drug prices on people enrolled in Medicare, underscoring the need for Congressional reform to lower drug prices. Read the report >

And from the Congressional Budget Office…

From 2009 to 2018, the average net price of brand-name prescription drugs more than doubled in Medicare Part D from $149 to $353 and increased by nearly 50% in Medicaid, from $147 to $218. Read the analysis >

Bottom line: Americans are demanding lawmakers act to lower prescription drug prices. Read more >

Criminal Justice

• "Right now, the false belief that cash bail keeps communities safe presents one of the biggest risks to public safety," writes former Rep. Doug Collins in The Daily Signal. He argues that it is up to conservatives to offer real solutions regarding bail reform.
   
• Citing the Waukesha tragedy, Utah County Attorney David O. Leavitt makes the case in Newsweek that cash bail is making us all less safe. "Wealth and freedom should be completely uncorrelated in this nation. While cash bail was part of our criminal justice system of the past, this principle simply does not belong in America's future." 
   
• This Advance Local investigation finds that the tiny Alabama town of Brookside is funding its operations through aggressive policing, with a soaring number of ticket-related fines and forfeitures trapping people in debt. “Brookside is a poster child for policing for profit,” says Carla Crowder, director of Alabama Appleseed Center for Law & Justice. “We are not safer because of it.”
  
  Related: Here is an excellent follow-up on the origins of such predatory policing. 
   

• “For far too long, the loudest voices have belonged to those with the keys to the debtors’ prison — police officers, prosecutors, sheriffs, even judges and legislators. Now more than ever, it is time for journalists to center the experiences of the people on the receiving end of their cruelty and neglect.” St. Louis Post-Dispatch columnist Tony Messenger writes in Inquest about the role of the journalist advocate.
   

• German Lopez writes in The New York Times how the impact of gun violence is felt unequally across the country, where a “small segment of neighborhoods account for most of the violence.”
   
• HuffPost examines the media’s use of language around police shootings. 
   
• Police departments are using social media and YouTube to boost public support and aid recruitment to counteract images of police brutality and calls for accountability, reports Buzzfeed News. 
   
• Roughly 1 in 8 people incarcerated in Florida is in solitary confinement, advocates say, and disproportionately they are people of color and those with mental illness, reports the Tampa Bay Times.
   
• Rahsaan “New York” Thomas, co-host of the Pulitzer Prize finalist podcast Ear Hustle, has been granted clemency. “While in prison, Mr. Thomas has dedicated himself to his rehabilitation,” California Gov. Gavin Newsom wrote.
   
• Remember this story about the judge locking up children in Tennessee? She will be stepping down from the bench, reports ProPublica. (That’s a win for impactful journalism.) 

Health 

• Surprise medical bills are ending, but patients could still be “surprised, confused, and angered” over health care bills, writes Larry Levitt in JAMA Health Forum.
  
  Related: A majority of voters want Congress to take action to lower health care prices.
   
• How dogged reporting helped drive change on surprise medical billing — and why the story doesn’t end there, via the Center for Health Journalism. 
   
• From The Commonwealth Fund, premium contributions and deductibles accounted for more than 11% of U.S. median income in 2020. These high costs are increasingly a burden for American families.
   
• Pharmacists may now dispense hormonal contraception without a doctor’s prescription in Illinois; Chicago Magazine explains how the new law works. Commenting in WTTW News, Katie Thiede of Illinois Contraceptive Access Now says, “One in three women has struggled to access birth control during the pandemic, due to health centers’ limited telehealth infrastructure. For Black and Hispanic women in particular, distrust of the health care system due to experiences of discrimination, racism and or contraceptive coercion, remains a barrier to care.”
   
• In The Hill, Martha Nolan calls for insurers to comply with Affordable Care Act’s legal requirements to provide free access to the full range of FDA-approved contraceptives. (Guess what, they haven’t been.)
   

Higher Education

• The Gainful Employment rule, meant to protect students from debt that far outstrips their earning potential, was a large part of the U.S. Department of Education’s negotiated rulemaking session this week. Diverse Issues in Higher Education explains the impact of the rule.
   
• The Department of Education must put a stop to the exploitation of veterans and their G.I. Bill dollars, writes Will Hubbard of Veterans for Education in The Hill. Says Hubbard, “For-profit colleges such as these aren’t just exploiting veterans; they’re ripping off taxpayers. Americans expect federal education benefits to provide veterans with the education and career opportunities they’ve earned. Instead, billions of dollars continue to line the pockets of for-profit college executives and their shareholders.”
   
• The Institute for Higher Education Policy released “Opening The Promise:” The Five Principles of Equitable Policymaking, a framework formed by more than two dozen higher education policy experts that examines entrenched inequities and opportunities for structural change.

Democracy

• Alaska’s state Supreme Court has upheld open primaries and ranked choice voting — which were chosen via ballot measure in 2020 — for its upcoming elections, The Anchorage Daily News reports.
  
  Related: How is Alaska empowering voters in 2022? Becky Bohrer of the Associated Press explains what open primaries will mean for representation across the state.
   
• Politico reports on Florida Gov. Ron DeSantis’ politically charged submission of redistricting maps for his own state, which “cut in half the number of African-American districts from four on current proposed congressional maps to two, while boosting the number of seats Donald Trump would have won in 2020 to 18 from the 16 on the map being considered by the GOP-led Florida Senate.”

The arresting “Wild: Bird of Paradise,” a four-part series from Emmy-nominated choreographer Jeremy McQueen, founder of The Black Iris Project. Original music, dance, poetry, and visuals coalesce to depict the experience of young Black men in New York City, and the trauma inflicted by persistent fear of persecution by the criminal justice system. McQueen drew inspiration from a visit to the Equal Justice Initiative’s Legacy Museum in Montgomery, Alabama, as well as Maurice Sendak’s classic children’s novel “Where the Wild Things Are.” His characters occupy space in the past, present, and future: “They're vying for and craving peace, a place where they can just be themselves, express themselves, rest and recharge,” McQueen tells The Marshall Project in this excellent writeup. “The boy in the dance lives, but I think really what happens to the boy next, or what happens to this ‘character’ next, truly lies in what we as viewers do to help support people like that young man.”

• Listen or watch, but hear the words of attorney and entrepreneur Brittany K. Barnett, who in this 12-minute TED Salon talk powerfully illustrates the ways unjust sentences can rob us all of ingenuity and interrupt the dreams of those languishing in prison. She shares the stories of Chris Young and Sharanda Jones, who, despite difficult circumstances that led to even harsher prison sentences, found ways to nurture their entrepreneurship while incarcerated. “Imagine what people like Chris and Sharanda, able to create and innovate under America's most inhumane conditions, could do if they were put in positions to thrive and not just survive. One thing is absolutely clear: We cannot keep rescuing people from prison and restoring them to poverty,” Barnett says. Keep listening to learn about the dividends of investing in the ideas of justice-impacted people, and what Young and Jones accomplished once released from prison.
   
• What is the No Surprises Act and how did it come about? AV’s Mark Miller, EVP of Health Care, joins The American Journal of Managed Care podcast to discuss the legislation, which went into effect Jan. 1 and protects patients for unaffordable surprise medical billing for out-of-network care. Miller discusses its implications for patients, and what might happen if lawsuits against the protection succeed. 
   
• Last week, Medicare proposed to only pay for a controversial new Alzheimer’s drug for Medicare patients willing to enroll in clinical trials. Tradeoffs Podcast has the analysis.

• On Jan. 27, the North Carolina Office of Strategic Partnerships will offer the workshop “Using Randomized Controlled Trials in North Carolina to Build Evidence for Effective Policy and Practice.” The session can be joined through this link from 9-10:15 a.m. ET. Can’t make it? The recorded session will be available here.
   
• Join AV and the Justice and Mobility Fund during the 2022 Economic Employment Convening for a 3-part conversation — Jan. 20, Jan. 27 and Feb. 3 — on removing barriers and increasing pathways to economic opportunity for people with criminal records. Learn more here.

• Belgian-British pilot Zara Rutherford, 19, has set a world record as the youngest woman to fly solo around the world.
   
• These high school football players understood the assignment. 
   
• Meet 6-year-old Kendall Rae Johnson, the youngest certified farmer in the state of Georgia.
   
• Carter Trozzolo is exhausted. Can you blame him?
   
• Challenge your historical knowledge with this timeline game.
   
• I'm sending this to my husband and all his dad friends immediately: "What Your Favorite Sad Dad Band Says About You," via McSweeney's.