A Record-Breaking Week

We need to rethink probation and parole policies, which are responsible for driving nearly half of all people into state prisons — at a time when coronavirus cases are spiking across the country. Safely reducing the supervision population is good for public health and safety (Between 2007 and 2016, 37 states experienced declines in both supervision and crime rates.)

#1 Probation and parole funnel people into jails and prisons; we need to reverse this flow to reduce the number of people exposed to the virus in correctional facilities, which are hotbeds for the virus. The five largest known outbreaks occurring in jails or prisons and nationwide, the known infection rate for people behind bars is 2.5 times higher than the general population.

#2 Continued supervision unnecessarily risks the health of millions of people — those serving probation or parole terms, community corrections staff, their families, and communities. This is a population that disproportionately suffers from the types of pre-existing health conditions that increase fatality rates from COVID-19. 

Related: Vincent Schiraldi of the Columbia Justice Lab writes in USA Today about the experience of Rayshard Brooks, who was well aware of the flaws of probation before he was killed by police, and says his words should be heeded amid calls for reform. “Supervision systems can, and routinely do, incarcerate people for non-criminal acts, like using alcohol or having contact with a police officer. Brooks knew this and knew that his liberty and the life he had built was in jeopardy before a shot was fired.”
 

Related: Hear Brooks talk about the justice system's impact on his family, in his own words.

When COVID-19 hit, Christian Alvarez-Silva saw his vibrant college experience at The George Washington University dwindle to a stream of one-way virtual lectures while his on-campus support system crumbled. Add to that new stressors at home, and “there are a lot of distractions,” said Alvarez-Silva, 19. “It takes away from being able to focus on my studying.”

The problem: The shift to online learning has put students like Alvarez-Silva at greater risk of falling behind and, if patterns from previous recessions hold, primed the higher education landscape for a new crop of predatory for-profit institutions eager to put students in massive debt for a subpar online education. “Outcomes across the board for online education are worse than in-person,” says Kelly McManus, Director of Higher Education at Arnold Ventures. “But those outcomes and gaps for low-income students and students of color are even more pronounced.”

A spring 2020 survey revealed some worrying statistics about the realities of online learning: 

• 20 percent of students are using their mobile data plan to access courses

• 20 percent have problems connecting to live video lectures

• A stunning 40 percent reported that they predominantly use their smartphone to complete coursework. 

Bottom line: The pandemic has exacerbated inequities that already existed in higher education (like it has in almost every other system across America), and advocates worry that disadvantaged students will fall further behind. They’re looking to a range of policy interventions to deliver quality education and regulate for-profit entities.

By Rhiannon Meyers Collette, Communications Manager

It’s like they took the words right out of our mouths. In a new report, a key Congressional advisory committee on Medicaid policy stated that integrating care for individuals who qualify for both Medicare and Medicaid would help to better address the needs of vulnerable people and reduce healthcare spending.

It’s precisely what our Complex Care team has been saying all along.

Medicaid and Medicare are two big and very different government programs that were never designed to work together, which has led to fragmented care and misaligned incentives. Health outcomes for the dual-eligible population are among the worst in the nation — and despite comprising only a fraction of the Medicaid/Medicare demographic, they drive one-third of total spending.

The Medicaid and CHIP Payment and Access Commission (or MACPAC, in health wonk circles) says evidence shows integrated care and financing models work best — but only 1 out of every 10 dual-eligible beneficiaries is enrolled in one.

More can — and should — be done to boost enrollment in these models, MACPAC says. We couldn’t agree more.

Read the story >

Related: Dual-eligible beneficiaries are among the hardest hit demographic in the pandemic, according to new data from the Centers for Medicare and Medicaid Services. These findings underscore the need to fix broken coverage incentives.

By Stuart Buck, Arnold Ventures Vice President of Research
 

In the past few months, COVID-19 research has been released at a breakneck pace: MedRxiv (the preprint server) has 4,602 papers mentioning "COVID" as of 6/25/2020, while PubMed has archived over 25,000 such papers. Unfortunately, as we've seen, quite a few of the high-profile findings covered in the news turn out to be shaky or even deserve retraction. 

Some observers have criticized the rise of preprints, assuming that their lack of peer review makes them more unreliable or even dangerous. But is that really so? Some of the most egregious COVID papers so far have appeared in the top 5 peer-reviewed medical journals. And perhaps that is no surprise. In a Wired column, psychology professor Simine Vazire makes the case that "journals don't even pretend to ensure the validity of scientific findings" by reexamining data or code; instead, peer reviewers are stuck judging the surface-level write-up, which is "like asking a mechanic to evaluate a car without looking under the hood."

Perhaps worse, journals often can be overly influenced by factors that don't actually bear on scientific quality — the anticipated publicity a study might gather, or how famous a scholar is. Vazire has an alarming story from her editor days at a top psychology journal: She chose to reject a submission from a famous psychologist because of "serious methodological flaws." But the famous scholar complained to the journal committee that had hired Vazire; the committee then warned her about stepping on toes.  

The jury is still out on how much value (if any) peer review adds once all the costs and benefits are taken into account. But that fact is itself surprising — with so little evidence that peer review actually works, why not experiment with new models of scientific publication?