Unsurprisingly, the Theme This Week is COVID

By Adrienne Faraci, Communications Manager

Communities of color are increasingly suffering from opioid use disorder. Even as the white overdose death rate has decreased in recent years, the rate among Black, Latino, and indigenous communities has skyrocketed.

What’s Happening: Experts on drug policy cite several factors for the increase. People of color are less likely to have access to health care, making it more difficult to get medications that are the gold standard for treating opioid use disorder. Because of racial disparities in justice involvement, they are also more likely to be incarcerated in jails and prisons, where these medications are often unavailable. And communities of color often have serious structural issues to overcome, such as a lack of stable housing, food, and education, which makes recovery harder.

Bottom Line: “We have medication, we have a variety of harm reduction interventions that are demonstrated by evidence to improve outcomes for people with opioid use disorder. But unfortunately, there are significant policy failures in the U.S. — rooted in stigma — that make these services hard to access, and for communities of color, that access gap is a lot greater,” says Sarah Twardock, AV Public Health Manager.

What’s Next: Advocates and researchers are promoting legislation that expands access to treatment and decriminalizes substance use, while practitioners are speaking up to demand more resources for treatment locally and working with people on the streets to deliver services. Making it a fiscal issue as state and local governments contend with budget shortfalls amid COVID-19 is also top of mind: “If a state legislature wants to pass legislation that expands access to treatment through any of these systems, particularly the criminal justice system, they're going to have to make the argument that it's going to save money,” says Regina LaBelle of the O’Neill Institute for National and Global Health Law at Georgetown University.

Related: What a Biden administration faces in the worsening opioid crisis, via The Washington Post. “For Biden, whose son Hunter has struggled with addiction, the issue is personal.”

Related: A surge in street fentanyl is leading to thousands of deaths in the Western U.S., NPR reports.

Related: A federal judge has approved Purdue Pharma’s settlement, calling it "a critical building block” to resolving lawsuits against the embattled company, despite objections from states still engaged in litigation.

By Rhiannon Meyers Collette, Communications Manager

The federal government is considering expediting Medicare coverage and payment for breakthrough medical devices — but there are reasons to be worried about this proposed rule, writes my colleague Rhiannon Euhus, analyst with AV's Low-Value Care portfolio (yes, there are two Rhiannons at one organization — AV's Fleetwood Mac game is strong.)
 

What’s Happening: The U.S. Food and Drug Administration already has fairly low standards for approving medical devices, a flaw that has led to people receiving ineffective — at times unsafe— devices that are later pulled from the market (Essure anyone?). And FDA approval does not indicate value — so accelerating payment for ineffective and low-value medical devices only serves to increase spending without any guarantee of better outcomes (in fact, patients could be harmed).
 

Why It Matters: This proposal pushes us in the wrong direction at a time when we can least afford to foot the bill for low-value care. “Many more ineffective, expensive, and possibly harmful medical devices may not only be approved, but paid for by taxpayers and Medicare beneficiaries despite their dubious value for patients,” Euhus writes. That's especially problematic at a time when COVID-19 is wreaking havoc on budgets and an economic slowdown is draining the fund that sustains Medicare.

By Rhiannon Meyers Collette, Communications Manager

Telehealth has exploded in popularity during the pandemic as people prefer to see their doctors from the comfort and safety of their own homes. But as federal policymakers consider expanding telehealth in Medicare and Medicaid, it's important to keep in mind that access to telehealth has not been equitable. 
 

What’s Happening: Access issues are especially problematic for dual-eligible beneficiaries, a group of individuals who qualify for both Medicare and Medicaid and tend to have more complex health care needs. Dual-eligible individuals tend to have less access to the internet and disproportionately have health conditions like dementia or impaired vision which make it difficult to communicate virtually. In addition, telehealth — when used as a supplement rather than a substitute for health care — may drive up spending at a time when Medicare and Medicaid are already stretched thin.
 

Why It Matters: Dual-eligible beneficiaries have been the hardest hit by COVID-19 and deserve better health care delivery mechanisms which is why any expansion of telehealth needs to be closely monitored to make sure it is equitable and doesn't lead to increased spending. “Innovation in care delivery and payment should result in more health, not more health spending,” says Arielle Mir, AV’s VP of Complex Care. “As policymakers consider ways to permanently expand coverage of telehealth services, it’s important to better understand the factors that limit equitable access to this kind of care and to prioritize addressing those limitations.”

• How the CalSavers retirement program is helping private-sector workers save more for their future, in the latest podcast from Georgetown University's Center for Retirement Initiatives. Executive Director Angela Antonelli speaks with California Treasurer Fiona Ma, Chair of the CalSavers Retirement Savings Board, and Katie Selenski, Executive Director of CalSavers, about the history and goals of the program, how it’s faring during the pandemic, and lessons learned. For some background, this story is a good primer on this “auto-IRA,” which makes saving the default option for employees and widens access for part-time, hourly, and gig workers.
   
• Also: Is working from home working? Do you miss your colleague from accounting? (Yes, I miss my friend Jillian from Accounting.) In this Hidden Brain podcast, economist Nicholas Bloom discusses our worldwide experiment. I’m among the 51 percent working from home who does not have a dedicated office (other than my patio) and suffers “flow interruption” from my homeschooled children, but like many, I see both the payoffs and downsides.

• The story behind Dolly Parton’s role in funding Moderna’s coronavirus vaccine. It began with a car accident and an unlikely friendship, writes The Washington Post.
   
• This mesmerizing bird’s eye view of a thousand sheep being herded by sheepdogs in New Zealand.
   
• Some truly stunning photography from around the world, courtesy of the International Landscape Photographer of the Year contest.
   
• And Time rounds up the 100 best inventions of 2020.