KFF’s Kaiser Health News (KHN) will hire a full-time Montana-based correspondent and recruit a team of freelance reporters to expand its coverage of health care policy and politics in the region, including the unfolding COVID-19 pandemic.

The expansion is made possible by a new long-term partnership among KFF, the Montana Healthcare Foundation, and the Headwaters Foundation, and follows the opening last year of KHN’s Mountain States Bureau in Denver and its Midwest Bureau in St. Louis.

Media outlets from Montana and elsewhere can publish KHN stories from the region at no charge. KHN also will publish the stories on kffhealthnews.org and promote them through its social media platforms. KHN is an award-winning nonprofit news service that is an editorially independent program of KFF, formally The Henry J. Kaiser Family Foundation, a San Francisco-based nonprofit, nonpartisan organization engaged in policy analysis, polling, journalism, and communications to produce trusted information on national health issues.

“At a time when many local news organizations are scrambling to cover the coronavirus crisis, KHN’s model of partnering with local outlets and producing high quality health journalism should quickly translate into better informed communities,” said Drew Altman, KFF’s CEO and KHN’s founding publisher.  “Thanks to the support of the Montana Healthcare Foundation and the Headwaters Foundation, we will be bringing the Mountain West more in-depth coverage not only of COVID-19, but also issues such as the Medicaid expansion, health care costs, rural health care and health care in the 2020 elections.”

“Montana Healthcare Foundation is committed to ensuring that Montanans have solid information on key health care and health policy issues in our state,” said Aaron Wernham, MHCF CEO. “We’re excited to partner with the nation’s preeminent health journalism outlet to give all Montanans access to high-quality coverage of health issues that affect us.”

“The people of Montana deserve the caliber of journalism that Kaiser Health News can provide so they can make informed decisions about their lives,” said Headwaters Foundation CEO Brenda Solorzano. “Headwaters Foundation is excited to partner in supporting this effort dedicated to high-quality journalism covering health issues that affect Montanans.”

KHN employs more than 60 journalists, with most based in the KHN newsroom in KFF’s Washington D.C. offices and others working in California, Colorado, and Missouri. The 11-year-old news service has won numerous awards, including a prestigious Barlett & Steele Award for Investigative Journalism and five “Best in Business” awards from the Society for Advancing Business Editing and Writing (SABEW). KHN also is a finalist for the 2020 Goldsmith Prize for Investigative Reporting by the Shorenstein Center on Media, Politics and Public Policy at Harvard University’s Kennedy School of Government.

Journalists interested in the Montana correspondent’s job can find details about the position and information about how to apply on kff.org.

News organizations interested in working with KHN should contact the news service at KHNPartnerships@kff.org, and those interested in helping to expand and improve health journalism around the country should contact KFF at healthjournalism@kff.org.

For more on our partners in Montana, visit the Montana Healthcare Foundation and the Headwaters Foundation online.

About The Henry J. Kaiser Family Foundation and Kaiser Health News:

Filling the need for trusted information on national health issues, KFF (The Henry J. Kaiser Family Foundation) is a nonprofit organization based in San Francisco, California. KHN is an editorially independent program of KFF and is the nation’s leading and largest health and health policy newsroom, producing stories that run on kffhealthnews.org and are published by hundreds of news organizations across the country.

In response to the ongoing coronavirus pandemic, current recommendations are for older adults to stay home and away from others. To prepare for extended stays at home, the Centers for Disease Control and Prevention (CDC) recommends gathering extra supplies, including prescription medicines. Some patients may encounter difficulty in doing so, however, as a result of their health plan’s ‘refill too soon’ restrictions, which block coverage for a prescription that is being refilled early. For example, a plan may have a policy of not allowing refills of 30-day prescriptions until at least three weeks after the prescription was last filled.

In light of the coronavirus pandemic, the Coronavirus Aid, Relief, and Economic Security (CARES) Act requires Medicare Part D plans to provide up to a 90-day (3 month) supply of covered Part D drugs to enrollees who request it. Part D plans currently provide drug coverage to more than 46 million older adults and people with disabilities. Prior to this requirement, Part D plans had the option to relax their ‘refill too soon’ restrictions to ensure enrollees had access to a sufficient extended supply of medications, and some plans stated they would temporarily lifted these restrictions, but plans were not required to do so. The change in law is designed to ensure that all Part D enrollees can obtain an extended supply of medications if they request it during the COVID-19 public health emergency.

This analysis examines the share of Part D enrollees who have access to extended supplies of generic, brand-name, and specialty-tier drugs covered by their plan in 2020, under policies that applied prior to the change in law, and that will apply after the COVID-19 emergency declaration ends, when Part D plans will no longer be required by law to issue extended supplies for all Part D drugs they cover.

Findings

Under Part D plan policies on extended supplies that were in effect at the start of the 2020 plan year and will be in effect after the COVID-19 emergency declaration ends:

• Three-quarters of Medicare Part D enrollees (27.5 million enrollees) are in a plan that covers extended supplies of all drugs on at least one of the plan’s two tiers for generic drugs (Figure 1).
• Nearly half of all Part D enrollees (47%, or 17.5 million enrollees) are in a plan that covers extended supplies of all drugs on at least one of the plan’s two tiers for brand-name drugs.
• Only 4 percent of Part D enrollees (1.5 million) are in a plan that covers extended supplies of all specialty tier medicines. Specialty tier medicines are defined by Medicare as medicines that cost more than $670 per month and include drugs to manage conditions such as cancer, hepatitis C, multiple sclerosis, and rheumatoid arthritis.
• A larger share of stand-alone drug plan enrollees than Medicare Advantage drug plan enrollees are in plans covering extended supplies of generic drugs (80% vs. 67%, respectively) and brand drugs in 2020 (56% vs. 37%, respectively), but the opposite is true for specialty tier drugs (2% vs. 6%, respectively) (Figure 2).

Discussion

This analysis shows that most Medicare Part D enrollees are in plans covering extended supplies of relatively low-cost generic drugs in 2020, but just under half are in plans that cover extended supplies of brands and only a small share of enrollees are in plans that cover extended supplies of more expensive specialty-tier medications. These coverage policies will be in effect after the COVID-19 emergency declaration ends, when plans will no longer be required by law to issue extended supplies for all Part D drugs they cover.

In light of the CDC recommendations for older adults and people with serious chronic medical conditions to take actions to reduce the risk of becoming infected with the new coronavirus, including staying home and having extra supplies of necessary medications, the requirement that all Part D plans provide up to a 3-month supply of medications to enrollees who request it will help Medicare beneficiaries avoid trips to the pharmacy when there is increased risk of spread of coronavirus in their communities.

Source

How Prepared is the US to Respond to COVID-19 Relative to Other Countries?

KFF’s Jen Kates and Josh Michaud on March 30 were the featured guests in The Commonwealth Club of California’s continuing virtual series on the coronavirus outbreak.

Among the topics discussed were:

• How does this epidemic compare to previous ones?
• What goes into epidemiological models, how do they work and how reliable are they?
• Who is at greatest risk for getting sick?
• Was China’s approach to social distancing more effective?
• When will we be able to relax social distancing measures?
• When people recover will they have immunity?
• What are Americans’ views on the epidemic?

Listen to the audio-only version.

KFF’s Kaiser Health News (KHN), an editorially independent news service focusing on health care and policy, has won five “Best in Business” awards from the Society for Advancing Business Editing and Writing (SABEW). The awards, announced today, recognize outstanding business journalism in 2019.

The five awards, all of which came in the division for medium size news organizations, include:

America’s Broken Health Care System, by Elisabeth Rosenthal, KHN Editor-in-Chief, winner in the Commentary/Opinion category. The judges wrote that Rosenthal “deftly uses the medical bills she received to guide readers through the maze of medical bureaucracy and deliver a clear exposition of how and why the nation’s health care system has become so beleaguered, unfair and inefficient.”

Hidden Harm, by Christina Jewett, winner in the government category and co-winner in the investigative reporting category.  The judges wrote that, “Jewett’s stories unearthed a Dr. Evil-scale cover-up of hidden FDA data on millions of medical device malfunctions, injuries and deaths. Her coverage forced the administration to open this vital data to both doctors who perform procedures as well as public scrutiny, and in the process, no doubt saved countless lives.”

University of Virginia Health System lawsuits, by Jay Hancock and Elizabeth Lucas, winner in the Health/Science category. The judges wrote that KHN “exposed how the center’s overly aggressive billing and collection policies were ruining people’s lives.”

In India’s burgeoning pain market, U.S. drugmakers stand to gain, by Sarah Varney, winner in the international reporting category. The judges wrote that “Varney uncovered a trend in India of sweeping importance: the relatively new cultural acceptance of pain medication and the pharmaceutical companies, largely chased away from places like the United States, that are looking to capitalize on the trend.”

KHN also earned two honorable mentions, including one in the economics category for No Mercy, a series by Sarah Jane Tribble that looks at what happens when the closure of a rural hospital disrupts a community, and another in the feature category, for Varney’s story about India’s market for pain medication.

For more on the awards, visit SABEW’s website.

KHN content is always available to news organizations to republish free of charge.

About The Henry J. Kaiser Family Foundation and Kaiser Health News:

Filling the need for trusted information on national health issues, KFF (the Henry J. Kaiser Family Foundation) is a nonprofit organization based in San Francisco, California.  KHN is an editorially independent program of KFF and is the nation’s leading and largest health and health policy newsroom, producing stories that run on kffhealthnews.org and are published by hundreds of news organizations across the country.

On March 26, we posted our 18^th annual 50-state survey of Medicaid and CHIP eligibility, enrollment, renewal, and cost sharing policies. It continues to serve as the only comprehensive resource for information on these policies across states and provides information that has enabled tracking of state implementation of the Medicaid expansion and streamlined enrollment and renewal procedures under the ACA.

This year’s survey, which provides data on policies in place as of January 2020, now serves a new purpose by providing a benchmark against which we can measure state actions to respond to COVID-19 and the economic crisis. The survey findings document policies states must maintain in order to access temporary enhanced federal Medicaid funding as part of COVID-19 response efforts. The Families First Coronavirus Response Act provides states a temporary 6.2 percentage point increase in the federal Medicaid matching rate. To receive those enhanced funds, states cannot implement more restrictive eligibility policies than those in place as of January 1, 2020 and must provide continuous coverage to Medicaid enrollees through the emergency period. For example, states cannot reduce income eligibility limits or increase requirements to verify eligibility criteria.

The survey findings show that, as of January 2020, there is wide variation in state policies that affect individuals’ ability to access coverage and care. For example, more individuals can access Medicaid coverage in states that have implemented the ACA Medicaid expansion to low-income adults than in states that have not expanded, where poor adults continue to face a coverage gap. Largely because of the ACA, individuals can apply for Medicaid and CHIP online or via phone, and states can connect individuals to coverage quickly through real-time eligibility determinations and renewals using electronic data matches. Moreover, some states have taken up options that expedite access to coverage and facilitate continuity of coverage, such as presumptive eligibility and 12-month continuous eligibility for children. However, certain policies and processes may by contributing to coverage losses among eligible individuals. For example, some states conduct periodic data checks between renewal periods to identify potential changes that might affect eligibility, provide enrollees limited time (e.g., ten days) to respond to requests to verify ongoing eligibility, and only contact enrollees once by mail to request information before terminating coverage. Changes the federal government was pursuing as part of program integrity efforts prior to COVID-19 may have further increased coverage barriers for eligible individuals, but the Centers for Medicare and Medicaid Services (CMS) recently withdrew its planned regulatory changes that would have tightened eligibility requirements.

States can take a range of actions through Medicaid under current rules and waivers to enhance their response to COVID-19. They can take some of these actions quickly without federal approval. For example, they can allow self-attestation of eligibility criteria other than citizenship and immigration status and verify income post enrollment, which would make signup easier and faster. They also can provide greater flexibility to enroll individuals who have small differences between self-reported income and income available through data matches. Further, they can suspend or delay renewals and periodic data checks between renewals (as noted above, states must provide continuous coverage to Medicaid enrollees through the emergency period to receive enhanced federal funding). States can take other actions allowed under existing rules by submitting a state plan amendment (SPA). For example, states could expand eligibility, including implementing the ACA Medicaid expansion to low-income adults in states that have not yet expanded; adopt presumptive eligibility; or modify cost sharing requirements. Beyond these options, states can seek additional flexibility through Section 1135 and Section 1115 waivers. CMS has provided states SPA and waiver templates and checklists to facilitate implementation of changes to respond to COVID-19, and state Medicaid policies and processes already are evolving as states implement changes to expedite enrollment in coverage, keep enrollees covered, and facilitate access to services as part of COVID-19 response efforts.

State Medicaid and CHIP eligibility and enrollment policies will remain an important indicator to watch looking forward. As evidenced by previous recessions, states will likely see growing demand for Medicaid and CHIP as individuals lose jobs and incomes decrease amid the declining economy. The ability to connect these individuals to coverage quickly and to keep them connected to coverage over time will help ensure they can access care for COVID-19 and more broadly.

Source

KFF analysis of data from the Office of Management and Budget, Agency Congressional Budget Justifications, Congressional Appropriations Bills, and U.S. Foreign Assistance Dashboard [website], available at: www.foreignassistance.gov.

A new analysis and chart collection highlights the available cross-national data on healthcare workforces and hospital resources to assess U.S. preparedness to respond to the COVID-19 pandemic relative to other large and wealthy countries. Additional charts explore coverage and affordability barriers that may limit access to care or cause serious financial burden for those needing COVID-19 treatment, and the prevalence of health conditions like heart disease, chronic respiratory disease, and diabetes that are linked to more serious outcomes for COVID-19 patients.The chart collection and analysis is part of the Peterson-KFF Health System Tracker, an online information hub dedicated to monitoring and assessing the performance of the U.S. health system.For more data, analysis, polling and journalism on the COVID-19 pandemic, visit our special resource page on kff.org.