Newsletter, periodic publication

The U.S. Department of HHS and CMS released final guidance on October 2 outlining the process for the second cycle of negotiations under the Medicare Drug Price Negotiation Program. The guidance includes information on how CMS will help ensure people with Medicare can access drugs at the negotiated prices when the prices become effective. CMS will announce the selection of up to 15 additional drugs covered by Part D for the second cycle of negotiations by February 1, 2025. This final guidance includes lessons learned from the first cycle of negotiations and comments received. Additionally, the final guidance outlines improvements to the design of patient-focused engagement events. Read the release to learn more.

On January 11, Mathematica published a blog titled “A Quick Guide to Choosing Federal Medicaid Authorities to Address Health-Related Social Needs.” This blog explores the three most common federal Medicaid authorities that enable states to offer health-related social needs (HRSN) services to Medicaid-enrolled individuals: Section 1915 HCBS waivers, Managed Care In Lieu of Services (ILOS), and Section 1115 demonstrations. It also discusses key factors to contemplate as a state Medicaid official when choosing how to cover HRSN services, emphasizing considerations such as the intended population, types of services, and program features.

The LEAD Center recently released the latest issue of the LEAD On! Newsletter titled “Good Jobs and Competitive Integrated Employment: Strategies for Success.” Various federal departments, including the Departments of Labor, Transportation, Energy and Commerce, rallied around the Investing in America (IIA) agenda, which has created access to good jobs for all America’s workers, including those with disabilities. This newsletter features several resources from the ODEP-funded LEAD Center to promote Good Jobs as Competitive Integrated Employment, including a recently released fact sheet.

The National Consumer Voice for Quality Long-Term Care recently published the Fall 2023 issue of “The Resident Advocate,” their newsletter for long-term care residents containing news and information on rights, care issues, and updates on national policy. This issue includes: Tips for living with a roommate in a long-term care facility, Staffing issues in long-term care and how you can advocate for change, Steps to take when there is a problem in your nursing home, Reminders for visiting long-term care facilities during the holidays, and Participating in this year’s Residents’ Rights Month.

On July 31, at the AIRS Discovery Conference and 50th Anniversary Celebration, the organization announced a new name and brand that will carry the association into the next fifty years. The Alliance of Information & Referral Systems (AIRS) is now Inform USA. Inform USA is the professional membership association for Information and Referral services, providing standards, program accreditation, and practitioner certification for the field.

On July 6, the U.S. Food and Drug Administration (FDA) converted Leqembi (lecanemab), indicated to treat adult patients with Alzheimer's Disease, to traditional approval following a determination that a confirmatory trial verified clinical benefit. Leqembi, developed by Biogen and Eisai, was approved in January 2023 under the Accelerated Approval pathway...

The FDA recently approved the first vaccine for respiratory syncytial virus or RSV for adults ages 60 and older. The vaccine, Arexvy, prevents lower respiratory tract disease caused by RSV. RSV is a highly contagious virus that causes infections of the lungs and breathing passages in individuals of all age groups. RSV circulation is seasonal, typically starting during the fall and peaking in the winter. In older adults, RSV is a common cause of lower respiratory tract disease (LRTD), which affects the lungs and can cause life-threatening pneumonia and bronchiolitis (swelling of the small airway passages in the lungs).

Through support from the Patient-Centered Outcomes Research Institute, CHCS has published a Patient-Centered Complex Care Research Agenda to help involve people with lived experiences with complex care in the research process. The Better Care Playbook spoke to two individuals who helped develop the Research Agenda to learn how involving people with lived experience in research can help strengthen the complex care evidence base.

This blog post from Mathematica discusses the importance of partnerships between states and the federal government through highlighting topics covered at NAMD's 2022 conference. Sessions touched on innovations developed as part of recently approved 1115 demonstrations in Arizona, Massachusetts, Oregon, and Arkansas which focused on the ways states are providing whole-person care by addressing the health-related social needs of members. The post also explores Mathematica's work with CMS and states to build stronger measurement and evaluation infrastructure for a broad range of demonstrations, including those addressing substance use disorder, mental illness, and health-related social needs.

Health Affairs has published a new blog highlighting the value of improving health and well-being through establishing community care hubs. Hubs are characterized as community-focused entities that support a network of community-based organizations providing services for health-related social needs. The blog complements ACL’s investments to develop and scale community care hubs across the country including the National Learning Community, and plans to administer grants to support community care hub infrastructure.