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Econometrica Ready for New CMS Priorities Under Brooks-LaSure

Chiquita Brooks-LaSure was sworn in as Administrator of the Centers for Medicare & Medicaid Services (CMS) on May 27, 2021. With any change in administration, new priorities take precedence.

Akin Gump of Strause Hauer & Feld LLP wrote a primer prior to her confirmation hearings on some of the priorities CMS will pursue under Brooks-LaSure, including healthcare coverage expansion, health equity, surprise billing, and healthcare financing.

These priorities match Brooks-LaSure’s career in the public and private sectors. She was intimately involved in the writing of and implementation of the Patient Protection and Affordable Care Act (ACA), first as a staffer for the U.S. House Committee on Ways and Means and then for CMS’ Center for Consumer Information and Insurance Oversight (CCIIO). She has also worked to improve access, quality, and efficiency in healthcare, and she consulted on healthcare financing and cost transparency.

Econometrica has worked with CMS for more than two decades and looks forward to continuing this partnership under Brooks-LaSure.

Source: CMS

Chiquita Brooks-LaSure – Administrator of the Centers for Medicare & Medicaid Services (CMS)

The Evolution of the Housing Supply Shortage

For years, the United States has faced a housing shortage, exacerbated by the COVID-19 pandemic. A recent analysis from Freddie Mac examines how a combination of strong demand and low mortgage rates have contributed to the shortfall, with estimates indicating the shortage rose 52 percent from 2.5 million in 2018 to 3.8 million in 2020.

The research note—which builds on an article Sam Khater, Freddie Mac’s Vice President and Chief Economist, wrote in April—points to the long-term decline in the construction of single-family homes as a main driver of the housing shortfall.

“As we navigate our way through the year and get beyond the pandemic, we expect the housing supply shortage to continue to be one of the largest obstacles to inclusive economic growth in the U.S.,” Khater wrote. “Simply put, we must build more single-family entry-level housing to address this shortage, which has strong implications for the wealth, health and stability of American communities.”

The number of new entry-level homes has fallen precipitously since the 1970s, according to the estimates. In 2020, Freddie Mac estimated that only 65,000 new entry-level homes were completed, less than one-fifth of the same homes constructed in the late 1970s and early 1980s.

High demand and low mortgage rates have driven the shortfall even higher. “This high demand has driven the housing supply shortage even higher and has also caused home prices to rise over 12% from a year ago,” Freddie Mac wrote.

The research notes several other reasons for the shortfall, including:

  • Lack of available construction labor.
  • Increasing raw material costs. During the pandemic, lumber prices increased more than 150 percent.
  • Land use regulations and zoning restrictions.
  • Demographic changes. In particular, Millennials, which are the largest demographic in the United States, are reaching prime first-time homebuying age.

The number of new entry-level homes has fallen precipitously since the 1970s, according to the estimates. In 2020, Freddie Mac estimated that only 65,000 new entry-level homes were completed, less than one-fifth of the same homes constructed in the late 1970s and early 1980s.

Utilizing the Social Security Administration’s Disability Analysis File

BETHESDA, MD – Since 2011, the Social Security Administration has offered its Disability Analysis File (DAF) on an annual basis, compiling data from a range of internal and external data sources into one cohesive database with additional composite variables. With historical data reaching back to 1994, these files contain data on all those individuals with disabilities below retirement age who have received benefits under the Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) programs. Data on these beneficiaries include one-time variables such as date of birth and Social Security Number, as well as historical and longitudinal data (e.g., eligible and actualized benefit payments, State of residence) tracked across multiple years. With the ability to retrieve reliable longitudinal data on beneficiaries with disabilities, the DAF is an important resource for those looking to perform any sort of analysis on this population.

More information about the DAF can be found on the Social Security Administration website at https://www.ssa.gov/disabilityresearch/daf.html.

With the ability to retrieve reliable longitudinal data on beneficiaries with disabilities, the DAF is an important resource for those looking to perform any sort of analysis on this population.

CMS’ New Case Study Showcases Successful Community Advisory Board Collaboration

The Centers for Medicare & Medicaid Services (CMS) released a case study highlighting Health Net of West Michigan, an organization participating in CMS’ Accountable Health Communities (AHC) Model. The AHC Model seeks to identify if healthcare costs and utilization can be impacted by the identification and subsequent mitigation of Medicare and Medicaid beneficiaries’ health-specific social needs. One part of Health Net’s approach to this identification is through its advisory board, which consists of community partners across multiple sectors and “focuses on addressing social determinants of health at the community and systems levels.”

The inclusion of community members on an advisory board can sometimes prove a struggle. As advisory boards do not have formal authority to direct change, participants can feel disheartened and superfluous to the process. Health Net seeks to engage its community advisory board members by putting them first: From letting the advisory board select their own role titles (“community advisor” was ultimately chosen) to helping advisors develop their professional skills and find opportunities that utilize their lived experiences, Health Net recognizes that by gaining their advisors’ trust and proving their commitment to the community, they will foster goodwill and find advisors with legitimate interest in bettering the community. The case study includes a quote from a community advisor, showcasing how Health Net’s approach to the community has resulted in engaged advisors who understand their role on the board and responsibility to their neighbors:

Health Net’s advisory board has proven beneficial for both the organization and the community at large. The community advisors bring their lived experiences to the table, ensuring that staff members recognize the humanity of those affected by the policies and challenges identified. Community advisors also ensure that Health Net’s actions are aligned with the needs and desires of the community at large, and can offer suggestions and ideas on how to “make [programs] more culturally sensitive and user friendly,” which further aids Health Net in fostering goodwill within the community.

“It’s important to me to decrease disparities about who gets help and who doesn’t […] I give them the idea of what it’s like to be a client out here… They always listen to what I have to say and support whatever I mentioned.” 

—Community Advisor

The CMS case study in full can be accessed at https://innovation.cms.gov/media/document/ahcm-casestudy-healthnet.

Health Net’s advisory board has proven beneficial for both the organization and the community at large. The community advisors bring their lived experiences to the table, ensuring that staff members recognize the humanity of those affected by the policies and challenges identified.

Census Releases Demonstration Data and Progress Metrics for New DAS

BETHESDA, MDThe Census Bureau continues to roll out data and information from the 2020 census. On April 28, it provided information about a new cryptography-inspired disclosure avoidance system (DAS) to protect the privacy of respondents. Using data from the 2010 census for demonstration purposes, Census has released several files of data to solicit feedback from users. The bureau hopes users can provide detailed information on the files’ fitness-for use, privacy, and any improvements that should be made.

More information can be found at https://www.census.gov/programs-surveys/decennial-census/2020-census/planning-management/2020-census-data-products/2020-das-development.html.

Using data from the 2010 census for demonstration purposes, Census has released several files of data to solicit feedback from users.

The State Data Resource Center’s Recommendations to Support Vaccine Equity

BETHESDA, MD – As of April 26, 29 percent of the U.S. population is fully vaccinated. Vaccines are now available to all U.S. adults, and 2.6 million doses are being administered in the United States every day. As vaccination rates continue to increase, it is important that vaccine distribution is monitored to ensure that vulnerable populations are reached. Ensuring equitable access to the COVID-19 vaccine—recognized as a national priority by the Centers for Disease Control and Prevention (CDC) —requires that data are available and appropriately used to evaluate socioeconomic and demographic vaccine distribution trends.

Earlier this month, the State Data Resource Center (SDRC) released information to support states in identifying COVID-19 vaccination Medicare claims among their dually eligible beneficiaries. SDRC was established by the Centers for Medicare & Medicaid Services (CMS) in 2011 to help states obtain dually eligible beneficiary data. Econometrica supports CMS in providing resources to states to assist in requesting and using Medicare data files for care coordination and program integrity purposes.

The COVID-19 vaccine information was posted as an announcement on the SDRC website, developed and operated by Econometrica, and includes a recommended process for identifying COVID-19 vaccine claims in both the Coordination of Benefits Agreement (eCOBA) file and the monthly Parts A and B dataset. In both files, Healthcare Common Procedure Coding System (HCPCS) codes are used to identify COVID-19 vaccine claims. Pfizer, Moderna, AstraZeneca, and Johnson & Johnson each have their own assigned HCPCS codes with additional vaccine administration codes that specify whether the claim was the individual’s first or second dose.

In addition to identifying COVID-19 vaccine claims and ensuring each beneficiary received the appropriate number of doses, SDRC recommends that states link these claims to the beneficiary’s demographic information. In doing so, disparities in vaccine uptake across race/ethnicity, disability status, or geography can be evaluated and addressed.

The SDRC announcement highlights an important opportunity for state Medicaid agencies. Analyses, made possible through the use of SDRC data and the SDRC support team, can help to inform policy. By identifying any racial, ethnic, or socioeconomic disparities in access to COVID-19 vaccines, state policymakers can shift their distribution plans to ensure vaccines are available to vulnerable, dually eligible beneficiaries.

Vaccines are now available to all U.S. adults, and 2.6 million doses are being administered in the United States every day.