GESTIÓN EN SALUD PÚBLICA: noviembre 2026

Policy Research At The National Institutes Of Health: An Imperative In Peril Scott Burris,Jamie F. Chriqui,Y. Tony Yang,S. Bryn Austin,Lisa F. Berkman,Ross C. Brownson,Magdalena Cerdá,Kao-Ping Chua,Ana V. Diez Roux,Gregg Gonsalves,Rita Hamad,Mark D. Hayward,Kelli A. Komro,Nancy Krieger,Laura D. Lindberg,Bruce G. Link,Julie Maslowsky,Angela McGowan,Jennifer Karas Montez,Kimberly M. Nelson, October 1, 2026

https://www.healthaffairs.org/content/forefront/policy-research-national-institutes-health-imperative-peril?utm_campaign=forefront&utm_medium=email&_hsenc=p2ANqtz--dXWrDU-Yv_StAjeyZaYEqZ48CdcruvvUlrrTmGs93k7M1ndq7dVkNSr8kREJoGjVic_nKWe7vlPAfneLoMeynjY2mGg&_hsmi=446794561&utm_source=well%20read Understanding the health consequences of policy is not peripheral to NIH’s mission. It is central to it.

Health Affairs Forefront Turns Twenty Chris Fleming October 7, 2026

https://www.healthaffairs.org/content/forefront/health-affairs-forefront-turns-twenty?utm_campaign=forefront&utm_medium=email&_hsenc=p2ANqtz--8iGK2-qlRqW2Dv_oh3yoTSk-dXV4mqeZ9xi7ER1MmlmSujhj2QAqlIqOjDRQXTf3A_hJGz8g2K_Y0BMtY-tVLorIREQ&_hsmi=446794561&utm_source=well%20read On October 5, 2006, Health Affairs Founding Editor John Iglehart wrote the first article on what was then Health Affairs Blog. Now, here we are, twenty years and approaching 10,000 articles later, having become Health Affairs Forefront along the way.

Opening The Black Box Of Medicaid Physician Payment: Medicaid Managed Care And State-Directed Payments Authors: Diane Alexander dealexa@wharton.upenn.edu, Molly Frommer, and Eric T. Roberts

https://www.healthaffairs.org/doi/10.1377/hlthaff.2026.00382?utm_campaign=november%202026%20issue&utm_medium=email&_hsenc=p2ANqtz-88vMcQ3tZ7gwZxi0eAvFtqL6slyIqB6Be5vosumABpDcAPWjyfWpeQxHofnWELevjRiaBzAcZZKW90OdXWrOg62tl9fQ&_hsmi=446794561&utm_content=ahead%20of%20print&utm_source=well%20read Provider payment rates in Medicaid are often assessed by comparing Medicaid fee-for-service rates with Medicare rates. However, this approach may poorly approximate payments in Medicaid managed care, where most enrollees receive coverage. State-directed payments (SDPs)—requirements that managed care plans increase Medicaid payments—have become a major means of increasing provider payment in Medicaid managed care. We used Centers for Medicare and Medicaid Services preprints from the period 2023–25 to estimate Medicaid managed care payments for primary care services and professional services at academic medical centers. For primary care services not performed in academic medical centers, most SDPs raised Medicaid managed care payment levels toward Medicare rates. In contrast, SDPs for services performed at academic medical centers varied widely across states and often raised payments well above Medicare rates, placing them above the caps established by the One Big Beautiful Bill Act. These patterns suggest that SDPs are being used both to bolster primary care payment and to deliver large supplemental payments to academic medical centers, underscoring a need for monitoring and policy guardrails to align SDPs with access and value in Medicaid.

Slower Price Growth, Modest Utilization Increases Drove Slowdown In US Health Care Spending Growth, 2014–19 Authors: Nikhil R. Sahni nikhil.sahni@gmail.com, Vishnu Murale, Heather Bello Thornhill, and David M. Cutler

Slower Price Growth, Modest Utilization Increases Drove Slowdown In US Health Care Spending Growth, 2014–19 Authors: Nikhil R. Sahni nikhil.sahni@gmail.com, Vishnu Murale, Heather Bello Thornhill, and David M. Cutler https://www.healthaffairs.org/doi/10.1377/hlthaff.2026.00207 US health care spending growth has long outpaced economic growth. However, during the period 2014–19 (before the COVID-19 pandemic), growth in per capita health care spending relative to per capita gross domestic product growth fell by 21 percent compared with 2007–14. We examined spending growth domestically and internationally to determine the causes of this slowdown. We decomposed spending growth by source of funds, compared four drivers of growth over time within the US and relative to fifteen Organization for Economic Cooperation and Development countries, and conducted a US-specific breakdown of utilization. We found that declining growth in health care prices and utilization were major drivers of the slowdown of health care spending. Slower growth did not appear to have been driven by across-the-board reductions in disease burden and input costs, although certain metrics fell. Utilization reduction was a major driver through technology allowing the use of alternative sites of care; greater use of preventive care that reduces costs; ongoing expansion of Medicare Advantage, managed Medicaid, and high-deductible health plans; and increased utilization management. This slowdown suggests the need to monitor trends more closely for signs of additional major shifts in spending growth.

Accessing Cancer Screening As A Person With Quadriplegia Author: Sharifa Abu-Hamda

https://www.healthaffairs.org/doi/10.1377/hlthaff.2025.01749 Care coordinators, proper accommodations, and funding can make cancer screenings more accessible to people with physical disabilities.