A Goal We Can All Agree On

By Morgan McGrath, Commercial Sector Prices

Earlier this summer, Colorado passed a new bipartisan law aimed at limiting predatory hospital billing behavior in certain cases. Effective this month, hospitals will be prohibited from pursuing medical debt collections against patients if they fail to publicly post their prices online in compliance with the federal Hospital Price Transparency law.

Why it Matters: With more than 100 million Americans burdened by medical debt, there is growing state and federal momentum to curb aggressive hospital billing and collection practices and address the excessive prices certain hospitals and physicians charge privately insured patients. Colorado is the first state to tie medical debt to hospital price transparency.

What’s Next: The Colorado approach is a first step that begins to address predatory billing practices and abusive pricing tactics that powerful hospitals and providers use. There are a range of policy options for states looking to increase transparency, improve competition, and regulate high prices.
 

By Evan Mintz, director of communications

In the early months of the pandemic, the murder of George Floyd under the knee of a man who supposedly had sworn to protect and serve sparked calls for change not only in the United States, but across the globe. This worldwide movement is the focus of the latest edition of the Journal of Community Safety and Well-Being, with Arnold Ventures Director of Criminal Justice Marc Krupanski serving as guest editor.

What's Happening: From Rio de Janeiro to London to Nairobi, activists and policymakers are imagining a better path forward for public safety — one that confronts the problems of excessive force, racial and ethnic disparities, and an overreliance on policing to address a broad range of social needs and challenges. Instead of viewing public safety exclusively through a criminal justice lens, people are beginning to craft public health models and other alternative responses to help build safer communities and save lives.

Why it Matters: “The emerging invigorated interest in alternative responses to the wide range of long-standing societal problems has brought into focus some fundamental questions,” Krupanski writes in his introductory essay. “What sort of partnerships between relevant sectors can be developed that better address social problems while minimizing harm? What kind of investments can government and international donors make to ensure safe and healthy communities while upholding people’s rights and liberties?”

What's Next: The United States doesn't have a monopoly on solutions. For example, law enforcement in Sumy, Ukraine, already divert people who use drugs to harm reduction services instead of arresting them — something considered an innovative practice in the U.S. Countries across the globe have an opportunity to learn from each other on crafting and implementing policies that maximize opportunity and minimize injustice in criminal justice systems.

Read the issue >

< 2 pennies

The amount per $1 of revenue that a majority of nonprofit hospitals spent on charity care
 

A new analysis in The Wall Street Journal (free link) found a whopping 60% of nonprofit hospitals spent under 2 cents on charity care for every $1 of revenue. It’s an especially stunning find considering nonprofit hospitals receive billions of dollars in tax breaks to provide community benefits, and charge privately insured patients excessively high prices for their care. 

Elsewhere, nonprofit hospitals in New York are garnishing patient wages over unpaid hospital bills, FiercePharma reported. Some North Carolina hospitals are pursuing debt collection against those who can least afford it, suing patients, garnishing their tax returns, and damaging credit scores — hurting their chances to buy homes and get jobs, according to a report issued earlier this year by the North Carolina Department of State Treasurer and the State Health Plan.

In related news, read this analysis in Health Affairs by researchers at Johns Hopkins, which suggests government and nonprofit hospitals’ charity care is not aligned with their favorable tax treatment.

All that to say: Nonprofit hospitals don’t behave that differently from their for-profit counterparts, and are a big part of the problem when it comes to driving up the cost of health care.

Criminal Justice

• "More people in the justice system means more dollars for agencies, governments and contracted for-profit firms." Ram Subramanian and Lauren-Brooke Eisen at the Brennan Center for Justice write in USA Today about financial motivations in the criminal justice system and how they undermine public safety.
   
• A new report from the Robina Institute examines non-routine releases from prison due to the pandemic to determine whether there are lessons that can be applied to reducing the effects of mass incarceration.
   
• In North Carolina, tens of thousands of people on community supervision for felony offenses gained the right to vote after a state court struck down a prohibition as unconstitutional, the Associated Press reports.
   
• The Times Union editorial board lays out the facts on bail reform and violent crime in New York. “Bail reform isn't just about high-minded principles of justice. It's about the very real-world consequences of imprisoning people and leaving them unable to work, pay the rent or mortgage, feed and otherwise provide for their families.”
   
• Hawaii has no girls in juvenile detention. The Washington Post explains how it got there.
   
• The story of Grace, the teen detained for not doing her online schoolwork during the pandemic, has prompted Michigan to propose a series of juvenile justice reforms meant to keep young people out of detention facilities and offer more resources such as counseling and mental health treatment.

Health

• Medicare should be able to negotiate for the prices of prescription drugs — full stop. We’ll be watching closely as the latest iteration of a reconciliation bill that includes drug price negotiation moves along in the coming weeks.
  
  ICYMI: The U.S. can increase true innovation and lower drug prices. Read more about why in a Harvard Business Review piece co-authored by Mark E. Miller, our EVP of Health Care.
   
• The Centers for Medicare & Medicaid Services has provided new tools for states to leverage when improving care for the 12 million individuals with both Medicare and Medicaid coverage, according to a new piece in Health Affairs.
   
• Hospice is booming alongside the aging U.S. population, and private equity firms are moving in, raising serious questions about care quality vs. profit.
   
• The Senate announced a hearing into failures from organ donation contractors next Wednesday, Aug. 3. Watch the hearing here.

Higher Education

• The Student Borrower Protection Center wrote an analysis on online program management (OPM) contracts, finding that they frequently target marginalized students, include predatory revenue extraction, operate in ways that are hidden from students, leverage the OPMs' position to upsell to schools, and build in contract terms that lock schools into working with OPMs, regardless of university satisfaction.
  
  Related: Online Program Management Companies: A For-Profit Pocket Within Higher Ed
   
• Third Way issued an updated economic mobility index, designed to define value based on how well schools serve low-income students; it now includes an interactive map, groups institutions into five distinct categories based on similar levels of economic mobility they provide, and incorporates the amount of federal financial aid institutions receive.
   
• Inside Higher Ed reports that the U.S. Department of Education pushed back the release of its proposed regulations on income-driven repayment (IDR). It’s unclear when the department will put forth the draft regulation.
   
• Diverse Education and Higher Ed Dive report that the Education Department has proposed rules to protect student veterans from predatory educational institutions by tightening the 90/10 rule, which defines how federal student aid from the GI Bill may be used by schools.
   
• Michael Itzkowitz and Chazz Robinson write for Third Way about the importance of quality accreditation in higher education. The accreditation agency the Southern Association of Colleges and Schools Commission on Colleges, which is up for federal regulatory review, has had a negative impact on low-income students because of its willingness to award accreditation to low-quality schools.
   
• The Education Department issued new guidance to prevent “accreditation shopping.” Colleges are required to obtain the agency’s approval before they attempt to switch accreditors or else risk losing access to federal financial aid. The goal is to prevent a race to the bottom in quality standards among accrediting agencies and to ensure that institutions cannot switch to an accrediting agency with less rigorous standards simply to evade accountability.
   

• ProPublica investigated the online programs at Liberty University, an evangelical college founded by the Rev. Jerry Falwell. It discovered that the online program relied heavily on federal taxpayer funding from student veteran GI Bills as well as from the Education Department, while providing a significant drop in quality from its traditional courses to the online versions. Student veterans have been complaining for years.

Journalism

• Congratulations to The Hechinger Report for nabbing three awards from the Education Writers Association, including this haunting story of the orphans left behind by Covid.
   
• Nonprofit news continues to expand at a rapid clip, boasting increases in revenue and dramatic growth in audience, according to the Institute for Nonprofit News’s annual index. 

"Facing Eviction," a new Frontline documentary that examines America's affordable housing crisis and how, despite a federal ban on evictions during the pandemic, many families still struggled to stay in their homes while navigating a confusing patchwork of eviction policies. Single mom Alexys Hatcher was one of first to be evicted in Texas, after losing her management job during the pandemic. She filed the right paperwork, but the Texas Supreme Court overturned the CDC moratorium on evictions. Her experience is all too common: The greatest indicators of eviction are being Black, a woman, and having children — with the presence of a child being the single greatest predictor, says Emily Benfer of The Eviction Lab at Princeton. Benfer says tenants' experiences during the pandemic were dependent on ZIP code — as well as landlord compliance, law enforcement, and local judges. The film also addresses the financial stresses placed on mom-and-pop landlords and the challenges states faced in disbursing billions of dollars in assistance to tenants and landlords. That aid has since run out and bans have expired, but the affordable housing crisis remains. "Housing is foundational," says Benfer. "It’s a pillar of resiliency in the same way that employment and education are. But if you knock out that one pillar, housing, where you live, your home, you can’t access any of the others."

Related: Learn about AV's work on affordable housing.

The new podcast "Not In Isolation: Voices of Youth," a project from Stop Solitary for Kids — created by directly impacted youth — on the dangers of solitary confinement for youth and ways to end it. The title of the latest episode, "Kalief Browder: 700 Days in a 12 x 8," refers to the long-term solitary confinement that 16-year-old Kalief Browder endured in Rikers Island Jail. Young creators and hosts Ronnie Villeda and Josue Pineda discuss Browder's unjust arrest, detention, and solitary confinement, which eventually led him to take his own life. Tragically, the harm inflicted on Browder at the hands of the youth justice system is all too common. This episode features a discussion with young advocates who have first-hand experience in the same system; they share their perspectives on Browder's story and how we can break the cycle of injustice.

• The wait is finally over. Beyoncé today released "Renaissance," her first solo album in more than five years, recorded during the pandemic. It's a sweet gift of escapism and pure fun. The best part? It's only the first of three acts. 
   
• Here's a fun distraction: Enter a phrase into the search bar on playphrase and see how many times it shows up in movies and television shows.
   
• Check out this Bollywood remake of "Forrest Gump."