Big thanks to @arnoldventures.bsky.social and an all-star team (Nick Daley, Andrew Hicks, Michael McWilliams, Meredith Rosenthal)

Billing of Medicare’s G2211 Longitudinal Care Code Among Traditional Medicare Beneficiaries This study examines patterns of Medicare’s G2211 billing code to understand its uptake and how often these payments went to primary care.

New study @jama.com on Medicare's G2211 billing code.

TLDR: The code was meant to support the longitudinal care typically provided by primary care physicians and in many cases by specialists. Actual use in the first year (2024) was a bit more complicated...

jamanetwork.com/journals/jam...

Primary Care Clinicians Available for New Patient Visits This cross-sectional study examines changes in the numbers of primary care physicians and primary care advanced practice practitioners available for new patient primary care visits.

📖 Our new study in @jamainternalmed.com examines the primary care workforce serving fee-for-service Medicare beneficiaries using a pragmatic, patient-centered measure: clinicians available for new patient visits per beneficiary.
👉Article: jamanetwork.com/journals/jam...
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Thank you @dusetzinas.bsky.social for making this project possible! Always a joy to work with you.

How you spend your days matters. Knowing the time impact from the treatments pursued (or not) can help patients and their families to be prepared for making informed decisions about cancer care. What an honor to be part of this work.

🧡

I didn’t really get how much “health care contact days” is a meaningful patient outcome until I got sick

thank you @ishaniganguli.bsky.social @dusetzinas.bsky.social @jamanetworkopen.com

Time Toxicity of Cancer Care—A Call to Action Oncologists have a fundamental responsibility to educate patients and families on the risks, benefits, and logistics of cancer treatment. This responsibility becomes particularly important for patient...

Here's the thoughtful editorial accompanying the study jamanetwork.com/journals/jam...

These contact days have increased from 2008 to 2019 across the board, especially for breast cancer despite no improvements in survival.
We hope these results can help patients and their care teams make difficult decisions about treatment trade-offs.

In the year after their diagnoses, older adults in traditional Medicare with metastatic breast, colorectal, lung, and prostate cancers who survived the whole year spent 40 to 63 days getting care, mainly in the ambulatory setting.

Health Care Contact Days in Older Adults With Metastatic Cancer This cohort study examines patterns and changes in health care contact days over time among traditional Medicare beneficiaries diagnosed with metastatic breast, colorectal, lung, and prostate cancers.

For older adults with metastatic cancer, each day spent on health care can take away from days that are often devastatingly limited. Our latest study led by Arjun Gupta and Shelley Jazowski with @dusetzinas.bsky.social and Avi Gupta is out now in @jamanetworkopen.com
jamanetwork.com/journals/jam...

Health Care Utilization and Low-Value Service Use After Risk-Based Contract Adoption This cohort study examined whether health care organizations’ transition to risk-based payment contracts in Medicare Advantage was associated with changes in health care utilization or use of low-valu...

🚨New Publication🚨 Risk-based provider payment is more common in Medicare Advantage than any other segment of US health care financing. What happens to broad categories of health care utilization, and low-value service use, when provider groups adopt these contracts? jamanetwork.com/journals/jam...

Treatment Burden Among Older Adults in the United States, 2022 Background Treatment burden refers to the patient-perceived effort of managing health and health care, which impacts quality of life and engagement in care. International studies of treatment burden...

🚨 New paper: As a PCP, I often hear from patients that managing their health care feels like a full-time job. To understand this better, we analyzed the first nationally-representative US survey of older adults’ self-reported treatment burden: agsjournals.onlinelibrary.wiley.com/doi/10.1111/...

cc @nickdaley.bsky.social @hneprash.bsky.social @laurenshughes.bsky.social @ddiamond.bsky.social @mdaware.org @drneelshah.bsky.social @wrightcensored.bsky.social @arghavansallesmd.medsky.social @michaelannica.bsky.social @dangoren.bsky.social @meddly.bsky.social @dusetzinas.bsky.social

What does this tell us? Even with its flaws, VBP may align better with traditionally gendered practice patterns - like more face-to-face and asynchronous time with patients - that are also likely good for patients and that all PCPs regardless of gender want to provide.

Using MA claims/Star rating data for 872 PCPs in 7 states who took on full risk for their MA patients, we found women PCPs had better quality outcomes and their patients had fewer ED visits and hospitalizations. Women earned the same per patient under FFS and *MORE* under VBP.

Gender Differences in Physician Earnings and Outcomes Under Medicare Advantage Value-Based Payment This cohort study assesses gender differences in reimbursed earnings and quality among primary care physicians participating in full risk-sharing arrangements with Medicare Advantage plans, which now ...

Women physicians face a persistent gender wage gap, which we've found is due in part to volume-based (FFS, or $/visit) payment models. In a new #JAMAHealthForum study, we find that under Medicare Advantage value-based payment (VBP), the gap reverses (!).
jamanetwork.com/journals/jam... @jama.com

⭐️future-doc @nickdaley.bsky.social presenting our work on RTBT tools and telemedicine contributions to primary care access in Medicare. Posters 53-4, come on by #SGIM25
cc @jefflinder.bsky.social

Inspiring plenary talk on tackling food insecurity by Seth Berkowitz at #SGIM25. I had the chance to chat with Seth about his study, listen here 👇🏽

Dr. Stone has had incredible impact in her career. Proud to be one of many lucky enough to be mentored by her. #SGIM25

cc @evemd1.bsky.social @carygross.bsky.social @ilanarichman.bsky.social @timandersonmd.bsky.social

On my way to #SGIM25 @societygim.bsky.social and excited to share my chat with @lisarotenstein.bsky.social @sethberkowitz.bsky.social and @lizdzeng.bsky.social about studies they're about to present #SGIM25. Check out the @jamainternalmed.com episode below.

👇🏽New study led by @nickdaley.bsky.social finds that for most older adults, every extra day getting health care costs them an extra $49 out-of-pocket. And above certain thresholds, these extra days offer diminishing marginal returns on care satisfaction.
@jama.com

Safe, Then Sorry? — The Psychological Biases that Drive Care Cascades - Journal of General Internal Medicine Journal of General Internal Medicine -

Docs & patients know the pain of chasing borderline/incidental findings w/ a string of visits, tests and treatments. Yet after that initial test, these cascades can feel unavoidable. In a new @journalgim.bsky.social, @ishaniganguli.bsky.social and I explore reasons why & potential solutions:

Exclusive: NIH to terminate hundreds of active research grants Studies that touch on LGBT+ health, gender identity and DEI in the biomedical workforce could be terminated, according to documents obtained by Nature.

"In an unprecedented move, the US National Institutes of Health (NIH) has begun mass terminations of research grants that fund active scientific projects because they no longer meet 'agency priorities'"

www.nature.com/articles/d41...

Yesterday, President Trump addressed members of Congress in the joint session, but he had little to say about health care.

Here's what our team is reading to make sense of what's happening in health policy...

So good to co-chair this report w/ @asaf-bitton.bsky.social and to work on it w/ esteemed Standing Committee for Primary Care colleagues incl
@kgrumbach.bsky.social @laurenshughes.bsky.social @drkamleigh.bsky.social

cc @commonwealthfund.org @arnoldventures.bsky.social
@milbankfund.bsky.social

Improving Primary Care Valuation Processes to Inform the Physician Fee Schedule Read online, download a free PDF, or order a copy in print.

Glad to share our new @health.nationalacademies.org report on Medicare primary care valuation.

We outline systemic challenges with the current approach that have cascading effects on the private sector and on patient outcomes, and we recommend a path forward.

bit.ly/4bozVUz
#primarycare

Thanks Aaron!