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!

These results should help to reassure policymakers concerned about telemedicine worsening care quality and spending.

Huge thanks to funders @commonwealthfund.org @arnoldventures.bsky.social

cc our fantastic team incl @davidmcutler.bsky.social @andrewlhicks.bsky.social
@jama.com

Using 100% Medicare claims + “DiD” analyses, we compared patients attributed (pre-pandemic) to health systems that later adopted telemed a lot or a little. Patients in high-telemed systems saw either a relative drop or no change across 20 tests, plus ⬇️ spending on a few tests and on visits overall.

Telemedicine Adoption and Low-Value Care Use and Spending Among Fee-for-Service Medicare Beneficiaries This cohort study aims to quantify the association between telemedicine adoption and low-value testing among fee-for-service Medicare beneficiaries.

Congress must decide if it will extend Medicare telehealth coverage beyond March 2025.

Our new JAMA IM study shows how this may benefit Medicare patients + taxpayers.

TLDR: Telemedicine ⬇️ some low-value test use + spending (eg,onsite EKGs,blood tests) + ⬇️ total visit spending.
shorturl.at/w6l5l

People who work or have worked at HHS, NIH, FDA, CMS, CDC, HRSA and other health agencies - we want to hear from you.

Researchers who rely on federal funding from any of these entities, we also want to hear from you.

Reach out to us: www.propublica.org/tips/

Or find me on Signal: 347-549-0332 🔎

With RFK Jr saying he wants to stop NIH doing infectious disease research “for 8 years” and Trump now slashing the NIH and CDC workforce, what exactly is the plan for tackling the H5N1 bird flu outbreak?

It's incredibly disheartening to hear about dedicated public health professionals getting mass-laid off from CDC. Including first year epidemic intelligence service officers. This program has been the backbone of outbreak investigations in US since 1951. Decimating this workforce makes us less safe.

How Trump’s Medical Research Cuts Would Hit Colleges and Hospitals in Every State Changes to a key funding formula will reduce research grants at hospitals and universities by billions — and may discourage future research.

A new Trump formula for NIH grants could have very broad effects. We dug into the numbers to show what it means for every university and hospital. www.nytimes.com/interactive/... @aatishb.bsky.social @emmbadger.bsky.social @ethansinger.bsky.social @irineoc.bsky.social @fparis.bsky.social

1. Today the NIH director issued a new directive slashing overhead rates to 15%.

I want to provide some context on what that means and why it matters.

grants.nih.gov/grants/guide...

A wonderful, thought-provoking piece by Paula Span @thenewyorktimes.bsky.social featuring our work.

Thank you for sharing @adambeckman.bsky.social!

Hey #healthpolicy crew! Looking into RFK Jr.’s beliefs on chronic conditions.

Hoping to interview a few chronic condition experts on best evidence to treat cc.

All suggestions welcome.

RT’s (or what they’re called here appreciated)

Standing Committee on Primary Care - November Open Meeting Register for this event from the National Academies of Sciences, Engineering, and Medicine.

Tomorrow! Join @NASEM Health and Medicine Division’s Nov 14 public meeting to explore federal efforts to strengthen the primary care workforce and review recent consensus study reports on primary care payments.
To register: secure-web.cisco.com/1gJCDDL9TQkk...

1/ I've been practicing #medicine, as a #primarycare doc and then a #hospitalist, for over a decade.

Cross-cutting any #social or #partisan divides is an increasingly common feeling: people are feeling #stuck and #trapped.

I think we are seeing the reverberations of that feeling everywhere.

With this in mind, we hope that these results can start conversations about how to optimize contact days for patients in exam rooms, board rooms, and govt offices.