Dr. Rishi Wadhera, MD MPP MPhil

Study on Medicaid Work Requirements Finds No Gains in Insurance, Employment State-level findings from Georgia may predict nationwide rollout

Work requirements enacted as part of a Medicaid expansion program in Georgia did not increase insurance coverage or employment relative to neighboring states that did not expand Medicaid, a study suggested.

https://www.medpagetoday.com/publichealthpolicy/medicaid/117748?trw=no

Trends in health insurance coverage and employment in Georgia and Medicaid non-expansion states

New BMJ Research finds the implementation of work requirements with Medicaid expansion in Georgia did not increase health insurance coverage or employment.

These findings have important implications after recently enacted legislation
www.bmj.com/content/390/...

Insurance coverage and employment after Medicaid expansion with work requirements: quasi-experimental difference-in-differences study Objective To understand how health insurance coverage and employment changed among working age adults with low incomes in Georgia, the first state to implement Medicaid expansion with work requirement...

1/8
Evidence keeps piling up: Medicaid work requirements do not increase employment. They just make it harder for people to get health insurance.

Latest evidence comes from a BMJ study on Georgia. 🧵

Medicaid work requirements will soon be mandatory nationwide

Our new @bmj.com study shows that in Georgia - the only state to expand Medicaid with work requirements - work requirements impeded gains in Medicaid coverage without increasing employment

www.bmj.com/content/390/...

Medicaid Work Requirements Don’t Boost Employment, Study Shows

Medicaid work requirements will soon be implemented nationwide

Our new @bmj.com study shows what happened to insurance coverage and jobs when Georgia rolled them out in 2023. bit.ly/3VE1QsK

Featured in @nytimes.com #medsky
www.nytimes.com/2025/09/30/w...

Question Has hospital length of stay increased more for Medicare Advantage beneficiaries than for traditional Medicare beneficiaries since the COVID-19 pandemic?Findings In this cohort study involving more than 89 million hospitalizations from 2017 to the third quarter of 2023, Medicare Advantage beneficiaries experienced disproportionately greater increases in extended hospital stays, especially among those discharged to skilled nursing facilities.Meaning These findings suggest that the Medicare Advantage plan design and practices may contribute to hospital discharge delays, with implications for patient outcomes and hospital capacity as enrollment continues to rise.

New paper w/ Brian McGarry, Ashvin Gandhi, and Drew Wilcock in @jamainternalmed.com!

Hospitals are complaining across the US that patients are "stuck" waiting for rehab beds at nursing homes when they are medically stable and ready for discharge. What is going on??

jamanetwork.com/journals/jam...

Surprise medical bills can be financially devastating

Our new @bmj.com study finds that the No Surprises Act - a recent law banning surprise medical bills - significantly ⬇️ out-of-pocket costs for patients without raising premiums.

Study link: t.co/hZTOVoNSy5
#medsky #cardiosky

Our @jama.com study leveraged a natural experiment to show that cutting SNAP benefits leads to ⬆️ food insecurity AND worse physical health.

The One Big Beautiful Bill’s deep cuts to SNAP are especially alarming.

Thanks for sharing @robcaliff.bsky.social!
jamanetwork.com/journals/jam...

In health insurers’ race to offload unprofitable members, winners begin to emerge If you’ve followed health insurance earnings lately, you might be experiencing some whiplash. But some lessons about the industry have also emerged.

Sure seems time to examine the purpose of health insurance if this is correct: "Both Humana and CVS’ Aetna, for example, made changes last year designed to drive away 10% of their least profitable Medicare Advantage members."

www.statnews.com/2025/08/01/h...

Rishi Wadhera of @harvardmed.bsky.social speaks with JAMA Associate Editor Karen Joynt Maddox about how measures of patient care experience changed after private equity acquisition of US hospitals.

ja.ma/4hao2DC

Patient Care Deteriorates After Private Equity Acquisition of Hospitals Study supports other research showing worse outcomes after private equity acquisition

"When private equity takes over a hospital, things generally get worse for patients." -- Rishi Wadhera, MD, MPP, MPhil, of @harvardmed.bsky.social, discussing research on private equity's impact on hospitals.
www.medpagetoday.com/hospitalbase...

Our @jama.com study leveraged a natural experiment to show that cutting SNAP benefits leads to ⬆️ food insecurity AND worse physical health.

The One Big Beautiful Bill’s deep cuts to SNAP are especially alarming.

Thanks for sharing @robcaliff.bsky.social!
jamanetwork.com/journals/jam...

Private Equity-Backed Hospitals Appear to 'Cherry-Pick' HF Patients Acquired hospitals may be inappropriately selecting patients and doing more profitable cardiac caths.

Private equity-acquired hospitals may be cherry picking low-risk HF patients and performing more profitable cardiac catheterizations. “There’s been growing concern that…they may select for certain types of patients to maximize reimbursement," said @rkwadhera.bsky.social www.tctmd.com/news/private...

In @jaccjournals.bsky.social, we find that after private equity firms acquired hospitals, clinical risk ⬇️ & catheterizations ⬆️ among patients w/ heart failure, but outcomes didn't improve

Big thanks to @rkwadhera.bsky.social, Michael, Andrew, and Vicky!

jacc.org/doi/full/10.1016/j.jacc.2025.05.037

Heart Failure Care and Outcomes After Private Equity Acquisition of U.S. Hospitals:

In this national study, #heartfailure outcomes didn’t improve after private equity hospital acquisitions, despite a 📉 in the clinical risk of patients. Transfer-outs nearly doubled for Black adults with HF. www.jacc.org/doi/10.1016/...

#ARM25 #JACC @danielyjohnson.bsky.social @rkwadhera.bsky.social

Hypertension, Diabetes, and High Cholesterol Awareness Among US Adults This cross-sectional study evaluated the changes in the proportion of US adults who were unaware they had hypertension, diabetes, or a high cholesterol level using 2013 to 2023 data from the National ...

Our new JAMA Cardiology study finds that many US adults don't know that they have hypertension, diabetes, or high cholesterol

Nearly 1 in 3 young adults w/ hypertension, 2 in 5 with diabetes, and 1 in 4 with high cholesterol are unaware of their condition.

bit.ly/45an6MC #medsky #cardiosky

Our new study in JAMA Cardiology finds that from 2013-2023, an increasing proportion of US adults were unaware that they had hypertension, especially young adults and women

Huge thanks to 🌟 mentors @rkwadhera.bsky.social and Lucas Marinacci

jamanetwork.com/journals/jam...

In a Cardio Business interview, Smith Ctr. for Outcomes Research Assoc. Director @rkwadhera.bsky.social discusses the rapid growth of private equity in cardiology, & the implications for quality & patient outcomes. cardiovascularbusiness.com/video/2025-0...

This BIDMC article discusses findings of a recent study published in @jama.com, bit.ly/3HhgqSN, focusing on cuts to food stamps and the link to rising food insecurity and declining health in the US. Study co-authors include HPM's Sara Bleich and Jose Figueroa (@joefigs.bsky.social).

Changes in Physical and Mental Health After the End of SNAP Emergency Allotments This cross-sectional study uses data from the Behavioral Risk Factor Surveillance System to examine how Supplemental Nutrition Assistance Program emergency allotments impacted physical and mental heal...

Congress has proposed deep cuts to SNAP, which provides nutritional benefits to >40 million Americans

Our new @jama.com study finds that ⬇️ SNAP benefits not only ⬆️ food insecurity, but also leads to significant ⬆️ poor physical health #medsky

jamanetwork.com/journals/jam...

After the end of emergency allotments, there were increases in food insecurity and poor physical health days among SNAP participants.

ja.ma/43dp8ZN @rkwadhera.bsky.social

Changes in Physical and Mental Health After the End of SNAP Emergency Allotments This cross-sectional study uses data from the Behavioral Risk Factor Surveillance System to examine how Supplemental Nutrition Assistance Program emergency allotments impacted physical and mental heal...

Congress has proposed deep cuts to SNAP, which provides nutritional benefits to >40 million Americans

Our new @jama.com study finds that ⬇️ SNAP benefits not only ⬆️ food insecurity, but also leads to significant ⬆️ poor physical health #medsky

jamanetwork.com/journals/jam...

Insurance Coverage Among Working-Age U.S. Adults After the End of the Medicaid Continuous Enrollment Provision | Annals of Internal Medicine

Our new Annals of Internal Medicine study finds a concerning ⬆️ uninsured rates among working-age US adults after the end of the continuous enrollment provision (Medicaid "unwinding") on March 2023 #medsky

www.acpjournals.org/doi/10.7326/...
@annalsofim.bsky.social

New @nejm.org study with alarming results.

The wealthiest Americans do not live as long as the wealthiest in other countries.

In fact, mortality among the wealthiest Americans appeared to be similar to people in the poorest quartile in northern and western
Europe.

www.nejm.org/doi/full/10....

Figure 1. Cardiometabolic Risk FActors and Cardiovascular Diseases by Age in Rural and Urban Areas, 2022

From JAMA Cardiology: Rural adults in the US have higher rates of cardiometabolic risk factors and cardiovascular diseases compared to urban adults, with disparities largely explained by social risk factors.

#ACC25 https://ja.ma/41QUhTm

@accintouch.bsky.social

#ACC25 is just around the corner!

Our Health Policy Team will be presenting timely research on the effects of private equity acquisitions, telehealth parity policies, & the Inflation Reduction Act on cardiovascular health

Come by to check out this amazing group of trainees work! #cardiosky

Figure. Mean HbA1c Level and Glycemic Control Among Adults With a Diagnosis of Diabetes by Age and Sex, 2013-2023

The prevalence of adults with diabetes did not significantly change between 2013 and 2023, but glycemic control among those with diagnosed disease worsened between 2021 and 2023. https://ja.ma/4khkCBe

Glycemic Control Worsening Among Young Adults With Diabetes Even as diabetes prevalence held steady over past decade

"We need to ensure that our younger adult patients are coming in for their annual checkups." -- @rkwadhera.bsky.social, of Beth Israel Deaconess Medical Center, on the stark worsening of glycemic control among young adults with #diabetes over the past few years.
www.medpagetoday.com/primarycare/...

Our new JAMA study finds that glycemic control worsened among US adults with diabetes in 2021-2023 following a decade of stability

This change was most pronounced in young adults (20-44 years), in whom control ⬇️ 20% (!) and HgbA1c levels ⬆️ by 1%
t.co/4Z8woN6LBB @jama.com #Cardiosky