JAMA Health Forum最新文献

{"title":"Inaction on Artificial Intelligence Regulation in a Time of Upheaval.","authors":"Sandro Galea","doi":"10.1001/jamahealthforum.2025.1246","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2025.1246","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 7","pages":"e251246"},"PeriodicalIF":9.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Problem With California's Plan to Contain Health Care Costs.","authors":"Lanhee J Chen","doi":"10.1001/jamahealthforum.2025.3383","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2025.3383","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 7","pages":"e253383"},"PeriodicalIF":9.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enrollment in Dual-Eligible Special Needs Plans and Disenrollment Rates.","authors":"David J Meyers, Eliza Macneal, Kendra Offiaeli, Eric T Roberts","doi":"10.1001/jamahealthforum.2025.1748","DOIUrl":"10.1001/jamahealthforum.2025.1748","url":null,"abstract":"<p><strong>Importance: </strong>Medicare beneficiaries dually enrolled in Medicare and Medicaid have some of the highest care needs. Finding ways to support dually eligible beneficiaries in the Medicare Advantage (MA) program has become a policy goal.</p><p><strong>Objective: </strong>To determine if enrollment in different MA plan types is associated with differences in disenrollment.</p><p><strong>Design, setting, and participants: </strong>This cross-sectional study included Medicare enrollment data from dually eligible Medicare beneficiaries in 2021. Analyses were conducted between March 2024 and February 2025. Data were analyzed from January through March 2025.</p><p><strong>Exposure: </strong>Enrollment in different MA plan types, including those that exclusively serve dual-eligible beneficiaries (coordination-only, dual-eligible special needs plans [D-SNPs] and fully integrated D-SNPs [FIDE-SNPs]), standard MA plans that serve dual-eligible and non-dual-eligible beneficiaries, and D-SNP look-alike plans, defined as standard MA plans that primarily enroll dual-eligible beneficiaries.</p><p><strong>Main outcomes and measures: </strong>One-year disenrollment from one plan to another or to traditional Medicare.</p><p><strong>Results: </strong>Among 2 698 434 dually eligible beneficiaries in 2021, the mean (SD) age was 66.9 (14.1) years, and 62.5% were female individuals. Of dual-eligible beneficiaries enrolled in FIDE-SNPs in 2021, 19 001 (8.1%) disenrolled by 2022. Of those enrolled in coordination-only D-SNPs, D-SNP look-alikes, and standard MA plans in 2021, disenrollment rates were 18.3%, 30.5%, and 28.2%, respectively. Disenrollment rates were higher for Black beneficiaries and those who used more health services, including inpatient stays and more days of nursing home care.</p><p><strong>Conclusions and relevance: </strong>The results of this cross-sectional study suggest that FIDE-SNPs retained their members at higher rates, which could be a sign of improved care experiences. Understanding how FIDE-SNPs may be affecting patient care will be important moving forward.</p>","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 7","pages":"e251748"},"PeriodicalIF":9.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement Bias in Documentation of Social Risk Among Medicare Beneficiaries.","authors":"Paula Chatterjee, Eliza Macneal, Eric T Roberts","doi":"10.1001/jamahealthforum.2025.1923","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2025.1923","url":null,"abstract":"<p><strong>Importance: </strong>Health care organizations are increasingly measuring social risk using Z codes. Types of social risk captured in Z codes include issues related to employment, housing, education, or other psychosocial circumstances. Prior work has found low use of Z codes overall, but measurement may be biased in other ways that have implications for risk adjustment and resource allocation.</p><p><strong>Objective: </strong>To characterize Z code measurement among hospitalized Medicare beneficiaries across levels of clinical complexity and historical health care utilization and examine implications of these patterns for mortality prediction.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study included Medicare beneficiaries with an inpatient hospital admission in 2022. Data were analyzed from May 2024 to June 2025.</p><p><strong>Main outcomes and measurements: </strong>Presence of Z codes (codes Z55 to Z65) in any diagnosis field for a hospital admission, variation in Z code documentation across beneficiaries categorized by clinical risk (Elixhauser Comorbidity Index risk scores and predicted 30-day mortality risk) and historical utilization levels (number of hospitalizations in the prior year), and the association between Z code documentation and observed 30-day mortality, controlling for hospital fixed effects.</p><p><strong>Results: </strong>Among 7 069 611 hospitalized Medicare beneficiaries in 2022, 3 816 420 (54.0%) were female, and 6 093 932 (86.1%) were 65 years or older. A total of 148 592 (2.1%) had at least 1 Z code on the index hospital claim. Within-hospital Z code prevalence was higher for beneficiaries with lower Elixhauser Comorbidity Index clinical risk scores (2.8% vs 1.5%) and higher among patients with at least 2 hospitalizations in the prior year (2.6%) than patients with zero (1.8%) or 1 (2.1%) prior hospitalizations. Despite known population-level associations between social risk and increased mortality, Z code prevalence was highest among beneficiaries with the lowest predicted 30-day mortality risk (4.4%) and lowest among beneficiaries with the highest mortality risk (1.6%). Correspondingly, in within-hospital analyses that did not adjust for patient-level covariates such as demographic characteristics and clinical risk, the presence of a Z code was associated with a lower probability of observed 30-day mortality (5.1% vs 4.2%; difference, -0.9 percentage points; 95% CI, -1.0 to -0.8).</p><p><strong>Conclusions and relevance: </strong>This cohort study found that Z code use patterns likely underrepresent social risk among clinically complex patients, resulting in a spurious negative association between documented social risk and mortality. Alternative socioeconomic indicators, including data collected for population and public health surveillance, may offer more reliable measures of social risk than Z codes.</p>","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 7","pages":"e251923"},"PeriodicalIF":9.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Projected Health System and Economic Impacts of 2025 Medicaid Policy Proposals.","authors":"Sanjay Y Basu, Sadiq Patel, Seth A Berkowitz","doi":"10.1001/jamahealthforum.2025.3187","DOIUrl":"10.1001/jamahealthforum.2025.3187","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 7","pages":"e253187"},"PeriodicalIF":9.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deliberate Actions to Weaken the Federal Nutrition Safety Net.","authors":"Sara N Bleich, Stacy Dean","doi":"10.1001/jamahealthforum.2025.3766","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2025.3766","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 7","pages":"e253766"},"PeriodicalIF":9.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JAMA Health Forum.","authors":"","doi":"10.1001/jamahealthforum.2024.4965","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2024.4965","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 7","pages":"e244965"},"PeriodicalIF":9.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Physician Exit From Fee-for-Service Medicare.","authors":"Hannah T Neprash, Michael E Chernew","doi":"10.1001/jamahealthforum.2025.2267","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2025.2267","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 7","pages":"e252267"},"PeriodicalIF":9.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Hospitals Participating in the Transforming Episode Accountability Model.","authors":"Sukruth A Shashikumar, Jie Zheng, Thomas C Tsai, E John Orav, Arnold M Epstein, Karen E Joynt Maddox","doi":"10.1001/jamahealthforum.2025.1996","DOIUrl":"10.1001/jamahealthforum.2025.1996","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 7","pages":"e251996"},"PeriodicalIF":9.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Errors in References Cited and Results Section.","authors":"","doi":"10.1001/jamahealthforum.2025.2898","DOIUrl":"10.1001/jamahealthforum.2025.2898","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 7","pages":"e252898"},"PeriodicalIF":9.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}