Pub Date : 2025-03-07DOI: 10.1001/jamahealthforum.2025.0187
Sandro Galea
{"title":"JAMA Health Forum-The Year in Review, 2024.","authors":"Sandro Galea","doi":"10.1001/jamahealthforum.2025.0187","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2025.0187","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250187"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674704","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}
Pub Date : 2025-03-07DOI: 10.1001/jamahealthforum.2025.0080
John Z Ayanian, Zirui Song
{"title":"Prospects for Artificial Intelligence in Health Policy and Practice.","authors":"John Z Ayanian, Zirui Song","doi":"10.1001/jamahealthforum.2025.0080","DOIUrl":"10.1001/jamahealthforum.2025.0080","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250080"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626823","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}
Pub Date : 2025-03-07DOI: 10.1001/jamahealthforum.2025.0046
Jason D Buxbaum
<p><strong>Importance: </strong>Congress appropriated $178 billion in emergency relief for health care providers (hospitals, physicians, and other health care professionals) in 2020 to stabilize finances and support the COVID-19 pandemic response. The US Department of Health and Human Services directed $35 billion of these funds to safety-net hospitals and high-impact hospitals using strict criteria. However, the importance of enhanced funding is inadequately understood.</p><p><strong>Objective: </strong>To evaluate the association between enhanced COVID-19 relief funding and hospital finances and clinical care for Medicare inpatients.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study used a differences-in-discontinuities study design with overlap weighting. Nonrural hospitals with data on costs and fee-for-service Medicare inpatient care for 2018 to 2021. Hospitals near a threshold for receiving high-impact and/or safety-net hospital funding were analyzed. Data were analyzed from July 2022 to January 2025.</p><p><strong>Exposures: </strong>Receipt of high-impact and/or safety-net hospital relief funds.</p><p><strong>Main outcomes and measures: </strong>Financial outcomes related to revenues, costs, margin, and liquidity and clinical outcomes related to volume, care processes, and mortality.</p><p><strong>Results: </strong>A total of 555 hospitals were included, with 311 receiving high-impact and/or safety-net hospital funds. Hospitals not receiving enhanced relief averaged $7.0 million in total relief (about $45 000 per bed), while hospitals receiving enhanced relief averaged $15.4 million in total relief (about $100 000 per bed). Operating revenues in 2020 increased by 4.5% (95% CI, 3.0-5.9) among basic relief hospitals and 6.1% (95% CI, 4.6-7.6) among enhanced relief hospitals. However, total costs grew similarly (basic relief: 4.6%; 95% CI, 3.6-5.6; enhanced relief: 4.5%; 95% CI, 3.4-5.7). This resulted in a significant differential increase of 1.4 points (95% CI, 0.3-2.5) in operating margin in association with enhanced relief. Enhanced relief was also associated with limited deterioration in liquidity (differential increase in net asset ratio of 0.03 points; 95% CI, 0-0.05). There was not a significant association between receipt of enhanced relief and fee-for-service Medicare inpatient admissions (-19.6 stays; 95% CI, -281.0 to 241.8), use of a sentinel deferrable procedure among fee-for-service Medicare inpatients (-3.9 admissions for lower joint replacement; 95% CI, -29.6 to 21.7), or use of 2 resource-intensive services among fee-for-service Medicare inpatients (-0.3 admissions with ventilation; 95% CI, -20.8 to 20.2; 0.9 admissions with dialysis; 95% CI, -15.4 to 17.1). Enhanced relief was not detectibly associated with change in the complexity (change in Charlson Comorbidity Index score, 0 points; 95% CI, 0-0) or inpatient mortality (-2.9 deaths; 95% CI, -11.3 to 5.5) for fee-for-service Medicar
{"title":"Enhanced COVID-19 Provider Relief, Hospital Finances, and Care for Medicare Inpatients.","authors":"Jason D Buxbaum","doi":"10.1001/jamahealthforum.2025.0046","DOIUrl":"10.1001/jamahealthforum.2025.0046","url":null,"abstract":"<p><strong>Importance: </strong>Congress appropriated $178 billion in emergency relief for health care providers (hospitals, physicians, and other health care professionals) in 2020 to stabilize finances and support the COVID-19 pandemic response. The US Department of Health and Human Services directed $35 billion of these funds to safety-net hospitals and high-impact hospitals using strict criteria. However, the importance of enhanced funding is inadequately understood.</p><p><strong>Objective: </strong>To evaluate the association between enhanced COVID-19 relief funding and hospital finances and clinical care for Medicare inpatients.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study used a differences-in-discontinuities study design with overlap weighting. Nonrural hospitals with data on costs and fee-for-service Medicare inpatient care for 2018 to 2021. Hospitals near a threshold for receiving high-impact and/or safety-net hospital funding were analyzed. Data were analyzed from July 2022 to January 2025.</p><p><strong>Exposures: </strong>Receipt of high-impact and/or safety-net hospital relief funds.</p><p><strong>Main outcomes and measures: </strong>Financial outcomes related to revenues, costs, margin, and liquidity and clinical outcomes related to volume, care processes, and mortality.</p><p><strong>Results: </strong>A total of 555 hospitals were included, with 311 receiving high-impact and/or safety-net hospital funds. Hospitals not receiving enhanced relief averaged $7.0 million in total relief (about $45 000 per bed), while hospitals receiving enhanced relief averaged $15.4 million in total relief (about $100 000 per bed). Operating revenues in 2020 increased by 4.5% (95% CI, 3.0-5.9) among basic relief hospitals and 6.1% (95% CI, 4.6-7.6) among enhanced relief hospitals. However, total costs grew similarly (basic relief: 4.6%; 95% CI, 3.6-5.6; enhanced relief: 4.5%; 95% CI, 3.4-5.7). This resulted in a significant differential increase of 1.4 points (95% CI, 0.3-2.5) in operating margin in association with enhanced relief. Enhanced relief was also associated with limited deterioration in liquidity (differential increase in net asset ratio of 0.03 points; 95% CI, 0-0.05). There was not a significant association between receipt of enhanced relief and fee-for-service Medicare inpatient admissions (-19.6 stays; 95% CI, -281.0 to 241.8), use of a sentinel deferrable procedure among fee-for-service Medicare inpatients (-3.9 admissions for lower joint replacement; 95% CI, -29.6 to 21.7), or use of 2 resource-intensive services among fee-for-service Medicare inpatients (-0.3 admissions with ventilation; 95% CI, -20.8 to 20.2; 0.9 admissions with dialysis; 95% CI, -15.4 to 17.1). Enhanced relief was not detectibly associated with change in the complexity (change in Charlson Comorbidity Index score, 0 points; 95% CI, 0-0) or inpatient mortality (-2.9 deaths; 95% CI, -11.3 to 5.5) for fee-for-service Medicar","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250046"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574666","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}
Pub Date : 2025-03-07DOI: 10.1001/jamahealthforum.2025.0269
{"title":"JAMA Health Forum Peer Reviewers in 2024.","authors":"","doi":"10.1001/jamahealthforum.2025.0269","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2025.0269","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250269"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674728","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}
Pub Date : 2025-03-07DOI: 10.1001/jamahealthforum.2025.0954
Larry Levitt
{"title":"A Backlash Against Health Insurers, Redux.","authors":"Larry Levitt","doi":"10.1001/jamahealthforum.2025.0954","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2025.0954","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250954"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626803","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}
Pub Date : 2025-03-07DOI: 10.1001/jamahealthforum.2025.0040
Thomas A Buckley, Byron Crowe, Raja-Elie E Abdulnour, Adam Rodman, Arjun K Manrai
{"title":"Comparison of Frontier Open-Source and Proprietary Large Language Models for Complex Diagnoses.","authors":"Thomas A Buckley, Byron Crowe, Raja-Elie E Abdulnour, Adam Rodman, Arjun K Manrai","doi":"10.1001/jamahealthforum.2025.0040","DOIUrl":"10.1001/jamahealthforum.2025.0040","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250040"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626806","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}
Pub Date : 2025-03-07DOI: 10.1001/jamahealthforum.2025.0817
Michelle M Mello, Jamie Wang
{"title":"The Hard Road Ahead for State Public Health Departments.","authors":"Michelle M Mello, Jamie Wang","doi":"10.1001/jamahealthforum.2025.0817","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2025.0817","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250817"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568818","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}
Pub Date : 2025-03-07DOI: 10.1001/jamahealthforum.2025.0213
Sandro Galea
{"title":"The US, the World Health Organization, and the Global Health Infrastructure.","authors":"Sandro Galea","doi":"10.1001/jamahealthforum.2025.0213","DOIUrl":"10.1001/jamahealthforum.2025.0213","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 3","pages":"e250213"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626828","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}
Pub Date : 2025-02-07DOI: 10.1001/jamahealthforum.2024.4960
{"title":"JAMA Health Forum.","authors":"","doi":"10.1001/jamahealthforum.2024.4960","DOIUrl":"https://doi.org/10.1001/jamahealthforum.2024.4960","url":null,"abstract":"","PeriodicalId":53180,"journal":{"name":"JAMA Health Forum","volume":"6 2","pages":"e244960"},"PeriodicalIF":9.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366798","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}
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