Remote Physiologic Monitoring Use Among Medicare Patients: Differences By Race, Ethnicity.

Between 2018 and 2022, remote physiologic monitoring (RPM) claims increased, especially for Black (25,253 percent) and Hispanic (5,051 percent) Medicare patients. After adjustment for age, sex, and clinical factors, in 2022, Black and Hispanic Medicare patients had 88 percent and 84 percent higher RPM use rates, respectively, compared with White patients.

Palliative Care Specialist Use Among Medicare Decedents Who Had Poor-Prognosis Cancers.

Importance: Palliative care (PC) use patterns may have changed in recent years due to increased adoption of telehealth and the availability of more advanced practice clinicians who specialize in PC delivery.

Objective: To describe changes in the use of specialty PC during the last year of life among Medicare beneficiaries who had cancers with poor prognoses (cancers that commonly caused death, rare cancers with high mortality rates, or solid tumors with concurrent nonlymphatic metastases; hereinafter termed poor-prognosis cancers).

Design, Setting, And Participants: This retrospective cohort study includes all US Medicare fee-for-service beneficiaries who died from poor-prognosis cancers between January 1, 2018, and December 31, 2023, and received care in hospital and outpatient settings.

Obstetricians' experiences with remote monitoring programs for hypertensive disorders.

Background: Despite widespread use in primary care, remote patient monitoring (RPM) in obstetrics for hypertensive disorders in pregnancy remain limited. Little is known about the specific modalities, perceived impact, and integration of RPM into standard practice in obstetrics.

Objective: To explore obstetricians' experiences with RPM for hypertensive disorders in the perinatal period and barriers in implementation, and to identify promising practices to overcome these barriers.

Telehealth Use for Mental Health Treatment Among US Adolescents.

Purpose: To examine telehealth use for mental health treatment in a 2022 national sample of adolescents.

Methods: We analyzed data on adolescents (ages 12-17) who received mental health treatment in the past 12 months (N = 3,708) from the 2022 National Survey of Drug Use and Health. Proportions of adolescents who used telehealth as part of their treatment were compared across treatment settings.

Benchmarking the Transformed Medicaid Statistical Information System Analytic Files for analysis of opioid use disorder treatment.

Objective: To evaluate the data consistency and quality of Medicaid claims data on opioid use disorder (OUD) treatment, benchmarking the Transformed Medicaid Statistical Information System Analytic Files (TAF) against metrics reported by the Medicaid Outcomes Distributed Research Network (MODRN), which analyzed data obtained directly from 11 state Medicaid agencies.

Data Sources And Study Setting: The primary data source was TAF claims for the years 2017 and 2018, limited to non-dual, full-benefit Medicaid beneficiaries aged 12-64 in one of the 11 states in our study sample.

Study Design: Using TAF data, we replicated performance on the following five OUD quality metrics reported by MODRN: number of enrollees receiving any OUD medication, receipt of behavioral health counseling, completion of urine drug screens, receipt of any opioid analgesic fill, and receipt of any benzodiazepine fill.

Experiences With Online Mutual Support Groups for Problematic Drinking.

Objective: This study sought to evaluate how the recent increase in use of online meetings has influenced participant experiences with peer-based mutual support groups for problematic drinking.

Methods: The authors conducted semistructured interviews in June and July 2024 with 20 adults who participated in online mutual support meetings for problematic drinking. Participants were recruited from a nationwide online research panel.

Quantifying Indirect Billing Within the Medicare Physician Fee Schedule.

Importance: Under certain circumstances, advance practice clinicians (APCs), such as physician assistants and nurse practitioners, can bill Medicare directly or indirectly (ie, incident to the services of a physician). With indirect billing, the submitted claim states the care was provided by the physician, and the reimbursement is higher.

Objective: To quantify volume and spending on office-based encounters billed indirectly in the Medicare program.

Telelactation Services and Breastfeeding by Race and Ethnicity: A Randomized Clinical Trial.

Importance: There are substantial disparities in breastfeeding rates by race and ethnicity. Telelactation services that connect parents to lactation consultants via video are increasingly available and may reduce inequities in breastfeeding support; however, there is limited evidence on effectiveness.

Objective: To assess the impact of video telelactation services on breastfeeding duration and exclusivity across a racially and ethnically diverse population of parents.

Telemedicine Adoption and Low-Value Care Use and Spending Among Fee-for-Service Medicare Beneficiaries.

Importance: Low-value care is a persistent problem with direct and cascading harms. Telemedicine is now commonly used and may reduce low-value testing by introducing barriers to completing tests at a given visit or expand opportunities for low-value testing by contributing to higher visit volumes.

Objective: To quantify the association between telemedicine adoption and low-value testing among fee-for-service Medicare beneficiaries.

The role and reach of alcohol reduction apps.

Although apps are widely available and have several advantages as a tool to support alcohol reduction and recovery, little is known about how individuals are using them. In 2024, we conducted an exploratory sequential mixed-methods study that coupled in-depth interviews with 22 app users and a nationally representative survey of 2002 adults. We explored experiences with and perceptions of alcohol reduction apps.

Strengths And Weaknesses Of Introducing An Inflation Factor Into The Medicare Physician Fee Schedule.

Unlike most other Medicare fee schedules, the Medicare Physician Fee Schedule does not include an automatic inflation update. We describe the history of Physician Fee Schedule update systems and present paradigms for evaluating the merits of adding an inflation-based adjustment factor to the schedule's updating formulas. We adopt an incentive paradigm, which emphasizes how access to care and the consolidation of health care facilities are affected by fees.

Patient Experiences With Group Teletherapy for the Treatment of Mental Illness: A Qualitative Study.

Objective: The authors sought to understand patient experiences with group teletherapy to inform improvements in service delivery.

Methods: From December 2022 to October 2023, semistructured interviews were conducted with 20 adults with depression or bipolar disorder who had received outpatient group teletherapy in the past 2 years. A rapid thematic analysis was conducted by using a matrix to identify patterns and synthesize data.

Reforming Physician Licensure in the United States to Improve Access to Telehealth: State, Regional, and Federal Initiatives.

Policy Points The reinstitution of pre-COVID-19 pandemic licensure regulations has impeded interstate telehealth. This has disproportionately impacted patients who live near a state border; geographically mobile patients, such as college students; and patients with rare diseases who may need care from a specialist outside their state. Several promising and feasible reforms are available, at both state and federal levels, to facilitate interstate telehealth.

Factors Underlying Reduced Hospitalizations for Myocardial Infarction During the COVID-19 Pandemic.

Importance: The incidence of hospital encounters for acute myocardial infarction (AMI) decreased sharply early in the COVID-19 pandemic and has not returned to prepandemic levels. There has been an ongoing debate about what mechanism may underlie this decline, including patients avoiding the hospital for treatment, excess mortality from COVID-19 among patients who would otherwise have had an AMI, a reduction in the incidence or severity of AMIs due to pandemic-related changes in behavior, or a preexisting temporal trend of lower AMI incidence.

Objective: To describe drivers of changing incidence in AMI hospital encounters during the COVID-19 pandemic.

The diagnostic and triage accuracy of the GPT-3 artificial intelligence model: an observational study.

Background: Artificial intelligence (AI) applications in health care have been effective in many areas of medicine, but they are often trained for a single task using labelled data, making deployment and generalisability challenging. How well a general-purpose AI language model performs diagnosis and triage relative to physicians and laypeople is not well understood.

Methods: We compared the predictive accuracy of Generative Pre-trained Transformer 3 (GPT-3)'s diagnostic and triage ability for 48 validated synthetic case vignettes (<50 words; sixth-grade reading level or below) of both common (eg, viral illness) and severe (eg, heart attack) conditions to a nationally representative sample of 5000 lay people from the USA who could use the internet to find the correct options and 21 practising physicians at Harvard Medical School.