JAMA Health Forum Editors' Summary

Increased health insurance coverage in the US has had a broad range of positive impacts on US health, including increases in preventive care and better chronic disease management. Larry Levitt, MPP, of KFF joins JAMA Health Forum Editor in Chief Sandro Galea, MD, DrPH, to discuss challenges facing US health insurance coverage today. Related Content: The Ongoing, and Heightened, Threat to Health Insurance Coverage in the US A Backlash Against Health Insurers, Redux

The first months of the Trump administration have been marked by a flurry of actions, many that have affected agencies directly related to health domestically and globally. Joshua M. Sharfstein, MD, of the Johns Hopkins Bloomberg School of Public Health joins JAMA Health Forum Editor in Chief Sandro Galea, MD, DrPH, to discuss the contemporary threats to the health of the American public. Related Content: The Potential Consequences of Disinvestment in Health in the US

US withdrawal from the World Health Organization will have significant implications for global health. Lawrence Gostin, JD, JAMA Legal and Global Health Correspondent and Faculty Director of the O'Neill Institute for National and Global Health Law at Georgetown University, joins JAMA Health Forum Editor in Chief Sandro Galea, MD, DrPH, to discuss global health in an era of new uncertainty. Related Content: The US, the World Health Organization, and the Global Health Infrastructure

Incoming Editor in Chief Sandro Galea, MD, DrPH, discusses the journal and the state of health policy with Deputy Editor Julie Donohue, PhD, and Senior Editor Melinda Buntin, PhD. Related Content: JAMA Health Forum: Meet the Editor in Chief, Sandro Galea, MD, DrPH JAMA Health Forum—Paving the Way for the Future of Health Policy Science and Scholarship

Founding Editor in Chief John Ayanian, MD, MPP, reflects on the origins and the highlights of the journal's first 5 years, including seminal publications, the journal's current No. 1 slot in the rankings, and the amazingly collegial editorial team, with JAMA Health Forum founding Deputy Editor Melinda Buntin, PhD. Related Content: Reflections on the First 5 Years of JAMA Health Forum

Research shows that Tobacco 21 (T21) policies with a minimum legal age to purchase tobacco products of 21 years reduce youth smoking, yet their potential long-term impact varies across US states. Jamie Tam, MPH, PhD, of the Yale University School of Public Health discusses these findings with JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD. Related Content: US Tobacco 21 Policies and Potential Mortality Reductions by State

Extreme heat in the US led to deaths and hospital admissions among community-dwelling older adults with low incomes. Hyunjee Kim, PhD, of the Oregon Health & Science University, and Jose F. Figueroa, MD, MPH, of Harvard University, discuss these findings with JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD. Related Content: Heat Waves and Adverse Health Events Among Dually Eligible Individuals 65 Years and Older The Alarming Risks for Dually Eligible Beneficiaries During Heat Waves

The use of care by patients of physicians considered more altruistic differs from the use of care of physicians considered less. Lawrence P. Casalino, MD, PhD, MPH, of Weill Cornell Medicine, discusses his work around this with JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD. Related Content: Physician Altruism and Spending, Hospital Admissions, and Emergency Department Visits

JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, spoke with Sherry Glied, PhD, and Dong Ding, MA, MPA, of New York University, about the effects of participation in health care savings accounts. Participation in flexible spending accounts is linked to higher health care and tax expenditures, while health care savings accounts do not reduce expenditures. Related Content: Health Care–Related Savings Accounts, Health Care Expenditures, and Tax Expenditures

AcademyHealth CEO Aaron Carroll, MD, MS, shares highlights from the AcademyHealth 2024 Annual Research Meeting in an interview hosted by JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD. John and Melinda then discuss key findings from 4 highly rated abstracts presented at the meeting that were published concurrently as Original Investigations in JAMA Health Forum. Related Content: Coverage and Access Changes During Medicaid Unwinding Changes in Health Care and Prescription Medication Affordability in the US During the COVID-19 Pandemic Household Health Care Payments Under Rate Setting, Spending Growth Target, and Single-Payer Policies Pay-for-Performance Incentives for Home Dialysis Use and Kidney Transplant JAMA Health Forum Highlights From the AcademyHealth Annual Research Meeting

More than 50 million adults in the US are eligible to vote but not registered. Alister F. Martin, MD, MPP, of Harvard University, and Katherine McCabe, PhD, of Rutgers University speak with JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, about a program to register new voters in health care settings that has enrolled younger and racially and ethnically diverse adults. Related Content: Increasing Voter Participation Through Health Care–Based Voter Registration

JAMA Health Forum Editor John Ayanian, MD, MPP, speaks with Kelsey M. Owsley, PhD, of the University of Arkansas, and Sayeh Nikay, PhD, MPH, of the University of Minnesota, about how the 340B drug discount program influences the services offered by public and nonprofit hospitals. They also discuss new state policies and proposed federal policies to promote greater transparency and accountability in the 340B program. Related Content: US Hospital Service Availability and New 340B Program Participation Public Hospitals May Use the 340B Program Differently Than Nonprofit Hospitals

Benjamin D. Sommers, MD, PhD, of Harvard University, speaks with JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, about differences in Medicaid enrollment as measured in surveys and administrative data. These differences have implications for estimating coverage now that the federal policy of continuous Medicaid eligibility during the COVID-19 pandemic has ended. Related Content: Survey-Reported Coverage in 2019-2022 and Implications for Unwinding Medicaid Continuous Eligibility

JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, speak with Rachel A. Prusynski, DPT, PhD, of the University of Washington about differences in the use and outcomes of home health services provided to beneficiaries in traditional Medicare and Medicare Advantage. Related Content: Differences in Home Health Services and Outcomes Between Traditional Medicare and Medicare Advantage

The COVID-19 pandemic has caused major disruptions in ambulatory care. In this interview with JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, Rishi K. Wadhera, MD, MPP, MPhil, of Harvard Medical School discusses how access to care and preventive services changed for different racial and ethnic groups in the US from 2019 to 2022. Related Content: Changes in Health Care Access and Preventive Health Screenings by Race and Ethnicity

JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, speak with Lindsay D. Allen, PhD, about how setting-specific opioid prescription duration limits helped reduce opioid overuse in West Virginia. Related Content: Opioid Prescribing Patterns After Imposition of Setting-Specific Limits on Prescription Duration

Smoking remains a leading cause of preventable morbidity and mortality in the US. Rafael Meza, PhD, of the British Columbia Cancer Research Institute, discusses recent trends in smoking by US adults across different age and income groups in this interview with JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD. Related Content: Trends in US Adult Smoking Prevalence, 2011 to 2022

JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, speak with Ge Bai, PhD, CPA, author of Pharmacy Benefit Managers: History, Business Practices, Economics, and Policy, about how pharmacy benefit managers (PBMs) have evolved in recent decades to play a central role in the US prescription drug market, including the benefits and policy challenges that PBMs present in this market. Related Content: Pharmacy Benefit Managers

JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, spoke with Heather Taylor, MD, from Indiana University Richard M. Fairbanks School of Public Health, about the costs of untreated mental illness in the state of Indiana. Considering a wide set of direct and indirect costs, her team estimated the cost to Indiana is over $4 Billon per year. Related Content: Economic Burden Associated With Untreated Mental Illness in Indiana

In this interview, JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, explore with Erin K. McCreary, PharmD, and Atheendar S. Venkataramani, MD, PhD, how a large regional health system used a weighted lottery and intensive outreach to provide high-risk individuals in disadvantaged communities more equitable access to scarce monoclonal antibodies for preventing COVID-19. Related Content: Weighted Lottery to Equitably Allocate Scarce Supply of COVID-19 Monoclonal Antibody Moving Beyond Intent and Realizing Health Equity

JAMA Health Forum Editor John Ayanian, MD, and Deputy Editor Melinda Buntin, PhD, discuss with Sandra B. Nelson, MD (Massachusetts General Hospital, Boston), her JAMA Health Forum study of transmission of SARS-CoV-2 in schools in Massachusetts during 2 different phases of the COVID-19 pandemic. She found transmission rates were very low but varied by district and the availability of vaccines. Related Content: Prevalence and Risk Factors for School-Associated Transmission of SARS-CoV-2

JAMA Health Forum Editor John Ayanian, MD, MPP, and Associate Editor Julie Donohue, PhD, speak with Aaron S. Kesselheim, MD, JD, MPH, and Genevieve P. Kanter, PhD, about the role of advisory committees convened by the US Food and Drug Administration (FDA) to guide its decisions on whether to approve new prescription drugs. They also consider how the FDA has responded to recommendations from these advisory committees over the past decade. Related Content: Association of Advisory Committee Votes With US Food and Drug Administration Decision-Making on Prescription Drugs, 2010-2021 The Real Question the FDA Is Asking Its Advisory Committees

JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, talk with Anne N. Thorndike, MD, MPH, about the challenge of connecting Medicaid Accountable Care Organization (ACO) members with flexible benefits to address food and housing insecurity issues. Dr Thorndike and colleagues used a mixed-methods approach to conduct this evaluation of the implementation of a novel program in an ACO in Massachusetts. Related Content: Assessment of the Massachusetts Flexible Services Program to Address Food and Housing Insecurity in a Medicaid Accountable Care Organization

JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, discuss with Brystana G. Kaufman, PhD, Duke Margolis Center for Health Policy, how health care use and spending differ for individuals residing in the community or nursing homes who are dually eligible for Medicare and Medicaid. They also explore the potential value of more tailored approaches to integrating benefits covered by these 2 public insurance programs. Related Content: Health Care Use and Spending Among Need-Based Subgroups of Medicare Beneficiaries With Full Medicaid Benefits

In this interview, JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, speak with Megan B. Cole, PhD, MPH, about changes in performance measures and use of ambulatory services provided by federally qualified health centers in the US during the first 2 years of the COVID-19 pandemic. Related Content: Changes in Performance Measures and Service Volume at US Federally Qualified Health Centers During the COVID-19 Pandemic

Adjusting quality measurements and payments for health care services to reflect the social as well as clinical risk factors of patients is controversial. JAMA Health Forum Editor John Z. Ayanian, MD, MPP, and Deputy Editor Melinda B. Buntin, PhD, discuss a structured approach that can be used to make decisions about social risk factor adjustment in Medicare with Yale's Kasia J. Lipska, MD. Related Content: Adjustment for Social Risk Factors in a Measure of Clinician Quality Assessing Acute Admissions for Patients With Multiple Chronic Conditions

In this interview, JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, speak with David A. Hyman, JD, MD, about the role of paid malpractice claims in the past as a predictor of future paid malpractice claims, including how this link applies to lower-risk and higher-risk medical specialties. Related Content: Association of Past and Future Paid Medical Malpractice Claims

The COVID-19 pandemic has disrupted health care in many domains, including mental health services. JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, discuss with Ryan K. McBain, PhD, MPH, of RAND Corporation how the use of mental health care—both in-person and telehealth visits—changed for commercially insured adults during the first year of the COVID-19 pandemic in 2020. Related Content: Mental Health Service Utilization Rates Among Commercially Insured Adults in the US During the First Year of the COVID-19 Pandemic

Medicare spending growth per beneficiary has been historically low since the passage of the Affordable Care Act in 2010. JAMA Health Forum Deputy Editor Melinda B. Buntin, PhD, of Vanderbilt University, speaks with JAMA Health Forum Editor John Ayanian, MD, MPP, and Associate Editor Zirui Song, MD, PhD, about the factors that explain this slowdown in Medicare spending and the implications for policy makers, physicians, and Medicare beneficiaries. Related Content: Trends in and Factors Contributing to the Slowdown in Medicare Spending Growth, 2007-2018

In this conversation with Zoe Bouchelle, MD, of the University of Pennsylvania, JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, discuss the magnitude of the increase in food insufficiency among US households following the discontinuation of the COVID-19 pandemic–related monthly child tax credit payments. Related Content: Food Insufficiency Following Discontinuation of Monthly Child Tax Credit Payments Among Lower-Income US Households

Authors Andrew Feher, PhD, of Covered California, and Adrianna McIntyre, PhD, MPP, MPH, of Harvard T.H. Chan School of Public Health, speak with JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, about research on the best ways to help people losing Medicaid coverage to enroll in health insurance Marketplace plans so they do not become uninsured. Related Content: Effect of Personalized Outreach on Medicaid to Marketplace Coverage Transitions Evidence-Based Outreach Strategies for Minimizing Coverage Loss During Unwinding

Early in the COVID-19 pandemic, most states approved temporary regulatory changes so out-of-state physicians could provide telemedicine services to residents. Ateev Mehrotra, MD, of Harvard Medical School, and Chad Ellimoottil, MD, MS, of the University of Michigan, speak with JAMA Health Forum Editor John Ayanian, MD, and Deputy Editor Melinda Buntin, PhD, about the features of telemedicine visits provided for Medicare beneficiaries across state borders during the first year of the pandemic and potential policy changes that would enable such visits to continue.   Related Content: Receipt of Out-of-State Telemedicine Visits Among Medicare Beneficiaries During the COVID-19 Pandemic Takeaways From 2 Key Studies on Interstate Telehealth Use Among Medicare Fee-for-Service Beneficiaries

President Biden has signed into law the Inflation Reduction Act containing important provisions related to prescription drug costs. JAMA Health Forum Editor John Z. Ayanian, MD, MPP, and Deputy Editor Melinda B. Buntin, PhD, discuss the effects of these provisions on patients with Aaron S. Kesselheim, MD, JD, MPH, of Harvard Medical School and Brigham and Women's Hospital. Related Content: New Reforms to Prescription Drug Pricing in the US Estimating Rebates and Other Discounts Received by Medicare Part D Estimation of the Share of Net Expenditures on Insulin Captured by US Manufacturers, Wholesalers, Pharmacy Benefit Managers, Pharmacies, and Health Plans From 2014 to 2018 Spending by the Centers for Medicare & Medicaid Services Before and After Confirmation of Benefit for Drugs Granted US Food and Drug Administration Accelerated Approval, 2012 to 2017 Improving Prescription Drug Affordability Through Regulatory Action

Hurricane Maria in Puerto Rico in 2017 was one of the most costly and catastrophic storms in US history. In this podcast, Maricruz Rivera-Hernandez, PhD, of Brown University speaks about her study of migration and mortality among patients with kidney failure requiring dialysis in Puerto Rico before and after Hurricane Maria with JAMA Health Forum Editor John Z. Ayanian, MD, MPP, and Deputy Editor Melinda B. Buntin, PhD. Related Content: Changes in Migration and Mortality Among Patients With Kidney Failure in Puerto Rico After Hurricane Maria

Rishi K. Wadhera, MD, MPP, MPhil, Beth Israel Deaconess Medical Center, discusses his article investigating the association of the Medicare Hospital Value-Based Purchasing program with changes in patient care experience at safety-net vs non–safety-net hospitals with JAMA Health Forum editors John Z. Ayanian, MD, MPP, and Melinda B. Buntin, PhD. Related Content: Association of the Medicare Value-Based Purchasing Program With Changes in Patient Care Experience at Safety-net vs Non–Safety-net Hospitals

In July 2022, Kirsten Bibbins-Domingo, PhD, MD, MAS, took on a new role as the 17th editor in chief of JAMA and the JAMA Network. In conversation with Nobel laureate Harold Varmus, MD, Bibbins-Domingo discusses her research background, approaches to leadership in health care, and the critical role that journals play in communication about public health and science. Related Content: The Urgency of Now and the Responsibility to Do More—My Commitment for JAMA and the JAMA Network A Conversation With Dr Kirsten Bibbins-Domingo, JAMA's New Editor in Chief (video) A Conversation With Dr Kirsten Bibbins-Domingo, JAMA's New Editor in Chief (audio)

Through the Patient Protection and Affordable Care Act, Medicaid expansion has yielded clear improvements in insurance coverage and access to care for low-income adults younger than 65, but has Medicaid expansion also had spillover benefits for adults 65 and older? In this interview with JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, Melissa McInerney, PhD, describes how older adults with low incomes and limitations related to chronic conditions were more likely to have Medicaid coverage and recent visits with physicians in states that have expanded Medicaid for younger adults than those in nonexpansion states. Related Content: Spillover Benefits of Medicaid Expansion for Older Adults With Low Incomes Medicaid Expansion and Health Care in Older Adults With Low Income and Chronic Condition Limitations

The COVID-19 pandemic has created an unprecedented need for accelerated collaborative research in health care systems. In a conversation with JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, Jonathan Perlin, MD, PhD, of the Joint Commission (and formerly of HCA Healthcare) discusses lessons learned from a novel COVID-19 research consortium developed through a collaboration of HCA Healthcare, the federal Agency for Healthcare Research and Quality, and numerous academic partners. Related Content: Harnessing COVID-19 Data Through Collaboration—The Consortium of HCA Healthcare and Academia for Research Generation

The health care workforce has yet to recover from the COVID-19 pandemic, and there is a concerning trend of increasing numbers of physicians leaving the workforce. JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, discuss with Bianca Frogner, PhD, of the University of Washington new findings that show how all segments of the health care workforce have struggled, with more pronounced effects among long-term care workers, aides, assistants, workers with young children, and workers of color. Related Content: Tracking Turnover Among Health Care Workers During the COVID-19 Pandemic US Health Care Workforce Changes During the COVID-19 Pandemic Changes in Material Hardship During the First Year of the COVID-19 Pandemic

Prison staff and residents have faced increased risks of COVID-19 infections. JAMA Health Forum Editor John Ayanian, MD, MPP, and Deputy Editor Melinda Buntin, PhD, speak with Jeremy Goldhaber-Fiebert, PhD of Stanford University about patterns of COVID-19 vaccinations among staff in California state prisons. They also speak with Jaimie Meyer, MD, MS of Yale University about efforts to promote COVID-19 vaccinations among prison staff and residents in California and other states. Related Content: Uptake of COVID-19 Vaccination Among Frontline Workers in California State Prisons

For the duration of the COVID-19 pandemic public health emergency, state Medicaid programs elected to maintain eligibility for Medicaid recipients in exchange for increased federal funding. In this podcast, Dr Laura Dague of the Bush School of Government & Public Service at Texas A&M University discusses her JAMA Health Forum article finding that this policy was associated with the higher Medicaid enrollment seen during the pandemic. JAMA Health Forum Editor John Ayanian and Deputy Editor Melinda Buntin discuss the policy implications of this work with Dr Dague and other recent articles touching on Medicaid enrollment. Related Content: Trends in Medicaid Enrollment and Disenrollment Early in the COVID-19 Pandemic in Wisconsin Medicaid Disenrollment After the COVID-19 Pandemic Medicaid Coverage Disruptions Among Children Enrolled in North Carolina Medicaid, 2016-2018 Association of Medicaid Expansion in Arkansas With Postpartum Coverage, Outpatient Care, and Racial Disparities

Overuse of health care, or providing services of low value or no value, is wasteful, potentially harmful to patients, and a contributor to high US health care costs. Jodi Segal, MD, of the Johns Hopkins University School of Medicine joins JAMA Health Forum Editor John Ayanian and Deputy Editor Melinda Buntin to discuss characteristics of health systems associated with overuse of health care services for Medicare beneficiaries and the implications for health systems, hospitals, and clinicians seeking to reduce such overuse. Related Content: Factors Associated With Overuse of Health Care Within US Health Systems