@ishaniganguli.bsky.social
Health services researcher, primary care doctor, and writer | Associate Professor @HarvardMed @BrighamDGIM via @MassGeneral @BostonGlobe | Associate Editor @JAMAInternalMed
Using MA claims/Star rating data for 872 PCPs in 7 states who took on full risk for their MA patients, we found women PCPs had better quality outcomes and their patients had fewer ED visits and hospitalizations. Women earned the same per patient under FFS and *MORE* under VBP.
May 27, 2025 at 11:11 PM
Using MA claims/Star rating data for 872 PCPs in 7 states who took on full risk for their MA patients, we found women PCPs had better quality outcomes and their patients had fewer ED visits and hospitalizations. Women earned the same per patient under FFS and *MORE* under VBP.
⭐️future-doc @nickdaley.bsky.social presenting our work on RTBT tools and telemedicine contributions to primary care access in Medicare. Posters 53-4, come on by #SGIM25
cc @jefflinder.bsky.social
cc @jefflinder.bsky.social
May 16, 2025 at 10:16 PM
⭐️future-doc @nickdaley.bsky.social presenting our work on RTBT tools and telemedicine contributions to primary care access in Medicare. Posters 53-4, come on by #SGIM25
cc @jefflinder.bsky.social
cc @jefflinder.bsky.social
Using 100% Medicare claims + “DiD” analyses, we compared patients attributed (pre-pandemic) to health systems that later adopted telemed a lot or a little. Patients in high-telemed systems saw either a relative drop or no change across 20 tests, plus ⬇️ spending on a few tests and on visits overall.
February 24, 2025 at 9:48 PM
Using 100% Medicare claims + “DiD” analyses, we compared patients attributed (pre-pandemic) to health systems that later adopted telemed a lot or a little. Patients in high-telemed systems saw either a relative drop or no change across 20 tests, plus ⬇️ spending on a few tests and on visits overall.
Also, ambulatory care days were rare on weekends (not surprising) but also were not evenly spread across weekdays. In fact, these days (especially specialist visit days) were much less likely to be on Fridays (!!).
January 24, 2024 at 6:06 PM
Also, ambulatory care days were rare on weekends (not surprising) but also were not evenly spread across weekdays. In fact, these days (especially specialist visit days) were much less likely to be on Fridays (!!).
These days varied not only by older adults' medical complexity, but also by factors like where they lived, their race, and their care-seeking habits. Most of the variation was not explained by these factors (my guess-health system and clinician practice variation play big roles).
January 24, 2024 at 6:05 PM
These days varied not only by older adults' medical complexity, but also by factors like where they lived, their race, and their care-seeking habits. Most of the variation was not explained by these factors (my guess-health system and clinician practice variation play big roles).
We used nationally-representative Medicare claims-linked survey data and found that contact day counts varied WIDELY by person and geography.
Most common were days for specialist visits (6 days/yr), treatments like chemo (6 days/yr), and tests (5 days/yr).
Most common were days for specialist visits (6 days/yr), treatments like chemo (6 days/yr), and tests (5 days/yr).
January 24, 2024 at 6:04 PM
We used nationally-representative Medicare claims-linked survey data and found that contact day counts varied WIDELY by person and geography.
Most common were days for specialist visits (6 days/yr), treatments like chemo (6 days/yr), and tests (5 days/yr).
Most common were days for specialist visits (6 days/yr), treatments like chemo (6 days/yr), and tests (5 days/yr).
What did we find? Most patients discussed ≥1 test with their PCP. But there were no stat sig differences in shared decision-making quality (SDMP), medical test knowledge, or other secondary outcomes. There were also no differences in testing rates between groups.
November 9, 2023 at 11:13 PM
What did we find? Most patients discussed ≥1 test with their PCP. But there were no stat sig differences in shared decision-making quality (SDMP), medical test knowledge, or other secondary outcomes. There were also no differences in testing rates between groups.
To evaluate the intervention, we matched-pair randomized 20 Brigham and Women's Hospital primary care physicians (PCPs) based on testing rates and gender, and enrolled 314 of their patients with scheduled annual visits.
November 9, 2023 at 11:13 PM
To evaluate the intervention, we matched-pair randomized 20 Brigham and Women's Hospital primary care physicians (PCPs) based on testing rates and gender, and enrolled 314 of their patients with scheduled annual visits.
New in JAMA Network Open: Our RCT of a peer comparison/education intervention to improve PCP-patient medical test conversations during annual visits jamanetwork.com/journals/jam...
November 9, 2023 at 11:11 PM
New in JAMA Network Open: Our RCT of a peer comparison/education intervention to improve PCP-patient medical test conversations during annual visits jamanetwork.com/journals/jam...
When we compared Black and white adults within given systems or accounted for system racial composition, results were similar. That is, these differences were due to differential care WITHIN systems rather than to Black and White adults getting care in different systems. (7)
October 31, 2023 at 1:16 AM
When we compared Black and white adults within given systems or accounted for system racial composition, results were similar. That is, these differences were due to differential care WITHIN systems rather than to Black and White adults getting care in different systems. (7)
In unadjusted and adjusted analyses, Black adults were generally at ⬆️ risk of low-value acute diagnostic tests like head scans for headache. White adults were generally at ⬆️ at risk of low-value screening & treatments like antibiotics for colds. (6)
October 31, 2023 at 1:15 AM
In unadjusted and adjusted analyses, Black adults were generally at ⬆️ risk of low-value acute diagnostic tests like head scans for headache. White adults were generally at ⬆️ at risk of low-value screening & treatments like antibiotics for colds. (6)
We found…
On average compared to white adults, Black adults were younger, more likely to be Medicaid-eligible, and more medically complex; they also had lower continuity of care.
Health systems varied widely in share of their Medicare patients who were Black (range 1-82%). (5)
On average compared to white adults, Black adults were younger, more likely to be Medicaid-eligible, and more medically complex; they also had lower continuity of care.
Health systems varied widely in share of their Medicare patients who were Black (range 1-82%). (5)
October 31, 2023 at 1:14 AM
We found…
On average compared to white adults, Black adults were younger, more likely to be Medicaid-eligible, and more medically complex; they also had lower continuity of care.
Health systems varied widely in share of their Medicare patients who were Black (range 1-82%). (5)
On average compared to white adults, Black adults were younger, more likely to be Medicaid-eligible, and more medically complex; they also had lower continuity of care.
Health systems varied widely in share of their Medicare patients who were Black (range 1-82%). (5)
Our new study, out last week @bmj_latest, tackles racial disparities in low-value care - services that offer patients little to no benefit yet can cause both direct and cascading harms and divert resources from needed care. (1)🧵👇
October 31, 2023 at 1:12 AM
Our new study, out last week @bmj_latest, tackles racial disparities in low-value care - services that offer patients little to no benefit yet can cause both direct and cascading harms and divert resources from needed care. (1)🧵👇