Literature Review

All posts tagged with “Research News.”



Research brief: Medicare Advantage Special Needs Plans linked to use of inferior hospice care

03/12/25 at 03:00 AM

Research brief: Medicare Advantage Special Needs Plans linked to use of inferior hospice carePenn LDI - Leonard Davis Institute of Health Economics; 3/11/25 Beneficiaries of Medicare Advantage special needs plans are significantly more likely to use lower-quality hospices than beneficiaries of other Medicare plans. These disparities may result from the geographic availability of high-quality hospices or the referrals that beneficiaries receive from their plans’ contracted hospitals and nursing homes. The results support incentivizing referrals to high-quality hospices and improving consumer information about hospice quality.

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Using virtual reality to improve outcomes related to quality of life among older adults with serious illnesses: Systematic review of randomized controlled trials

03/08/25 at 03:50 AM

Using virtual reality to improve outcomes related to quality of life among older adults with serious illnesses: Systematic review of randomized controlled trialsJournal of Medical Internet Research; Bhagvat Maheta, Alexandra Kraft, Nickolas Interrante, Soraya Fereydooni, Jeremy Bailenson, Brian Beams, Christina Keny, Thomas Osborne, Karleen Giannitrapani, Karl Lorenz; 2/25Virtual reality (VR) has promise as an innovative nonpharmacologic treatment for improving a patient's quality of life. VR can be used as an adjunct or treatment for many acute and chronic conditions, including serious illnesses. Nascent evidence suggests VR's potential in mitigating pain, anxiety, and depression and improving mobility among persons with serious illnesses.

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Tracking US health care spending by health condition and county

03/08/25 at 03:30 AM

Tracking US health care spending by health condition and countyJAMA; Joseph L. Dieleman, PhD; Meera Beauchamp, BS; Sawyer W. Crosby, BA; Drew DeJarnatt, MS; Emily K. Johnson, MSc; Haley Lescinsky, MPH; Theresa McHugh, PhD; Ian Pollock, MLS; Maitreyi Sahu, MPH; Vivianne Swart, MPH; Kayla V. Taylor, MPH; Azalea Thomson, MPH; Golsum Tsakalos, MS; Maxwell Weil, MS; Lauren B. Wilner, MPH; Anthony L. Bui, MD, MPH; Herbert C. Duber, MD, MPH; Annie Haakenstad, ScD, MA; Bulat Idrisov, MD, MSc; Ali Mokdad, PhD; Mohsen Naghavi, MD, MPH, PhD; Gregory Roth, MD, MPH; John W. Scott, MD, MPH; Tara Templin, PhD, MS; Christopher J. L. Murray, DPhil, MD; 2/25Health care spending in the US totaled $3.8 trillion in 2019 and is projected to reach more than $7 trillion by 2031. Within the US, spending varies dramatically across states, although many key drivers of health care spending, such as access to care, service prices, disease and injury prevalence, and underlying need for health care, vary at more local levels. Broad variation in health care spending was observed across US counties. Understanding this variation by health condition, sex, age, type of care, and payer is valuable for identifying outliers, highlighting inequalities, and assessing health care gaps.

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An opportunity to advance cannabis science—DEA rescheduling

03/08/25 at 03:20 AM

An opportunity to advance cannabis science—DEA reschedulingJAMA Psychiatry; Kevin P. Hill, MD, MHS; Anshul V. Puli, BS; 2/25In 1970, the US Congress enacted the Controlled Substances Act (CSA), establishing a scheduling system for drugs based on their medical use, abuse potential, and safety. The most restrictive classification is Schedule I; cannabis along with other drugs, such as heroin and lysergic acid diethylamide (LSD), have this classification. May 13, 2024, the Drug Enforcement Agency (DEA), the agency regulating substance scheduling, issued a Notice of Proposed Rulemaking to investigate rescheduling cannabis from Schedule I to Schedule III. This was due to a recommendation from the US Department of Health and Human Services (HHS) to reschedule based on its review of the medical and scientific cannabis research. Still, the FDA investigated HHS’ CAMU [cannabis’ current accepted medical use] claim and found some credible scientific support for treating “anorexia related to a medical condition, nausea and vomiting (eg, chemotherapy-induced), and pain.”

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Knowledge of and preferences for medical aid in dying

03/08/25 at 03:20 AM

Knowledge of and preferences for medical aid in dyingJAMA Network Open; Elissa Kozlov, PhD; Elizabeth A. Luth, PhD; Sam Nemeth, BA; Todd D. Becker, PhD, LMSW; Paul R. Duberstein, PhD; 2/25In the US, approximately 74 million people (22%) live in a jurisdiction that allows medical aid in dying (MAID), a legal practice that allows terminally ill patients to obtain a prescription for medication to end their life. In this online survey study of 3,227 US adults, 51.3% did not know if MAID was legal in the US, and 50.8% did not know if MAID was legal in their state. In the full sample, 44.0% expressed interest in using MAID if terminally ill. This study suggests that there is substantial interest across all demographic groups in using MAID, but significant knowledge gaps exist about its legality, which may be associated with observed racial and ethnic and educational differences in MAID’s use. These findings highlight the need for public education, policy initiatives, and patient-clinician discussions to ensure equitable access to patient-centered end-of-life options and informed decision-making. 

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Pulmonary embolism–related mortality in patients with cancer

03/08/25 at 03:10 AM

Pulmonary embolism–related mortality in patients with cancerJAMA Network Open; Marco Zuin, MD, MS; Anju Nohria, MD; Stanislav Henkin, MD, MPH; Darsiya Krishnathasan, MS; Alyssa Sato, BA; Gregory Piazza, MD, MS; 2/25This cohort study ... found that despite decreases in cancer-related mortality rates, temporal trends demonstrated an increase in age-adjusted PE [pulmonary embolism]-related mortality from 2011 to 2020 among patients with cancer, with a significantly higher rate of increase observed in younger patients aged 15 to 64 years, Black, Hispanic, and White individuals; and the Southern region of the US. Recognition of such patterns may inform further research into thromboprophylaxis and treatment of PE as a complication of cancer and cancer-directed therapy.

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Algorithm-based palliative care in patients with cancer-A cluster randomized clinical trial

03/08/25 at 03:05 AM

Algorithm-based palliative care in patients with cancer-A cluster randomized clinical trialJAMA Network Open; Ravi B. Parikh, MD, MPP; William J. Ferrell, MPH; Yang Li, MS; Jinbo Chen, PhD; Larry Bilbrey; Nicole Johnson, BSN; Jenna White, MSW; Ramy Sedhom, MD; Natalie R. Dickson, MD; Stephen Schleicher, MD; Justin E. Bekelman, MD; Sandhya Mudumbi, MD; 2/25In this randomized clinical trial conducted in a community oncology network between November 2022 and December 2023 among 562 patients with advanced cancer identified by an automated electronic health record algorithm, default orders increased palliative care consultation (44% vs 8%) and decreased end-of-life systemic therapy (6% vs 16%) compared with usual care but did not improve patient-reported or hospice outcomes. The findings suggest that default algorithm-based palliative care orders are a scalable implementation strategy to increase palliative care referrals and reduce intensive end-of-life care. 

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Increasing awareness and access to integrated behavioral health and palliative care: An introduction to the American Journal of Hospice and Palliative Medicine's

03/08/25 at 03:00 AM

Increasing awareness and access to integrated behavioral health and palliative care: An introduction to the American Journal of Hospice and Palliative Medicine'sAmerican Journal of Hospice and Palliative Care; James Gerhart, Michael Hoerger, Stacie Levine, Sean O'Mahony; 2/25Mental health symptoms are common in the general population and are overrepresented in patients receiving palliative care and hospice services. This introduction to the special issue on Mental Health in Palliative Care and Hospice highlights the ongoing need for research and training to prepare our palliative care workforce to address the concerns of patients experiencing serious illness and mental health concerns. Multilevel approaches are needed to enhance understanding of mental health needs among people with serious illness. Public health outreach is needed within our communities, targeted support is needed for family caregivers, and structured training for palliative care and hospice clinicians is needed to enhance competent mental health in these settings.

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When is the best time to deliver supportive interventions to hospice family caregivers? A Multi-Method Study

03/08/25 at 03:00 AM

When is the best time to deliver supportive interventions to hospice family caregivers? A Multi-Method StudyGerontologist; by Oonjee Oh, Debra Parker Oliver, Karla Washington, George Demiris; 2/25While problem-solving interventions can teach caregivers effective coping skills throughout hospice, the optimal timing for introducing such resources remains unclear. We explored how the timing of a problem-solving intervention impacts its effectiveness for hospice caregivers. We conducted a multi-method study analyzing quantitative and qualitative data from a randomized clinical trial of a Problem-solving Intervention to Support Caregivers in End-of-life care Settings (PISCES)... Caregivers' anxiety showed significant pre-post differences regardless of the intervention timing, modality, and components... Three themes emerged from the qualitative analysis: timing for PISCES to be most effective, emotions during various stages of hospice, and the length of PISCES. Strategically integrating PISCES into hospice practice can help alleviate caregivers' distress.

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Mitigating moral injury for palliative care clinicians

03/08/25 at 03:00 AM

Mitigating moral injury for palliative care cliniciansPalliative Medicine Reports; by Anne G. Pereira, Mark Linzer, Leonard L. Berry; 2/23Palliative care clinicians (PCCs) in the United States face the combination of increasing burnout and a growing need for their services based on demographic changes and an increasing burden of serious illness... We propose three solutions to address moral distress and moral injury in PCCs to reduce burnout. These solutions are grounded in the dilemmas particular to palliative care and in best evidence: first, to create space for PCCs to confront moral challenges head-on; second, to integrate ethics consultations into care of some patients cared for by PCCs; and third, to reassess care models for PCCs. These approaches can mitigate burnout and thus address the growing gap in our ability to provide high-quality palliative care for those patients in need.

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Explaining racial and ethnic disparities in advance care planning: A decomposition analysis

03/08/25 at 03:00 AM

Explaining racial and ethnic disparities in advance care planning: A decomposition analysisJournal of Pain and Symptom Management; Yifan Lou, Emma Zang, Qianqian Li; 2/25The ACP [advance care planning] disparities between White and Hispanic populations were nearly twice as large as the disparity between White and Black populations. Interventions targeting less educated older Black and Hispanic individuals should be prioritized to narrow the ACP disparity. Negative healthcare experiences in previous care and household dynamics should be addressed while working with Black and Hispanic older adults, respectively.

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WVU nursing faculty aim to enhance rural home care for chronically ill through NIH award

03/03/25 at 02:00 AM

WVU nursing faculty aim to enhance rural home care for chronically ill through NIH award WVU Today - West Virginia University, Morgantown, WC; Press Release; 2/26/25 Three West Virginia University nursing faculty know firsthand the difficulties faced by family caregivers and their chronically ill loved ones. With a $2.7 million award from the National Institutes of Health’s National Institute of Nursing Research that is one of the largest ever for the WVU School of Nursing, the faculty researchers aim to support these families while increasing access to care in the rural reaches of the Mountain State by testing an integrated, nurse-led intervention for family home care management of end-stage heart failure and palliative care. ... Through their lived experiences, as well as their previous studies using nursing science to develop and test nurse-led interventions, the three said they hope to improve family caregivers’ and their loved ones’ overall health and well-being, including reducing depression and anxiety, and monitoring and managing end-of-life symptoms.

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Shareholder payouts among large publicly traded health care companies

03/01/25 at 03:45 AM

Shareholder payouts among large publicly traded health care companiesJAMA Internal Medicine; Victor Roy, MD, PhD; Victor Amana, MPH; Joseph S. Ross, MD, MHS; Cary P. Gross, MD; 2/25There is growing concern that a large proportion of US health care spending appears to be directed to corporate shareholders rather than enhancing affordable access, improving quality of care, or advancing research and development. Total shareholder payouts from S&P 500 health care companies have more than tripled in the past 20 years. Payouts were concentrated among a small number of companies, with the pharmaceutical, biotechnology, managed care, and health care equipment and supplies subindustries distributing the largest amounts. Given greater health care affordability challenges for US households and the major role of federal and state governments in financing the health care sector, shareholder payouts have critical implications for stakeholders, especially patients. Increasing capital distributions to shareholders of publicly traded companies may be associated with higher prices and may not be reinvested in improving access, delivery, or research and development.

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New FDA policies could limit the full value of AI in medicine

03/01/25 at 03:40 AM

New FDA policies could limit the full value of AI in medicineJAMA Health Forum; Scott Gottlieb, MD; 2/25Some experts within the [AI] field predict that in the next several years, developers may realize artificial general intelligence (AGI)—a revolutionary form of AI capable of understanding, learning, and applying knowledge across various tasks with human-like proficiency. Unlike today’s narrow AI systems that excel at tasks such as image recognition or language translation, AGI can tackle any intellectual challenge a human can, demonstrating a deep comprehension of diverse disciplines. Artificial intelligence tools with advanced analytical capabilities used in clinical practice, especially tools that synthesize complex clinical information from distinct sources, may automatically be classified as medical devices ... [by the US Food and Drug Administration]. This could deny health care clinicians access to AI tools that have the potential to transform the productivity and safety of medical care. 

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Patients’ trust in health systems to use artificial intelligence

03/01/25 at 03:35 AM

Patients’ trust in health systems to use artificial intelligenceJAMA Network Open; Paige Nong, PhD; Jodyn Platt, PhD; 2/25This analysis found low trust in health care systems to use AI responsibly and protect patients from AI-related harms. General trust in the health care system, but not health literacy or AI knowledge, was associated with these perceptions. Low trust in health care systems to use AI indicates a need for improved communication and investments in organizational trustworthiness.

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Challenges to video visits for patients with non–English language preference-A qualitative study

03/01/25 at 03:30 AM

Challenges to video visits for patients with non–English language preference-A qualitative studyJAMA Network Open; Marianna Kong, MD; Francine Rios-Fetchko, BA; Madelyn Olmos-Rodriguez, BA; Linda Branagan, PhD; Bradley Iott, MPH, MS, PhD; Therese Chan Tack, DO, MPH; Carol Yarbrough, MBA; Kevin Grumbach, MD; Alicia Fernandez, MD; 2/25Telemedicine, or synchronous video or audio-only visits, has made clinical encounters more convenient and accessible for many patients. Prior to the COVID-19 pandemic, video and telephone visits comprised a small minority of primary care visits, but by April 2020, approximately one-half of US physicians were treating patients virtually and nonurgent telemedicine video visits increased by more than 600%. In this qualitative study, participants with NELP [non-English language preference] perceived multiple barriers to video visits, including greater communication difficulties, lower medical evaluation quality, and technical issues. These findings suggest that addressable technical challenges associated with language barriers hamper access to video visits and decrease motivation for use and that interventions are needed to increase telehealth equity. 

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Associations between end-stage ALS care and specialty palliative care: A hypothesis-generating study

03/01/25 at 03:25 AM

Associations between end-stage ALS care and specialty palliative care: A hypothesis-generating studyMuscle and Nerve; Christi M Lero, Annabelle Yang, Elyse Everett, Kyle A Pitzer, Kelly McCoy Gross, Karla T Washington; 2/25Amyotrophic lateral sclerosis (ALS) care is typically delivered via a multidisciplinary approach that may include specialty palliative care (SPC). Patients who received SPC (59%), had lower mean forced vital capacity ... , and more often used respiratory support ... , participated in goals of care conversations ... , reported a healthcare proxy ... , and enrolled in hospice ... than patients who received standard care alone. No differences between groups were found in duration of illness (mean = 51.7 months), use of assistive feeding, Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) scores, ... documentation of a healthcare proxy, length of hospice stay (mean = 47.3 days), or location of death.

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Influence of culture and spiritual tradition on support for families of children dying in intensive care units

03/01/25 at 03:20 AM

Influence of culture and spiritual tradition on support for families of children dying in intensive care unitsJournal of Pediatric Nursing; Sung-Jin Jeanie Ju, Janie Ito, Aubree Lin, Dagmar Grefe, Jennifer Baird, Rebecca Ortiz La Banca Barber; 2/25Parents utilize spirituality as a means of coping during and after a child's death. Complexity of grief associated with loss of a child suggests the paramount importance of providing appropriate support for parents while experiencing their child's critical illness or end of life. Findings indicated three themes that illustrate the end-of-life and bereavement process: 1) Coping during hospitalization and the end-of-life stage; 2) coping during the bereavement stage; and 3) advice for parents and staff. To integrate the results into practice, hospital-wide education for staff on the importance of cultural and spiritual sensitivity is recommended. Additionally, collaboration with spiritual care teams, especially for patients and families facing complex diagnoses or advance care planning, will enhance the provision of culturally and spiritually sensitive care.

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Development of an interprofessional clinician training in pediatric serious illness communication

03/01/25 at 03:15 AM

Development of an interprofessional clinician training in pediatric serious illness communicationJournal of Palliative Medicine; Danielle D DeCourcey, Rachelle Bernacki, John Carozza, Sithya Lach, Andrea Wershof Schwartz; 2/25Early advance care planning (ACP) is associated with improved outcomes in pediatrics, yet few rigorously developed curricula exist to train interprofessional clinicians in ACP communication. We developed an interactive, skills-based three-hour synchronous online clinician training program using Kern's Six-Step Curriculum Design, incorporating didactic and simulated patient encounters with a trained actor. Following training, 97% of participants were highly satisfied with training quality, and 100% endorsed that they would recommend it to colleagues. Additionally, clinician self-reported comfort discussing fundamental elements of ACP significantly increased following the training.

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“You sure feel like you’re alone, kind of flailing away out there”: Family caregiver perspectives of caring for an individual with glioblastoma multiforme

03/01/25 at 03:10 AM

“You sure feel like you’re alone, kind of flailing away out there”: Family caregiver perspectives of caring for an individual with glioblastoma multiformeCambridge University Press; by Christy Muasher-Kerwin, Abby Baumbach, Yujun Liu, M. Courtney Hughes; 2/25Glioblastoma multiforme (GBM) is the most common and aggressive form of brain cancer... Nineteen current and former family caregivers for individuals with GBM participated in semi-structured interviews from October 2023 through January 2024... Three themes emerged from the interview analysis: (1) overwhelming caregiver burden, (2) difficulties coping with the caregiver role, and (3) gaps in caregiver support... Family caregivers for individuals with GBM desire more straightforward and proactive information and education about their care recipients from their medical providers. There is an opportunity for more utilization of hospice, palliative, and rehabilitation services to provide necessary training to GBM patients and their caregivers.

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Informal caregivers connecting on the Web: Content analysis of posts on discussion forums

03/01/25 at 03:05 AM

Informal caregivers connecting on the Web: Content analysis of posts on discussion forumsJMIR Formative Research; by Michelle L Foster, Chinenye Egwuonwu, Erin Vernon, Mohammad Alarifi, M Courtney HughesAbout 53 million adults in the United States offer informal care to family and friends with disease or disability. Such care has an estimated economic value of US $600 million. Most informal caregivers are not paid nor trained in caregiving, with many experiencing higher-than-average levels of stress and depression and lower levels of physical health. Some informal caregivers participate in web-based forums related to their caregiving role. This study aimed to explore how informal caregivers use easy-to-access caregiving web-based forums, including the types of information they share and seek from others... Domains identified included handling interpersonal challenges, navigating complicated systems, gathering tactical coping strategies, managing emotions, and connecting with others in similar situations... Informal caregivers play an essential role in society. Many experience multifaceted challenges related to their caregiving role, and some turn to the internet for community. Accessing web-based discussion forums is a low-barrier method for informal caregivers to connect with others who may be experiencing similar emotions and challenges. Gaining a greater understanding of the ways informal caregivers seek advice and offer support to one another provides insight into the challenges they face.

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Contemporary patterns of end-of-life care among Medicare beneficiaries with advanced cancer

03/01/25 at 03:00 AM

Contemporary patterns of end-of-life care among Medicare beneficiaries with advanced cancer JAMA Network - JAMA Health Forum; by Youngmin Kwon, PhD; Xin Hu, PhD, MPSH; Kewei Sylvia Shi, MPH; Jingxuan Zhao, MPH, PhD; Changchuan Jiang, MD, MPH; Qinjin Fan, MS, PhD; Xuesong Han, PhD; Zhiyuan Zheng, PhD; Joan L. Warren, PhD; K. Robin Yabroff, PhD, MBA; 2/21/25Conclusions: In a contemporary cohort of older Medicare decedents originally diagnosed with advanced breast, prostate, pancreatic, or lung cancer, we found that many patients continue to receive potentially aggressive interventions at EOL at the expense of supportive care services. To make meaningful improvements in the quality of EOL care, a multifaceted approach that addresses patient, physician, and system-level factors associated with persistent patterns of potentially aggressive care will be required. Editor's note: Though published just one week ago--February 21--this journal article is already being used extensively, as demonstrated in our posts on 2/24 and 2/25.

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Proposed framework for setting practical and ethical boundaries in medicine

02/22/25 at 03:40 AM

Proposed framework for setting practical and ethical boundaries in medicineJAMA Internal Medicine; Sarah C. Hull, MD, MBE; Nancy R. Angoff, MD, MPH, MEd; 2/25At a national conference session addressing challenges for women in cardiology, one of us (S.C.H.) was struck by a junior attending physician’s account of her struggle to establish boundaries, expressing her desire to be helpful and collaborative as well as her reticence to decline requests lest she appear unkind. Reflecting on my own experience, I realized that women are often socialized to avoid saying no for fear of disappointing others or appearing selfish, but this socialization has not served us well. Indeed, this is a common refrain we have heard from young women entering the medical profession. Our anecdotal experience matches data suggesting that, compared with men, women are more likely to be asked and less likely to decline low-promotability task requests.

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Pursuing equity with artificial intelligence in health care

02/22/25 at 03:35 AM

Pursuing equity with artificial intelligence in health careJAMA Health Forum; Kevin B. Johnson, MD, MS; Ivor B. Horn, MD, MPH; Eric Horvitz, MD, PhD; 1/25The National Academy of Medicine defines equitable AI as “applications accompanied by proof of appropriate steps to ensure fair and unbiased development and access to AI-associated benefits and risk mitigation measures.” Health care–providing organizations deploying AI must take responsibility for monitoring and achieving equitable performance. There is much to learn as we face the challenge of understanding how AI applications affect long-standing inequities and discovering the best ways to harness AI to address them. By embedding equity considerations at every stage of AI development and deployment, the US can start to take meaningful steps toward using AI’s growing capabilities to tackle pressing problems in health care. 

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Health policy challenges for 2025 and beyond

02/22/25 at 03:35 AM

Health policy challenges for 2025 and beyondJAMA Health Forum; Lanhee J. Chen, JD, PhD; 1/25Despite multiple reform attempts, the US health care system is still burdened by high costs, limited access to quality care, and policies that have resulted in the inefficient delivery of care. However, technological advances, insights from the COVID-19 pandemic, and approaching policy deadlines, such as expiration at the end of 2025 of enhanced coverage subsidies available through the Affordable Care Act (ACA), offer policymakers a reason to act. The next few years will present policymakers with opportunities to address key health care challenges, including the future of Medicare, the continuing implementation of the ACA, and the health care provisions included in the federal tax code. The new administration and Congress will have their hands full in 2025 because the expiring tax and subsidy provisions are action-forcing events. Lawmakers will face a unique opportunity to reform the system in a way that improves accessibility and affordability and enforces some measure of fiscal discipline, and to make decisions that could positively affect the future of health care for millions of individuals in the US.

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