Sign in

ishaniganguli.bsky.social

@ishaniganguli.bsky.social
289 followers 158 following 55 posts

Health services researcher, primary care doctor, and writer | Associate Professor @HarvardMed @BrighamDGIM via @MassGeneral @BostonGlobe | Associate Editor @JAMAInternalMed

PostsRepliesMedia
Reposted by @ishaniganguli.bsky.social
Jeff Linder @jefflinder.bsky.social · 24/09/2026
This NEJM "Clinical Decisions" is about whether you should do a physical exam in an otherwise healthy person. How about the TOTALLY UNNECESSARY testing that's being done here. "Pursue a laboratory workup"?! For what!? ht: @ishaniganguli.bsky.social www.nejm.org/doi/10.1056/...
152
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 24/02/2026
Big thanks to @arnoldventures.bsky.social and an all-star team (Nick Daley, Andrew Hicks, Michael McWilliams, Meredith Rosenthal)
000
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 24/02/2026
New study @jama.com on Medicare's G2211 billing code. TLDR: The code was meant to support the longitudinal care typically provided by primary care physicians and in many cases by specialists. Actual use in the first year (2024) was a bit more complicated... jamanetwork.com/journals/jam...
jamanetwork.com
Billing of Medicare’s G2211 Longitudinal Care Code Among Traditional Medicare Beneficiaries
This study examines patterns of Medicare’s G2211 billing code to understand its uptake and how often these payments went to primary care.
250
Reposted by @ishaniganguli.bsky.social
Kate Majzoub Morgan @katemmorgan.bsky.social · 20/01/2026
📖 Our new study in @jamainternalmed.com examines the primary care workforce serving fee-for-service Medicare beneficiaries using a pragmatic, patient-centered measure: clinicians available for new patient visits per beneficiary. 👉Article: jamanetwork.com/journals/jam... (1/5)
jamanetwork.com
Primary Care Clinicians Available for New Patient Visits
This cross-sectional study examines changes in the numbers of primary care physicians and primary care advanced practice practitioners available for new patient primary care visits.
294
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 10/12/2025
Thank you @dusetzinas.bsky.social for making this project possible! Always a joy to work with you.
010
Reposted by @ishaniganguli.bsky.social
Stacie Dusetzina @dusetzinas.bsky.social · 09/12/2025
How you spend your days matters. Knowing the time impact from the treatments pursued (or not) can help patients and their families to be prepared for making informed decisions about cancer care. What an honor to be part of this work.
172
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 10/12/2025
🧡
010
Reposted by @ishaniganguli.bsky.social
Seth Trueger @mdaware.org · 09/12/2025
I didn’t really get how much “health care contact days” is a meaningful patient outcome until I got sick thank you @ishaniganguli.bsky.social @dusetzinas.bsky.social @jamanetworkopen.com
74611
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 09/12/2025
Here's the thoughtful editorial accompanying the study jamanetwork.com/journals/jam...
jamanetwork.com
Time Toxicity of Cancer Care—A Call to Action
Oncologists have a fundamental responsibility to educate patients and families on the risks, benefits, and logistics of cancer treatment. This responsibility becomes particularly important for patient...
001
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 09/12/2025
These contact days have increased from 2008 to 2019 across the board, especially for breast cancer despite no improvements in survival. We hope these results can help patients and their care teams make difficult decisions about treatment trade-offs.
121
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 09/12/2025
In the year after their diagnoses, older adults in traditional Medicare with metastatic breast, colorectal, lung, and prostate cancers who survived the whole year spent 40 to 63 days getting care, mainly in the ambulatory setting.
141
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 09/12/2025
For older adults with metastatic cancer, each day spent on health care can take away from days that are often devastatingly limited. Our latest study led by Arjun Gupta and Shelley Jazowski with @dusetzinas.bsky.social and Avi Gupta is out now in @jamanetworkopen.com jamanetwork.com/journals/jam...
jamanetwork.com
Health Care Contact Days in Older Adults With Metastatic Cancer
This cohort study examines patterns and changes in health care contact days over time among traditional Medicare beneficiaries diagnosed with metastatic breast, colorectal, lung, and prostate cancers.
1135
Reposted by @ishaniganguli.bsky.social
Aaron Schwartz @aschwartz.bsky.social · 10/11/2025
🚨New Publication🚨 Risk-based provider payment is more common in Medicare Advantage than any other segment of US health care financing. What happens to broad categories of health care utilization, and low-value service use, when provider groups adopt these contracts? jamanetwork.com/journals/jam...
jamanetwork.com
Health Care Utilization and Low-Value Service Use After Risk-Based Contract Adoption
This cohort study examined whether health care organizations’ transition to risk-based payment contracts in Medicare Advantage was associated with changes in health care utilization or use of low-valu...
173
Reposted by @ishaniganguli.bsky.social
Audrey D. Zhang @audreydzhang.bsky.social · 27/06/2025
🚨 New paper: As a PCP, I often hear from patients that managing their health care feels like a full-time job. To understand this better, we analyzed the first nationally-representative US survey of older adults’ self-reported treatment burden: agsjournals.onlinelibrary.wiley.com/doi/10.1111/...
agsjournals.onlinelibrary.wiley.com
Treatment Burden Among Older Adults in the United States, 2022
Background Treatment burden refers to the patient-perceived effort of managing health and health care, which impacts quality of life and engagement in care. International studies of treatment burden...
35320
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 28/05/2025
cc @nickdaley.bsky.social @hneprash.bsky.social @laurenshughes.bsky.social @ddiamond.bsky.social @mdaware.org @drneelshah.bsky.social @wrightcensored.bsky.social @arghavansallesmd.medsky.social @michaelannica.bsky.social @dangoren.bsky.social @meddly.bsky.social @dusetzinas.bsky.social
010
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 28/05/2025
What does this tell us? Even with its flaws, VBP may align better with traditionally gendered practice patterns - like more face-to-face and asynchronous time with patients - that are also likely good for patients and that all PCPs regardless of gender want to provide.
240
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 28/05/2025
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.
141
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 28/05/2025
Women physicians face a persistent gender wage gap, which we've found is due in part to volume-based (FFS, or $/visit) payment models. In a new #JAMAHealthForum study, we find that under Medicare Advantage value-based payment (VBP), the gap reverses (!). jamanetwork.com/journals/jam... @jama.com
jamanetwork.com
Gender Differences in Physician Earnings and Outcomes Under Medicare Advantage Value-Based Payment
This cohort study assesses gender differences in reimbursed earnings and quality among primary care physicians participating in full risk-sharing arrangements with Medicare Advantage plans, which now ...
1277
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 16/05/2025
⭐️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
052
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 16/05/2025
Inspiring plenary talk on tackling food insecurity by Seth Berkowitz at #SGIM25. I had the chance to chat with Seth about his study, listen here 👇🏽
041
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 16/05/2025
Dr. Stone has had incredible impact in her career. Proud to be one of many lucky enough to be mentored by her. #SGIM25
071
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 14/05/2025
cc @evemd1.bsky.social @carygross.bsky.social @ilanarichman.bsky.social @timandersonmd.bsky.social
000
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 14/05/2025
On my way to #SGIM25 @societygim.bsky.social and excited to share my chat with @lisarotenstein.bsky.social @sethberkowitz.bsky.social and @lizdzeng.bsky.social about studies they're about to present #SGIM25. Check out the @jamainternalmed.com episode below.
144
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 17/03/2025
👇🏽New study led by @nickdaley.bsky.social finds that for most older adults, every extra day getting health care costs them an extra $49 out-of-pocket. And above certain thresholds, these extra days offer diminishing marginal returns on care satisfaction. @jama.com
073
Reposted by @ishaniganguli.bsky.social
Nick Daley @nickdaley.bsky.social · 07/03/2025
Docs & patients know the pain of chasing borderline/incidental findings w/ a string of visits, tests and treatments. Yet after that initial test, these cascades can feel unavoidable. In a new @journalgim.bsky.social, @ishaniganguli.bsky.social and I explore reasons why & potential solutions:
link.springer.com
Safe, Then Sorry? — The Psychological Biases that Drive Care Cascades - Journal of General Internal Medicine
Journal of General Internal Medicine -
222
Reposted by @ishaniganguli.bsky.social
Stand Up for Science! @standupforscience.net · 06/03/2025
"In an unprecedented move, the US National Institutes of Health (NIH) has begun mass terminations of research grants that fund active scientific projects because they no longer meet 'agency priorities'" www.nature.com/articles/d41...
nature.com
Exclusive: NIH to terminate hundreds of active research grants
Studies that touch on LGBT+ health, gender identity and DEI in the biomedical workforce could be terminated, according to documents obtained by Nature.
23441237
Reposted by @ishaniganguli.bsky.social
Tradeoffs @tradeoffs.org · 05/03/2025
Yesterday, President Trump addressed members of Congress in the joint session, but he had little to say about health care. Here's what our team is reading to make sense of what's happening in health policy...
122
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 28/02/2025
So good to co-chair this report w/ @asaf-bitton.bsky.social and to work on it w/ esteemed Standing Committee for Primary Care colleagues incl @kgrumbach.bsky.social @laurenshughes.bsky.social @drkamleigh.bsky.social cc @commonwealthfund.org @arnoldventures.bsky.social @milbankfund.bsky.social
120
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 28/02/2025
Glad to share our new @health.nationalacademies.org report on Medicare primary care valuation. We outline systemic challenges with the current approach that have cascading effects on the private sector and on patient outcomes, and we recommend a path forward. bit.ly/4bozVUz #primarycare
bit.ly
Improving Primary Care Valuation Processes to Inform the Physician Fee Schedule
Read online, download a free PDF, or order a copy in print.
110
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 25/02/2025
Thanks Aaron!
010
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 24/02/2025
These results should help to reassure policymakers concerned about telemedicine worsening care quality and spending. Huge thanks to funders @commonwealthfund.org @arnoldventures.bsky.social cc our fantastic team incl @davidmcutler.bsky.social @andrewlhicks.bsky.social @jama.com
000
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 24/02/2025
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.
100
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 24/02/2025
Congress must decide if it will extend Medicare telehealth coverage beyond March 2025. Our new JAMA IM study shows how this may benefit Medicare patients + taxpayers. TLDR: Telemedicine ⬇️ some low-value test use + spending (eg,onsite EKGs,blood tests) + ⬇️ total visit spending. shorturl.at/w6l5l
shorturl.at
Telemedicine Adoption and Low-Value Care Use and Spending Among Fee-for-Service Medicare Beneficiaries
This cohort study aims to quantify the association between telemedicine adoption and low-value testing among fee-for-service Medicare beneficiaries.
1188
Reposted by @ishaniganguli.bsky.social
Annie Waldman @anniewaldman.bsky.social · 24/02/2025
People who work or have worked at HHS, NIH, FDA, CMS, CDC, HRSA and other health agencies - we want to hear from you. Researchers who rely on federal funding from any of these entities, we also want to hear from you. Reach out to us: www.propublica.org/tips/ Or find me on Signal: 347-549-0332 🔎
propublica.org
How to Contact ProPublica Securely — ProPublica
ProPublica is an independent, non-profit newsroom that produces investigative journalism in the public interest.
14744454
Reposted by @ishaniganguli.bsky.social
Prof Gavin Yamey MD MPH @gavinyamey.bsky.social · 14/02/2025
With RFK Jr saying he wants to stop NIH doing infectious disease research “for 8 years” and Trump now slashing the NIH and CDC workforce, what exactly is the plan for tackling the H5N1 bird flu outbreak?
156830
Reposted by @ishaniganguli.bsky.social
BK. Titanji @boghuma.bsky.social · 14/02/2025
It's incredibly disheartening to hear about dedicated public health professionals getting mass-laid off from CDC. Including first year epidemic intelligence service officers. This program has been the backbone of outbreak investigations in US since 1951. Decimating this workforce makes us less safe.
420282
Reposted by @ishaniganguli.bsky.social
Margot Sanger-Katz @sangerkatz.bsky.social · 14/02/2025
A new Trump formula for NIH grants could have very broad effects. We dug into the numbers to show what it means for every university and hospital. www.nytimes.com/interactive/... @aatishb.bsky.social @emmbadger.bsky.social @ethansinger.bsky.social @irineoc.bsky.social @fparis.bsky.social
nytimes.com
How Trump’s Medical Research Cuts Would Hit Colleges and Hospitals in Every State
Changes to a key funding formula will reduce research grants at hospitals and universities by billions — and may discourage future research.
58649
Reposted by @ishaniganguli.bsky.social
Carl T. Bergstrom @carlbergstrom.com · 08/02/2025
1. Today the NIH director issued a new directive slashing overhead rates to 15%. I want to provide some context on what that means and why it matters. grants.nih.gov/grants/guide...
grants.nih.gov
NOT-OD-25-068: Supplemental Guidance to the 2024 NIH Grants Policy Statement: Indirect Cost Rates
NIH Funding Opportunities and Notices in the NIH Guide for Grants and Contracts: Supplemental Guidance to the 2024 NIH Grants Policy Statement: Indirect Cost Rates NOT-OD-25-068. OD
25469974076
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 25/11/2024
A wonderful, thought-provoking piece by Paula Span @thenewyorktimes.bsky.social featuring our work. Thank you for sharing @adambeckman.bsky.social!
030
Reposted by @ishaniganguli.bsky.social
Dan Gorenstein @dgorenstein.bsky.social · 14/11/2024
Hey #healthpolicy crew! Looking into RFK Jr.’s beliefs on chronic conditions. Hoping to interview a few chronic condition experts on best evidence to treat cc. All suggestions welcome. RT’s (or what they’re called here appreciated)
74113
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 14/11/2024
Tomorrow! Join @NASEM Health and Medicine Division’s Nov 14 public meeting to explore federal efforts to strengthen the primary care workforce and review recent consensus study reports on primary care payments. To register: secure-web.cisco.com/1gJCDDL9TQkk...
secure-web.cisco.com
Standing Committee on Primary Care - November Open Meeting
Register for this event from the National Academies of Sciences, Engineering, and Medicine.
021
Reposted by @ishaniganguli.bsky.social
Atheendar Venkataramani @atheendar.bsky.social · 11/11/2024
1/ I've been practicing #medicine, as a #primarycare doc and then a #hospitalist, for over a decade. Cross-cutting any #social or #partisan divides is an increasingly common feeling: people are feeling #stuck and #trapped. I think we are seeing the reverberations of that feeling everywhere.
1308
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 24/01/2024
With this in mind, we hope that these results can start conversations about how to optimize contact days for patients in exam rooms, board rooms, and govt offices.
000
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 24/01/2024
Knowing that contact days are not created equal, and that better understanding patient preferences is key, it's clear that we can do more to honor patient/family time/burden when delivering care. E.g. by avoiding unnecessary care, coordinating services, and shifting care to home settings.
100
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 24/01/2024
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 (!!).
100
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 24/01/2024
We found fascinating patterns that pointed to targets for improvement. For instance, only ~50% of test days and imaging days were on same days on visits, might some have these been grouped to ease patient burdens?
110
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 24/01/2024
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).
100
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 24/01/2024
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).
100
ishaniganguli.bsky.social @ishaniganguli.bsky.social · 24/01/2024
Prior, @LauraBurke & others had measured days away from hospitals/SNFs and found (luckily) hospital/SNF days are uncommon for most people. So we developed a claims-based measure, health care contact days (first proposed by @ermeara @bynumjulie), to capture the full spectrum of care outside the home.
100