The New England Journal of Medicine: Search Results in Health Policy and Reform

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Real-Time Patient–Provider Video Telemedicine Integrated with Clinical Care

To the Editor: Telemedicine by means of video visits can increase patient access to care, but there is little evidence about broad integration of video visits into existing clinical care, particularly for primary care. In an integrated delivery system …

Physician as Double Agent — Conflicting Duties Arising from Employer-Sponsored Wellness Programs

U.S. employers are increasingly implementing “wellness programs” that tie the cost of employees’ health insurance to their willingness to undertake health-promoting behaviors. Some of these programs enlist employees’ physicians in monitoring their pati…

Dialysis-Facility Joint-Venture Ownership — Hidden Conflicts of Interest

Since 1972, when the U.S. government began covering the costs of dialysis for nearly all Americans with end-stage renal disease (ESRD), dialysis has become big business. In 2015, the Centers for Medicare and Medicaid Services (CMS) spent roughly $34 bi…

New Tools in the Ebola Arsenal

Human Ebola virus disease can be caused by four viruses: Sudan virus, Tai Forest virus, Bundibugyo virus, and Ebola virus (EBOV, species Zaire ebolavirus). The 2014 outbreak of EBOV in West Africa was the worst ever, with more than 28,000 cases and mor…

The FDA Amendments Act of 2007 — Assessing Its Effects a Decade Later

Prescription-drug policy in the United States has developed through a process of punctuated evolution, often driven by crises. Progressive-era concern about “patent medicines” that contained primarily alcohol or opium led to mandatory labeling under th…

Payment and Delivery-System Reform — The Next Phase

After nearly a decade of experimentation with value-based payment (VBP), U.S. health care payers, providers, and purchasers are confronting uneven adoption of new care guidelines, modest early results, and still-unacceptable gaps in spending and qualit…

Being PrEPared — Preexposure Prophylaxis and HIV Disparities

If current trends persist, one in six U.S. men who have sex with men will be infected with human immunodeficiency virus (HIV) in their lifetime, according to the Centers for Disease Control and Prevention (CDC). This prediction highlights the long road…

Effect of Aspirin on Disability-free Survival in the Healthy Elderly

Several large, randomized trials have shown the efficacy of aspirin for the secondary prevention of cardiovascular disease among persons with a history of coronary heart disease or stroke. The evidence supporting a benefit of aspirin therapy in the pri…

Effect of Aspirin on All-Cause Mortality in the Healthy Elderly

The Aspirin in Reducing Events in the Elderly (ASPREE) trial was a primary prevention trial that was established to investigate whether the daily use of 100 mg of enteric-coated aspirin would prolong the healthy life span of older adults. The trial, wh…

The Violence of Uncertainty — Undermining Immigrant and Refugee Health

Hawa rushed her husband Ahmed to the emergency department when she found him unconscious. For months, Ahmed had refused to go to the hospital because he knew Immigration and Customs Enforcement (ICE) officers were nearby. Ahmed is a U.S. citizen, but h…