About the Study: In this cohort study, participation in mandatory value-based payment programs was associated with increased hospital administrative costs. These findings suggest that policymakers should consider administrative burden when designing and evaluating payment reforms to ensure that anticipated improvements in cost, quality, and access are not offset by increased complexity.

JMIR Publications released three feature News and Perspectives articles on current issues and developments in digital health care.

As more Americans with HIV live into older age, Medicare spending on their care is projected to rise dramatically from $10.9 billion in 2026 to $27.3 billion in 2035, with HIV medications accounting for nearly two-thirds of total costs.

New findings challenge the assumption that drivers should keep a functioning gasoline vehicle until the end of its life before switching to an elective vehicle (EV). Despite the carbon footprint of manufacturing the electric car, the study shows, replacing even a brand-new gasoline vehicle with an EV results in lower lifetime greenhouse gas emissions. In the United States, personal vehicles are responsible for more carbon dioxide (CO₂) emissions than all other forms of transportation combined, including air, rail, water, and commercial trucking and busing. This dominance makes the transition away from gasoline-powered cars, SUVs, and trucks central to climate policy. Battery electric vehicles (EVs) generally produce far fewer lifetime greenhouse gas emissions than internal-combustion-engine (ICE) vehicles, and their climate advantages are expected to grow as electricity grids become cleaner. However, while the emission benefits of choosing an EV over an ICE vehicle during a new vehicle purchase are well established, just when to retire a working gasoline-powered vehicle and replace it with an EV remains an open question. Keeping the gasoline vehicle on the road avoids the additional manufacturing emissions of producing a new EV, but replacing it early could deliver substantial savings because EVs generate far fewer emissions during operation. To address this question, Elliott Campbell and Roland Geyer estimated the life-cycle CO₂ emissions associated with keeping an ICE vehicle in use versus scrapping it early and replacing it with an EV. They conducted life-cycle analyses across a broad range of retirement scenarios and vehicle classes, taking into account variation in powertrain, battery size and manufacturing, electricity sources, and retirement year. According to the findings, replacing a functioning internal-combustion vehicle with an EV can reduce carbon emissions across a broad range of conditions, even when the gasoline vehicle is relatively new. The authors argue that this result makes vehicle scrappage-and-replacement programs a potentially powerful climate policy.

Why do some companies pay higher rates than others, and what drives some to pay less in taxes? New research from the McCombs School of Business at The University of Texas at Austin sorts through 30 years of research on corporate tax avoidance to uncover the most significant factors. Hint: It’s not primarily manipulation or trickery.

“There’s all this noise about companies that don’t pay taxes or have very low tax rates, but if you dig in, a lot are driven by pretty benign factors,” says Andrew Belnap, assistant professor of accounting.