Good morning! In this issue, we take a closer look at the role primary care physicians can play in palliative and end-of-life care, and how they can help ensure it meets patients' needs.

Also, learn about the challenges hospitals in underserved communities face with the use of telehealth and health information exchanges.

An AI voice-based agent helped older adults with hypertension accurately report home blood pressure measurements, according to a study presented at the American Heart Association's Hypertension Scientific Sessions. The AI agent was associated with a 17% improvement in Medicare Advantage Stars ratings for blood pressure control. The study also found high patient engagement and satisfaction.

Women with type 2 diabetes who use oral hormone replacement therapy in menopause may face a higher risk of pulmonary embolism and heart disease, while those who use HRT skin patches do not, according to a study of more than 36,000 patients. The study, which has not been peer-reviewed, suggests that women with diabetes should avoid oral estrogen therapy, says researcher Matthew Anson.

Novo Nordisk has reported positive results from a late-stage trial of its obesity treatment cagrilintide. The once-weekly injection led to an average weight loss of 11.8% over 68 weeks, compared with 2.3% for a placebo.

Universal hepatitis B vaccination within 24 hours of birth is a safe and effective way to prevent chronic hepatitis B infection, cirrhosis and liver cancer, according to internal medicine physician Dr. Rita Kuwahara. "Universal HBV vaccine recommendations work, and the HBV vaccine has been instrumental in reducing rates of chronic HBV infection and liver cancer in our nation," Kuwahara writes.

Experts say improving housing conditions by eliminating mold and dampness could lead to substantial health and economic gains. The research suggests potential savings in health care costs and increased income, alongside improved respiratory and cardiovascular health.

Hospitals in socioeconomically disadvantaged areas are significantly behind in adopting health information technology such as telehealth and joining a health information exchange, according to a study in JAMA Health Forum. The study cites barriers like limited infrastructure and funding, though it notes that adoption has increased overall since 2018.

Health care groups have expressed concerns about the proposed 2026 Physician Fee Schedule, citing potential destabilization of health care practices and undermining of value-based care. The Medical Group Management Association and National Association of Accountable Care Organizations have voiced opposition to aspects such as payment rates and mandatory participation in the ambulatory specialty model.

The CMS Interoperability and Prior Authorization Final Rule, effective Jan. 1, 2026, will require payers to make prior authorization decisions within 72 hours for urgent requests and within seven days for standard requests and to provide detailed explanations for denials. Payers will also be required to report 2025 approval and denial rates by March 31 and to report average response times and post-appeal approval rates. Payers will be required to use application programming interfaces in the prior authorization process by 2027.