The New York Times: Dropout By Dartmouth Raises Questions On Health Law Cost-Savings Effort
In its quest to remake the nation’s health care system, the Obama administration has urged doctors and hospitals to band together to improve care and cut costs, using a model devised by researchers at Dartmouth College. But Dartmouth itself, facing mounting financial losses in the federal program, has dropped out, raising questions about the future of the new entities known as accountable care organizations, created under the Affordable Care Act. (Pear, 9/10)

New Hampshire Public Radio: Dartmouth-Hitchcock To Lay Off Hundreds Of Employees 
Dartmouth-Hitchcock plans to lay off hundreds of employees after a poor financial performance last fiscal year. In an email sent to Dartmouth-Hitchcock employees, CEO James Weinstein said the company needs to shave $100 million ... in annual expenses to achieve financial stability. The company finished last fiscal year with a $12 million ... deficit. (Moon, 9/9)

New Hampshire Times Union: Tear Up Hospital Contract, Pols Urge 
Republican candidates for governor are calling for inquiries into how the new contract between the New Hampshire Hospital with Dartmouth-Hitchcock was handled — with some pushing for the outright cancellation of the deal. Up to 460 layoffs were announced Friday, just two days after Dartmouth-Hitchcock was awarded a controversial, $37 million state contract by members of the Executive Council. (Feely, 9/11)

In other health law news —

The Associated Press: NY Regulators Announce Measure To Protect Some Insurers
New York's Department of Financial Services has issued an emergency regulation intended to help the state's health insurers deal with a federal requirement that puts some under sharp financial stress. The federally mandated program for adjusting financial risk under the Affordable Care Act transfers pooled funds to plans showing higher-risk clients. (9/11)

Modern Healthcare: Employers Hate The Cadillac Tax. Why? 
Steve Banke employs 40 people at 3-Points, a small IT outsourcing company he founded almost 15 years ago. And he wants those workers and their families to have strong health insurance options. Employees at the firm, based in Oak Brook, Ill., can choose between two types of Blue Cross and Blue Shield of Illinois plans: a PPO with a broader network of hospitals and doctors or a cheaper HMO network. Banke's company covers a percentage of the premiums, and those costs have risen rapidly over the past several years, often more than 12% annually, he said. (Herman, 9/10)

The CT Mirror: ConnectiCare Could Become Third Insurer To Exit Exchange Today
It has been a tumultuous year for Connecticut’s state health insurance exchange, but the latest – and most significant – blow could come Monday if its largest insurer decides not to offer plans next year. The insurer, ConnectiCare Benefits, is facing a Monday deadline to decide whether to leave the exchange in 2017 after a Superior Court judge in New Britain blocked a motion Friday afternoon that would have given the Farmington-based company more time. Whether ConnectiCare will remain on the exchange has not been determined, and potentially could be decided based on how the state Insurance Department rules on a last-minute appeal submitted by the insurer Friday evening. (Constable, 9/12)

The Washington Post: Clinton Falls Ill During 9/11 Memorial Service In New York
Democratic presidential nominee Hillary Clinton fell ill during a memorial service marking the 15th anniversary of the Sept. 11, 2001, terrorist attacks, leaving abruptly and inserting new speculation about her health into a presidential campaign in which Republican Donald Trump has called her weak and unfit. Video of Clinton’s hurried departure from the Ground Zero memorial showed her buckling and stumbling as she got into her van. Clinton’s campaign issued a statement from her doctor later Sunday revealing that she had been diagnosed with pneumonia two days earlier. (Phillip and Gearan, 9/11)

The Wall Street Journal: Hillary Clinton’s Pneumonia Jolts The Presidential Race
Hillary Clinton’s campaign said Sunday she had been diagnosed with pneumonia and would cancel a planned two-day swing through California, hours after the Democratic presidential nominee abruptly left a 9/11 memorial ceremony in New York for what her aides described as her feeling “overheated.” The diagnosis, coupled with a remark by Mrs. Clinton late Friday criticizing some Trump supporters as a “basket of deplorables,” is an unwelcome distraction for a campaign facing a tightening of polls in recent weeks. (Nicholas and Hook, 9/12)

The Hill: Clinton Has Pneumonia, Cancels California Swing 
Hillary Clinton has been ill with pneumonia, her doctor revealed in a Sunday evening statement that may shake up the presidential race. Clinton’s health had been the subject of much speculation, fueled most recently by a coughing fit she had at the start of a campaign event in Cleveland, Ohio, last Monday. But now it seems that the symptoms she blamed on seasonal allergies may have been a sign of the pneumonia that was diagnosed on Friday. (Hellman, 9/11)

The Hill: Martin Shkreli Taunts Clinton Outside Apartment After 9/11 Ceremony
Embattled ex-pharmaceutical CEO Martin Shkreli showed up outside of Chelsea Clinton's New York City apartment Sunday to taunt Hillary Clinton about her health. The Democratic presidential nominee left a 9/11 memorial ceremony early Sunday after becoming "overheated," aides said. After resting at her daughter's apartment, she emerged, telling reporters she felt great. Shkreli stood outside yelling and telling her to drop out of the presidential race. "Do you need pharma bro's help?" Shkreli yelled at Clinton, according to a video he posted on YouTube. (Hellmann, 9/11)

Bloomberg: Clinton Health Another Landmine For Suddenly Vulnerable Markets
Investors nursing wounds after the worst selloff in three months for equity and debt markets got another stress to ponder after concerns over Hillary Clinton’s health flared anew. The 68-year-old Democratic presidential nominee, whose polling edge over Donald Trump has soothed traders who fear ruptures to U.S. policy and see virtue in political gridlock, is suffering from pneumonia and became overheated and dehydrated during a Sept. 11 commemoration Sunday, forcing her to leave abruptly, her doctor said. (Renick and Ciolli, 9/11)

The New York Times: Hillary Clinton Has Pneumonia: What That Means
Hillary Clinton, the Democratic presidential nominee, has pneumonia, her doctor said in a statement on Sunday. Here are some facts about the illness: what it is, what it does and how people recover. (Chokshi, 9/11)

ABC News: What To Know About Pneumonia And Older Adults
Democratic presidential candidate Hillary Clinton's diagnosis with pneumonia brings national attention to a common but deadly infection and one of the most frequent causes of hospital visits in the United States. ... For U.S. seniors, hospitalization for pneumonia has a greater risk of death compared to any of the other top 10 reasons for hospitalization, according to the American Thoracic Society, a physician's organization that advocates for improving care for lung diseases. (Gallagher, 9/12)

CNN: Hillary Clinton Has Pneumonia, Doctor Says, After Early 9/11 Event Exit
Hillary Clinton has pneumonia, her doctor said Sunday, hours after the Democratic nominee stumbled and exited a 9/11 commemoration ceremony early. The incident seems certain to prompt further scrutiny of Clinton's health and her campaign's transparency -- though Republican rival Donald Trump was uncharacteristically silent throughout a solemn day marking the 15th anniversary of the September 11 attacks. (Bradner, Prokupecz and Merica, 9/12)

Politico Pro: Dr. Oz Invites Trump To His Scientifically Dubious TV Show 
In lieu of releasing his medical records, Donald Trump is turning to a familiar space — a TV doctor show — to allay voters’ concerns about his health. That’s the game plan next week when the 70-year-old reality TV star-turned-politician plans to appear on Dr. Mehmet Oz’s highly rated — and highly criticized — daytime talk show to discuss his “personal health regimen,” as the show promoted it, amid demands that he and Hillary Clinton both disclose their medical records. (Cook, 9/9)

Meanwhile, Clinton's camp responds to criticism of her drug plan —

Reuters: Clinton Spokeswoman Defends Drug Plan After Pfizer Comments
U.S. Presidential candidate Hillary Clinton's spokeswoman said on Friday Clinton's plan to curb drug spending was not the blow to medical innovation that Pfizer Inc Chief Executive Ian Read described it as being on Thursday. "Throughout this campaign, Hillary Clinton has called for expanding investments in innovation for healthcare, from a cure for Alzheimer's to building on Vice President Biden's Cancer Moonshot initiative," campaign spokeswoman Julie Wood said in an emailed statement. (Humer and Pierson, 9/9)

The Wall Street Journal: Zika-Funding Deal Nears With Talk Of Dropping Planned Parenthood Clause
Lawmakers are edging closer to breaking a monthslong impasse over funds to combat the Zika virus, as Republican lawmakers and aides said they expected to drop a contentious provision that would effectively block funding to clinics in Puerto Rico that work with Planned Parenthood. Lawmakers and aides from both parties said Friday they anticipated that this month Congress would pass a package combining Zika funding with a spending bill that would keep the government running until early December. The government’s current funding is scheduled to expire at midnight on Sept. 30. (Peterson, 9/9)

Health News Florida: Gov. Scott Will Urge Congress To Fund Fight Against Zika 
Florida Gov. Rick Scott will go to Washington, D.C., this week to urge Congress to fund the fight against the mosquito-borne Zika virus as the disease continues to be detected in Miami-Dade County. ... President Barack Obama requested Congress allocate $1.9 billion for the Zika fight in February. But Congress has been unable to agree on a funding plan. (9/11)

Health News Florida: Bipartisan Group Of Florida’s Congressional Delegation Still Hopeful Over Zika Funding Bill
After about two months in recess, Congress is back in Washington D.C., and people are hopeful there will be some agreement on what can be done to combat the Zika virus—which has already plagued more than 750 Floridians. That comes as the Senate failed to pass another Zika funding bill again this week and there may be even more issues surrounding the mosquito-borne disease on the table. (Cordner, 9/9)

The Associated Press: Puerto Rico Doctors Warn Of Scarce Resources To Fight Zika
Doctors in Puerto Rico are warning that the U.S. territory does not have the resources to handle the fallout of a Zika epidemic as officials report an uptick in the number of fetuses with malformations that were carried by women infected with the virus. The cases are among the first of what health officials believe could reach a couple hundred next year, sparking concerns about the lack of funds and specialists needed to care for children with severe birth defects on an island mired in a deep economic crisis. (9/9)

CNN: Zika Is An STD: Why Not Call It One?
Zika is working its way around the United States. ... But while mosquitoes are a key menace when it comes to Zika, the media and public officials are too focused on them. They also need to pay attention to sex: If we are going to stop the spread of this disease, we are going to need better access to Zika testing for anyone who is sexually active in a Zika zone. (Folkers, Caplan and Igel, 9/11)

NBC News: Sprays, Traps, And GM Bugs: A Look At Our Tools To Fight Zika 
Miami Beach authorities started spraying for Zika-carrying mosquitoes Friday, and spraying's expected to continue for weeks.Authorities in other states are also cracking down on mosquitoes as the Zika threat worsens. It is the peak of mosquito season in the U.S., and the insects can be expected to continue biting until October in warmer states. ... Here are some of the weapons available to fight disease-carrying mosquitoes. (Fox, 9/9)

Health News Florida: Miami-Dade County Completed First Round Of Zika Spraying In Miami Beach
The first round of aerial insecticide spraying in South Beach was completed at 5:32 a.m. Friday. ... Just after 5 a.m., a plane flew over the ocean just offshore and released the spray. According to county officials, on-board meteorological equipment was used to measure weather conditions and calculate a flight path that would allow the aircraft to spray the insecticide and let the wind waft over the island. (Flechas, 9/11)

NBC News: Miami Beach Starts Spraying For Zika Mosquitoes After Protest
Small aircraft started predawn spraying of insecticide to kill Zika-carrying mosquitoes in Miami Beach Friday morning. The spraying had been delayed a day after worried and angry residents complained to city officials and organized a small protest outside City Hall. Hours after spraying ended, the mayor's office announced that a fresh pool of mosquitoes had tested positive for the virus. (Fox, 9/9)

Health News Florida: Orlando Group Seeks Volunteers To Crunch Data In Zika Fight
An Orlando nonprofit is recruiting volunteers to process data for researchers studying the Zika virus. ...The World Community Grid developed from an IBM Corporate Citizenship project. To run massive computer simulations, the grid breaks down data to process in the background on personal devices without accessing private information. (9/11)

Houston Chronicle: South Texas Braces For Zika, Prepares For Challenges Ahead
The virus, transmitted mainly through bites from infected mosquitoes, has spread across parts of Latin America, the Caribbean and most recently Miami. While nearly all of the more than 170 cases reported in Texas were contracted by people traveling outside the country, health officials said South Texas is especially vulnerable to an outbreak. The Aedes aegypti mosquito, which can carry the Zika virus, dengue and chikungunya, is endemic to the Texas-Mexico border. Air conditioning and window screens help prevent transmission, but impoverished neighborhoods, known as colonias, often lack these amenities. (Nelsen, 9/11)

The New York Times: Health Care Providers Scramble To Meet New Disaster Readiness Rule
An estimated 72,315 American health care providers and suppliers — from hospitals and nursing homes to dialysis facilities and care homes for those with intellectual disabilities — will have a little over a year to meet federal disaster preparedness requirements completed this week by the Centers for Medicare and Medicaid Services. The new rule is aimed at preventing the severe breakdown in patient care that followed disasters including Hurricane Katrina and Hurricane Sandy, while also strengthening the ability to provide services during other types of emergencies, such as pandemics and terrorist attacks. (Fink, 9/9)

KQED: When Doctors Dump Insurance For Subscription Model, Who Benefits? 
[Dr. Lorraine Page is] one of a growing number of doctors who have cut loose from what she calls the “assembly-line, volume approach” that most of her colleagues have experienced. These breakaway docs are now using a health care delivery model called direct primary care. Page has cut back on the number of patients she sees, and spends more time with the ones she does. She doesn’t take insurance and deals mostly in cash. Page charges each time she sees a patient, but most direct primary care doctors bill a monthly fee for unlimited visits. (Gorn, 9/11)

Politico Pro: Hawaii's Largest Insurer Will Cap Physician Payments
Hawaii’s largest health insurer is plowing ahead with an ambitious plan to dramatically overhaul the way primary care doctors are paid — by giving them a monthly per patient fee. The Hawaii Medical Service Association, which covers more than half of the state’s 1.4 million residents, in January will start paying physicians a standard monthly rate per patient. It's part of health care industry’s effort — with encouragement from the Obama administration — to move away from a fee-for-service system that payers say encourages overtreatment and overspending. (Ehley, 9/9)

Los Angeles Times: 15 Years Later, Sept. 11 Responders Might Be Sick And Not Even Know It
Making the decision to help 15 years ago might end Garrett Goodwin's life early. Goodwin, 39, was one of tens of thousands of people at ground zero right after the Sept. 11, 2001, attacks. A trained medic, he traveled from Tampa, Fla., to New York to volunteer. But now, his lungs are failing him, and doctors say that will lead to his death. Goodwin is one of many volunteers who spent long hours toiling in the World Trade Center ruins, where toxic fumes have left many sick or dead. (Bowen, 9/9)

ABC News: 9/11 First Responders Battle Toxic Exposures 15 Years Later
In the years after the 9/11 attacks, health experts have learned more about how the debris, smoke and wreckage affected the health of first responders and other survivors of the attacks. Those who stayed in the area and breathed in the dust and smoke have been found to be more at risk for a host of health problems, including cancer, asthma, mental health disorders and gastrointestinal diseases. ... The FDNY reports that in addition to the 343 FDNY members killed on 9/11, another 127 firefighters have died of illnesses related to working at Ground Zero in the past 15 years. (Mohney, 9/11)

NBC News: Endless Attack: Sick 9/11 Responders Still Struggle To Get By
Fifteen years have passed since the worst international terrorist attack in history claimed the lives of nearly 3,000 people, more than 400 of whom were first responders. Since then, tens of thousands have developed illnesses stemming from exposure to toxins at Ground Zero. ... Under the 2005 World Trade Center Disability Law, public employees and retirees who became disabled as a result of September 11-related operations are entitled to a 75-percent disability pension. But in order to qualify, EMTs and rescue paramedics had to have submitted a sworn statement to the New York City Employee Retirement System (NYCERS) indicating the dates and locations of their participation at Ground Zero. (Margolin, 9/10)

CBS News: 9/11 Through A Child's Eyes: Survivor Overcomes PTSD, Addiction
This week, just days before the 15th anniversary of the September 11th terrorist attacks, [Helaina] Hovitz released a memoir entitled “After 9/11: One Girl’s Journey Through Darkness to a New Beginning.” In the book, she recounts the all-too familiar events of the day as seen through a child’s eyes. She also details her struggle through more than a decade of misdiagnosed post-traumatic stress disorder (PTSD) and  the alcoholism that came with it, and she writes about what finally helped her cope. (Welch, 9/9)

CBS News: Growing Concern Over 9/11 First Responders' Mental Health
In a study of 813 first responders, 12.8 percent had cognitive impairment. Responders like [Anthony] Flammia, with a diagnosis of PTSD with flashbacks, were three times as likely to have impairment. The average age of the group was just 53. (Lapook, 9/9)

CNN: 15 Years After 9/11, Parents Turn Pain Into Purpose
Strange. Beautiful. Disconcerting. For Liz and Steve Alderman, those were their first reactions when they walked into the 9/11 Memorial just days before the somber 15-year mark since the terror attack here. ... They founded The Peter C. Alderman Foundation (PCAF) in 2002 with the mission of helping "one of the world's most vulnerable populations recover from the emotional wounds of war," with a focus on mental health rehabilitation for victims of terror and the trauma of war. Liz and Steve have built the foundation into a $1.5 million-a-year organization operating in Cambodia, Uganda, Kenya and Burundi, and also working in refugee camps. (Harlow, 9/9)

Meanwhile, strides have been made in the area of trauma care —

Kaiser Health News: Better Training, Tourniquets And Techniques Since 9/11 Are Saving Lives
Kaiser Health News staff writer Rachel Bluth reports: "War abroad and carnage at home since 9/11 have taught Americans much about saving lives after violent tragedies. Whether they were hurt in mass shootings or gruesome car accidents, it’s not uncommon for victims to bleed to death on the scene because trained assistance didn’t arrive in time to help them. But one of the most powerful initiatives in trauma care in the past 15 years might make a difference." (Bluth, 9/12)

Milwaukee Journal Sentinel: Abuse Of ADHD Drugs Following Path Of Opioids
Public health officials have focused on the national plague of narcotic painkillers. But another scourge is looming largely unnoticed: The drugs used to treat attention deficit hyperactivity disorder in adults. Since 2013, there have been more than 19,000 reports of complications from ADHD drugs, most of which are stimulants like Adderall, made to the U.S. Food and Drug Administration, according to a Milwaukee Journal Sentinel/MedPage Today analysis. Of those, adults were far more likely than children to suffer severe complications, such as death and hospitalization. (Wynn and Fiore, 9/10)

Meanwhile, in news from the opioid crisis —

The Associated Press: Cops: Photos Of Boy With Passed-Out Adults Show Drug Scourge
A safety director in a city that released photos of a 4-year-old boy in a vehicle with two adults slumped over after overdosing on heroin and fentanyl said Friday he and others wanted to send a message to addicts they should find safe places for their children when using debilitating drugs. The photos were taken Wednesday in East Liverpool, a city of about 11,000 residents along the Ohio River, and were posted to the police department’s Facebook page Thursday. (Gillispie, 9/9)

The Washington Post: A Maker Of Deadly Painkillers Is Bankrolling The Opposition To Legal Marijuana In Arizona
The campaign against marijuana legalization in Arizona received a major infusion of cash last week from a synthetic cannabis drugmaker that has been investigated for alleged improper marketing of a highly addictive prescription painkiller, according to campaign finance reports. The $500,000 donation from Insys Therapeutics, based in Chandler, Ariz., amounts to more than one-third of all money raised by Arizonans for Responsible Drug Policy, the group opposing legalization. It's one of the largest single contributions to any anti-legalization campaign ever, according to campaign finance records maintained by ballotpedia.com. (Ingraham, 9/9)

Georgia Health News: Is Your Health Care Provider An Addict? The Problem We Can’t Ignore
Patients’ addiction problems hit home for Fishman and for thousands of other physicians who have recovered from their own drug dependence. Substance abuse among health professionals is not something the public likes to think about. But it’s very real. In 2014, a USA Today review of state and federal records identified hundreds of cases in recent years in which physicians and other health care practitioners were disciplined or prosecuted for drug diversion or other medical misconduct related to substance abuse. (Kanne, 9/11)

New Hampshire Times Union: Crews Not Going Away: Former Hope For NH Recovery Board Member Will Join Drug Steering Commission 
One of the harshest critics of how the state has handled the opioid addiction crisis is about to take her seat on the Governor's Commission on Drug and Alcohol Abuse, the steering committee for efforts to stop the soaring death toll. Melissa Crews, whose criticism of Democratic Gov. Maggie Hassan in a political ad led to her resignation from the board of Hope for New Hampshire Recovery, was recently named to the commission by Republican Senate President Chuck Morse. (Solomon, 9/10)

Stat: The Surprising History Of The War On Superbugs
Bacteria that have evolved to withstand antibiotics kill 700,000 people each year, and ever more powerful strains are spreading around the world. Researchers are worried that we will enter a post-antibiotic age, in which we are infected by bacteria that can defeat every drug medicine has to offer. Next week, the United Nations will convene a high-level meeting to coordinate the global fight against these invisible enemies. (Zimmer, 9/12)

NBC News: Superbug Source Remains A Mystery
Medical detectives said Friday they are still baffled about how much-feared drug-resistant superbugs infected two people in the U.S. this year, but they have good news: both patients recovered and don't seem to have infected anyone else. ... Scientists fear an E. coli bacteria with the mcr-1 gene could pass it to another superbug with other mutations -- creating a true superbug that resists all known antibiotics. (Fox, 9/9)

The Washington Post: Newest Superbug Found In A Connecticut Toddler
This summer, a Pennsylvania woman was found to carry a superbug that is resistant to the antibiotic of last resort, causing alarm about the potential of dangerous drug resistance spreading across the United States. Ever since, health researchers have been looking for where else such germs might be lurking. On Friday, the Centers for Disease Control and Prevention said the superbug popped up in a 2-year-old girl in Connecticut. She got sick in June and was found to have a strain of E. coli bacteria with the antibiotic-resistance gene known as mcr-1, making her the fourth human case in the United States identified so far. (Sun, 9/9)

ABC News: Renewed Fears Over Brain Injuries Cast Shadow Over NFL's Opening Weekend
The NFL kicked off its opening weekend for the 2016 season, and while the league's revenues continue to climb, a hit against a star quarterback in the season opener on Thursday has renewed controversy over brain injuries in America's most popular spectator sport.The NFL and the NFL Players' Association announced today that they are both addressing circumstances surrounding decisions made by medical personnel during Thursday's game between the Carolina Panthers and Denver Broncos when the Panthers' star quarterback Cam Newton took what appeared to be a brutal hit by Broncos safety Darian Stewart. (Hayden, 9/11)

CNN: Abstain From Abstinence-Only Sex Ed, Say Experts
Although refraining from having sexual intercourse is a sure-fire way to prevent pregnancies and sexually transmitted infections, a recent report published in the journal Pediatrics concluded that abstinence-only programs are ineffective in delaying the initiation of sex. The federal government has invested more than $100 million into abstinence-only sexuality education since an eight-point definition of abstinence education was enacted in 1996 under the Social Security Act. (Armstrong, 9/9)

Minnesota Public Radio: Screening Mental Health In Kindergarten Is Way Too Late, Experts Say
Briggs works at the Healthy Steps program at the Montefiore Comprehensive Health Care Center in the South Bronx, screening children as young as 6 months for mental health issues. That may sound young, too young maybe, but that's when some experts believe it's important to catch the first signs that something may be wrong. Many say waiting until kindergarten is too late. So Briggs sees a lot of babies at the Healthy Steps program, but the crying doesn't seem to faze her at all. Visiting with baby and parent, she watches the way they interact. (Cardoza, 9/9)

CBS News: "Super Lice" Not Budging With Over-The-Counter Treatments
A new report warns that over-the-counter products have lost much of their effectiveness against the so-called super lice. Prescription products, though, can still get rid of the creepy critters. Parents should turn to physicians first instead of trying to treat their children themselves with over-the-counter products, said report lead author Dr. Ellen Koch. She’s a dermatologist with the University of Pittsburgh Medical Center. (Dotinga, 9/9)

Fox News: Are Infant Cereals Really The Best First Food For Babies?
The American Academy of Pediatrics (AAP) states that there’s no medical evidence that starting solids in any particular order has any advantages. ...In fact, studies show babies’ food preferences actually start in utero. Babies whose mothers drank carrot juice during pregnancy and while breastfeeding had fewer negative expressions when they started to eat carrots than infants who had not been exposed to the flavor, a study in the journal Pediatrics found. (Revelant, 9/11)

The Washington Post: Vitamin D May Help Cut Down Asthma Attacks
For anyone with asthma, preventing attacks of wheezing, coughing, chest tightness and shortness of breath is a top priority. Might vitamin D help? (Searing, 9/10)

Stat: Where Specialists Are Scarce, A Push To Train Primary Doctors To Do The Job
Medical subspecialities began proliferating in the US in the 1970s, with the rise of more technologically advanced care. But with that trend came another novelty: Primary care doctors began referring their patients elsewhere for care. In the last 15 years, that practice has skyrocketed. Between 2000 and 2010 alone, referrals jumped from 41 million to 105 million annually. (Tedeschi and Fritz, 9/12)

NPR: A Map To Help Cancer Doctors Find Their Way
What if doctors could call up a computerized map that would show them how a case of cancer is likely to progress? Tumor cells can mutate in unexpected ways. And cancers can suddenly grow. For doctors, anticipating cancer's next moves can help guide timely, effective patient treatment. A mapping program, called PiCnIc for short, aims to help physicians in staying a step ahead of cancer and preparing long-term treatment plans with fewer elements of surprise. (Kim, 9/9)

In other health technology news —

The Star Tribune: Who's Holding The Knife? Growing Number Of Surgeons Expected To Use Robotic Tools 
A new wave of robotically assisted tools for knee and hip replacements is moving into specialty centers and hospitals around Minnesota, and the number of procedures appears poised to spike in 2017. The surgical robots carry big price tags, but people who use them say the cost is made up in quicker recovery times and more predictable results, especially in complex cases. (Snowbeck, 9/9)

Boston Globe: Home Care Waiting List For Elders Prompts Lawmakers’ Concern
For thousands of frail, older Massachusetts residents, home care visits offer a lifeline — and a way to remain in their houses even amid illness and disability. But that lifeline could be jeopardized by state budget cuts, according to elder advocates who say that as many as 200 residents a month could be added to waiting lists for services from Sept. 1 through June. They are urging legislators to act quickly, saying the state received federal money for elder home care and that money is just sitting in a trust fund. (Lazar, 9/10)

New Hampshire Times Union: Hospitals Band Together To Stay Healthy 
When Catholic Medical Center was looking to partner with Huggins Hospital, CMC executives held separate secret talks with executives from another hospital simultaneously, unbeknownst to the other. What emerged was a three-hospital affiliation agreement announced this summer aimed at sharing services and saving the patients and hospitals money. (Cousineau, 9/10)

The Star Tribune: After Months Of Talks, Allina Nurses So Close, Yet Far From Deal
Bleary-eyed from 22 hours of contract talks, leaders for Allina Health and its union hospital nurses appeared to be just one big issue away from agreement when they halted negotiations at 6 a.m. on Sept. 3. Forty-eight hours later the nurses hit the picket lines. Now, as the strike enters its second week, the question is: Will they still be that close when they return to bargaining after having slept, restrategized and traded bitter accusations for days? (Olson, 9/12)

Cincinnati Enquirer: Cincy-Area Lawmaker: Make House Members Use VA For Health Care
Rep. Warren Davidson wants members of Congress to get their health care from Veterans Affairs’ facilities, and he plans to introduce legislation this week that would force lawmakers and their staff to make that switch. Davidson, who represents Butler County, said the bill would motivate members of Congress to improve care at the VA’s vast network of clinics and hospitals — quickly and dramatically. (Shesgreen, 9/10)

Marketplace: Niche In Elder Care: Assisted Living For LGBT Seniors
With the nation’s senior population expected to double in the next 20 years, there’s a growing need for senior services. One niche: the millions of LGBT baby boomers who came from an era when equal rights were only a dream. A new community in Palm Springs is a sign of the changing times. (Napoli, 9/12)

Fox News: Leprosy Suspected In 2 California Kids: How Could They Contract It?
This week, officials in Riverside Country (which is near Los Angeles) said they are investigating the suspected cases of leprosy, now usually called Hansen's disease, at an elementary school in the area. Nursing staff at the school first notified officials about the possible infections on Sept. 2, but it will take several weeks to confirm them, according to the Los Angeles Times. Cases of Hansen's disease in the United States are rare, but they do occur, with about 100 to 200 cases typically reported each year, according to the Centers for Disease Control and Prevention. (Rettner, 9/12)

Kaiser Health News: Colorado Gun Shops Work Together To Prevent Suicides
It’s ladies night at the Centennial Gun Club in a suburb of Denver. More than 80 women are here for safety instruction and target practice. Tonight the club is offering more than shooting, though. The women rotate through the firing range, and in another large room, they hear a sobering presentation from emergency room doctor Emmy Betz. She’s part of a collaboration between gun shops and public health leaders in the state to help prevent suicide. (Daley, 9/12)

Orlando Sentinel: Orlando Health Rebrands 5 Centers 
Orlando Health has rebranded its five outpatient Boston Diagnostic Imaging centers to Orlando Health Imaging Centers. The health system and Medical Center Radiology Group created a company and purchased the five outpatient centers in December 2014. The centers are in Ocoee, Altamonte Springs, downtown Orlando and Sanford. The downtown clinic temporarily lost its certification in August 2015, after federal officials raised questions about the quality of their mammograms. (Miller, 9/10)

Minnesota Public Radio: MN Officials Confirm 5 Legionnaires' Disease Cases In Hopkins
State health officials have confirmed five cases of Legionnaires' disease in people who live or work in Hopkins and are investigating the source of the outbreak. Of those who became ill between Aug. 4 and Sept. 1, three are currently hospitalized, and two others were hospitalized and have recovered, the Minnesota Department of Health said Friday. The patients are all over the age of 50. Legionnaires' disease is a severe form of pneumonia usually caused by infection, according to the federal Centers for Disease Control and Prevention. (9/9)

Seattle Times: ‘Last Resort:’ A Rare Intestine Transplant At UW Medical Center
The procedure marks the first adult intestine transplant performed at UWMC, and one of just eight ever in the Northwest region that includes Washington, Oregon, Idaho, Montana and Alaska, federal data show. But it also demonstrates the maturation of the UW’s intestinal rehabilitation program, started by Reyes four years ago to treat patients like Oberts whose guts were failing. (Aleccia, 9/10)

Des Moines Register: Work Persists At Cherokee Mental Health Institute
More than a year after two of Iowa’s four mental health institutes were shut down, the institute in Cherokee is operating similarly to how it had been in recent years. Apprehension had run through Cherokee in 2009, when state officials explored closing one or more of the state’s four mental health institutes. The loss of the northwest Iowa campus would have delivered a $24 million hit to the local economy. (Hayworth, 9/11)

Chicago Tribune: Human Case Of West Nile Virus Reported In Ingleside 
The Lake County Health Department reported Friday that the county's first confirmed human case of West Nile virus affected an Ingleside resident late last month. In a news released issued Friday morning, health department officials said the patient was hospitalized in late August and discharged in early September. (9/9)

Orlando Sentinel: Teen Who Survived Brain-Eating Amoeba Ready To Go Back To School 
It's been a month since Sebastian DeLeon, an adventurous camp counselor in South Florida, went from being a regular teen to the boy who miraculously survived a deadly brain-eating amoeba. The 16-year-old is doing well and eager to get on with his life, he said on Friday from his South Florida home during a video call that was broadcast at the second annual Amoeba Summit at Florida Hospital. (Miller, 9/10)

The Washington Post: Heads Up! Important Poverty, Median Income And Health Insurance Data Out Tomorrow
Like the man said, important numbers are coming out tomorrow. But, I can hear you thinking, if they’re out tomorrow, why do we have to talk about them today? Fair question. It’s because these data tend, IMHO, to not get enough attention. That’s because they’re for last year (2015) and, thus, don’t move markets. Also, this Census Bureau report is not like the monthly jobs report we all know and love, where you can look at the unemployment rate and the payroll jobs number and call it a day (not that I’d ever do so!). These data provide tons of results — e.g., the three variables listed in the title by age, race, gender, region, and much more — so the report can be a bit overwhelming. There are also some tricky methodological issues to consider. (Jared Bernstein, 9/12)

Reuters: ‘Franken-Bugs’ May Be Our Best Weapon Against Zika
On Nov 8, the residents of a suburb of Key West will vote on whether to allow scientists to release genetically-modified mosquitoes into their backyards. Inserted into the mosquito's genetic makeup would be an artificial stretch of DNA that renders them unable to reproduce. As the “transgenic” mosquitoes mate with wild ones, the plan goes, their offspring would die, bringing the local population of skeeters down significantly — by as much as 90 percent, according to Oxitec, the for-profit firm that wants to release the modified mosquitoes. That would potentially reduce the risk to local residents of catching mosquito-borne diseases such as dengue and Zika. ... The controversy Oxitec’s mosquito project has caused in Florida is a microcosm of a broader debate over the new biotechnology. (Fred Guterl, 9/12)

CNN: Zika Is An STD: Why Are We Not Calling It One?
But while mosquitoes are a key menace when it comes to Zika, the media and public officials are too focused on them. They also need to pay attention to sex: If we are going to stop the spread of this disease, we are going to need better access to Zika testing for anyone who is sexually active in a Zika zone. (Kelly McBride Folkers, Arthur L. Caplan and Lee Igel, 9/11)

CNN: The Reality Of The Health Insurance Marketplace 
Twenty million people have health insurance today thanks to the ACA, and the uninsured rate in this country is the lowest on record. Plus, more than 10 million Americans now have coverage through the ACA's Marketplace. These consumers report that they're pleased with their coverage and can now access and afford the care they need. But we do expect 2017 to be a transition year for the Marketplace. (Sylvia Burwell, 9/9)

Chicago Tribune: Why Obamacare Failed
Come November, the grim trudge across the increasingly barren Obamacare landscape begins anew. Illinois consumers likely face staggering price hikes for individual insurance policies. Some types of plans could cost an average of 43 percent to 55 percent more. Ditto across the country: A first tranche of states approved 2017 rates with similarly cardiac-arrest-inducing premium increases. ... We can deny the current system's failings, or we can parlay our evolving knowledge into something much better. Put another way: The next president and Congress either reckon with Obamacare's failures or ... wait for the thud. (9/9)

Modern Healthcare: The Coming Transformation
No matter what the outcome of the election or its impact on the Affordable Care Act, there's one thing neither party disputes. The national imperative to promote systematic change of the healthcare delivery system, the focus of half that legislation, will remain intact. That means the shift from volume to value will not only endure, it will accelerate. The great transformation in how the U.S. pays for and delivers healthcare has become a permanent feature of the industry's landscape. (Merrill Goozner, 9/10)

The Washington Post: Americans Need To Know More About Clinton’s Health — And Trump’s
Eight years ago, I wrote a medical report on the health of then-presidential candidate Barack Obama, whose personal physician I had been for 22 years. That report was 276 words and described Obama’s health as excellent. I was derided for issuing such a brief report, but there was nothing of significance in the medical history of this healthy, 47-year-old male. Meanwhile, Republican John McCain — a 71-year-old with a history of skin cancer — made nearly 1,200 pages of records available for a group of reporters to review. (Dr. David L. Scheiner, 9/9)

The New York Times: Before You Spend $26,000 On Weight-Loss Surgery, Do This
Earlier this year, the Food and Drug Administration approved a new weight-loss procedure in which a thin tube, implanted in the stomach, ejects food from the body before all the calories can be absorbed. Some have called it “medically sanctioned bulimia,” and it is the latest in a desperate search for new ways to stem the rising tides of obesity and Type 2 diabetes. Roughly one-third of adult Americans are now obese; two-thirds are overweight; and diabetes afflicts some 29 million. Another 86 million Americans have a condition called pre-diabetes. None of the proposed solutions have made a dent in these epidemics. (Sarah Hallberg and Osama Hamdy, 9/10)

Bloomberg: The Three Most Important Words? 'I Don't Know'
I don’t know what is going on at Theranos. I never had a clue. I may be one of the few willing to admit it. This is a problem in both the technology and investment communities -- the simple inability to say “I don’t know.” There is plenty of evidence that many folks who claimed to understand the company and its founder -- putting lots of money at risk while giving the company a multibillion-dollar valuation -- didn’t have a clue either. The venture capitalists who funded this unicorn were unable to admit this. That blind spot is the focus of our attention today. (Barry Ritholtz, 9/9)

The Hill: Are 'Right-To-Try' Laws Good Medicine Or Partisan Politics?
Although more than half of states have passed right-to-try laws, some have resisted the trend, saying they make false claims, conflict with existing federal regulations, and have the potential to exploit patients. Gov. Jerry Brown (D) of California vetoed a right-to-try bill last October, disappointing many who had hoped for less-regulated access to unapproved therapies for the dying. Why are these kinds of laws so controversial and so politically charged? (Carolyn Long Engelhard, 9/9)

Denver Post: Prescription For Universal Health Care Is A Bitter Pill
The appeal of Amendment 69 for so many Coloradans is painfully obvious. The initiative for a single-payer health care system makes sense to anyone who has needed an EpiPen or a prescription for Hepatitis C, who has watched his take-home pay shrink while his insurance premiums and deductibles continue to soar, anyone whose blood boils when she hears about the outrageous salaries paid to CEOs of  hospital corporations and health insurance companies, and everyone who watched the support explode for an obscure Democratic socialist presidential hopeful from Vermont who campaigned for a “Medicare-for-all single-payer” health care system. (Diane Carman, 9/10)

The Star Tribune: MNsure Isn't The Cause Of Rising Insurance Rates
We can’t make a good decision in the state about what to do about exploding insurance premium rates for individuals if it’s MNsure that gets the blame. That’s because MNsure is nothing more than a government-run electronic marketplace and administrator that doesn’t insure anybody. Blaming it for escalating rates is a little like blaming your toaster for being overweight. (Lee Schafer, 9/10)