CBS News: Orphaned By UnitedHealth? Here's What You Can Do
UnitedHealth Group (UNH) CEO Stephen Hemsley's announcement on Tuesday -- saying the insurance company would leave all but a handful of state health care exchanges by 2017 -- sparked plenty of the usual debate about the viability of the Affordable Care Act and whether insurers can make money in the exchanges. But for the 795,000 patients who pay for UnitedHealth coverage through an exchange, the most pressing question is, "What do I do now?" (Konrad, 4/21)

The Arizona Republic: 5 Things To Know About Affordable Care Act Marketplace In Arizona
UnitedHealthcare’s decision to leave the health-insurance marketplace in Arizona and most other states will limit choices for consumers. But the question in Arizona and elsewhere is whether their consumers will have robust choices for health plans. (Alltucker, 4/21)

The Connecticut Mirror: In Fourth Year, Obamacare Exchange Eyes Broader Role
This fall, the exchange, Access Health CT, will begin its fourth year of selling private insurance plans to Connecticut residents, as well as enrolling people in Medicaid. But its leaders are eyeing a broader role, focused on not just getting people covered, but improving health. (Levin Becker, 4/22)

And The Fiscal Times looks ahead to 2017 premiums —

The Fiscal Times: Get Ready For Huge Obamacare Premium Hikes In 2017
Amid rising drug and health care costs and roiling market dynamics, the spokesperson for the nation’s health insurers is predicting substantial increases next year in Obamacare premiums and related costs. (Pianin, 4/21)

The Associated Press: Arkansas GOP Governor Uses Veto To Save Medicaid Program
Gov. Asa Hutchinson on Thursday effectively saved Arkansas' first-in-the-nation hybrid Medicaid expansion by voiding part of a budget bill that would have ended the subsidized insurance for more than 250,000 poor people. The Republican governor vetoed a provision in the Medicaid budget that ordered a Dec. 31 end to the program, which uses federal funds to purchase private insurance for the poor. (DeMillo, 4/21)

Arkansas News: Arkansas Works Funding Gets House OK, Governor’s Signature
The House approved Senate Bill 121, a bill to fund Arkansas Works and other Medicaid programs for the coming fiscal year, in a 76-13 vote a day after the Senate approved it in a 27-12 vote. Like most appropriation bills, the measure needed a three-fourths majority vote in each chamber to pass, or 75 votes in the House and 27 in the Senate. Before signing the bill, Hutchinson used his line-item veto power to veto a provision that would have required the program to end Dec. 31 of this year. (Lyon, 4/21)

KUAR (Arkansas Public Radio): Governor Hutchinson Uses Veto Plan To Continue Arkansas's Medicaid Expansion
While the Republican governor says Medicaid expansion will now continue, Senate President Jonathan Dismang and other backers are considering additional legislation to safeguard against legal challenges to their procedural move. Speaking to reporters after a taping of AETN's Arkansas Week, the Republican from Searcy said a measure could be adopted in a future special session to re-state the 2021 expiration date for Arkansas Works, that the governor puts back in place with his veto. (Hickey and Kaufman, 4/21)

Kaiser Health News: Using Novel Line-Item Veto, Ark. Governor Extends Medicaid Expansion
The Medicaid expansion covers more than 267,000 Arkansans who make less than 138 percent of the federal poverty level (about $16,000 for an individual or a little more than $33,000 for a family of four). The expansion came from a 2013 compromise between Republican lawmakers and Democratic Gov. Mike Beebe. It became known as the “private option” because the state received a federal waiver to use Medicaid funds to purchase private health insurance plans for most newly eligible beneficiaries. (Ramsey, 4/21)

Arkansas Democrat-Gazette: Medicaid-Bill Ploy On Track
Hutchinson advocated the line-item strategy so the expansion's opponents could vote for a bill that ended the funding. Later that afternoon, Hutchinson made good on his promise and vetoed that portion of the bill, which will now go back to the Senate, where only a simple majority is needed to uphold or overturn a veto. (Wickline and Willems, 4/22)

The New York Times: U.S. Suicide Rate Surges To A 30-Year High
Suicide in the United States has surged to the highest levels in nearly 30 years, a federal data analysis has found, with increases in every age group except older adults. The rise was particularly steep for women. It was also substantial among middle-aged Americans, sending a signal of deep anguish from a group whose suicide rates had been stable or falling since the 1950s. The suicide rate for middle-aged women, ages 45 to 64, jumped by 63 percent over the period of the study, while it rose by 43 percent for men in that age range, the sharpest increase for males of any age. The overall suicide rate rose by 24 percent from 1999 to 2014, according to the National Center for Health Statistics, which released the study on Friday. (Tavernise, 4/22)

The Washington Post: U.S. Suicide Rate Has Risen Sharply In The 21st Century
Last decade’s severe recession, more drug addiction, “gray divorce,” increased social isolation, and even the rise of the Internet and social media may have contributed to the growth in suicide, according to a variety of people who study the issue. But economic distress — and dashed hopes generally — may underpin some of the increase, particularly for middle-aged white people. The data showed a 1 percent annual increase in suicide between 1999 and 2006 but a 2 percent yearly hike after that, as the economy deteriorated, unemployment skyrocketed and millions lost their homes. (Keating and Bernstein, 4/22)

The Wall Street Journal: Suicides In The U.S. Climb After Years Of Declines
While more men kill themselves than women, the suicide rate for women rose faster between 1999 and 2014 than it did for men. “It narrowed the gap,” said Sally Curtin, a statistician at the CDC’s National Center for Health Statistics and an author of the report. The report showed a surge in suicides among middle-age men and women, a factor noted in rising death rates among middle-aged people and a decline in white Americans’ life expectancy in 2014. The suicide rate for white women ages 45 to 64 rose 80% and for white men of that age group 59% between 1999 and 2014, according to a second CDC report released on Friday. There were increases in the suicide rate of every age group for both sexes except those 75 and older. That includes a startling tripling in the suicide rate for the youngest girls, ages 5 to 14. (McKay, 4/22)

Los Angeles Times: U.S. Suicides Have Soared Since 1999, CDC Report Says
All told, some 42,773 Americans died of suicide in 2014, according to the Centers for Disease Control and Prevention. That made suicide the 10th leading cause of death for all ages. "This is definitely harrowing: The overall massiveness of the increase is to me the biggest shocker--the fact that it touched pretty much every group," said Katherine A. Hempstead, who recently published an analysis of U.S. suicide trends in the American Journal of Preventive Medicine. (Healy, 4/21)

NPR: Suicide Rates Climb In U.S., Especially Among Adolescent Girls
There is one age group that really stands out — girls between the ages of 10 and 14. Though they make up a very small portion of the total suicides, the rate in that group jumped the most — it experienced the largest percent increase, tripling over the last 15 years from 0.5 to 1.7 per 100,000 people. And, Curtin points out, in any given year, there are a lot more suicide attempts than there are suicide deaths. "The deaths are but the tip of the iceberg," she says. (Bichell, 4/22)

New Hampshire Public Radio: What The Data Tells Us About Opioid Use Right Now In N.H.
Last year saw more drug overdose deaths than ever before in New Hampshire. So far in 2016, the state’s confirmed at least 48 deaths, with another 89 potential cases on top of that — officials are waiting for more toxicology reports to add those into the total. (McDermott, 4/21)

New Hampshire Public Radio: Mapping An Epidemic: Where Did Overdose Deaths Happen In N.H. Last Year?
Manchester accounted for nearly a quarter of the fatal drug overdoses reported across New Hampshire last year, according to newly released data from the medical examiner’s office. The state's largest city saw 106 overdoses last year, out of a statewide total of 433. (McDermott, 4/21)

New Hampshire Public Radio: N.H. House Nixes Bill To Fund Opioid Prevention Program In High Schools
The New Hampshire House killed a bill Wednesday to fund a program designed to teach substance abuse prevention in high schools. HOPE, which stands for Heroin and Opiate Prevention Education, is run by Plymouth State University and offers peer to peer prevention. But not every school in the state participates (Sutherland, 4/21)

Meanwhile, in Washington, D.C., House lawmakers are still trying to figure out what their opioid bill will look like —

The Associated Press: House Tries To Sort Out Legislative Response To Drug Abuse
More than a month after the Senate acted on legislation to reduce heroin deaths, the House is trying to figure out how to deal with the election-year issue. Heroin and opioid painkiller abuse is a growing, deadly problem that has become a top political issue in many states. More than 47,000 Americans died of drug overdoses in 2014 in cities and rural areas alike, more than double the death rate in 2000. (4/21)

The Hill: House Turns Focus To Opioid Abuse
The leaders of the House’s bipartisan panel on opioid abuse are charging forward with a major legislative package they hope will mark one of the largest federal commitments to date on fighting addiction. The group, led by Reps. Frank Guinta (R-N.H.) and Annie Kuster (D-N.H.), will formally endorse 15 bipartisan bills on opioid abuse Thursday. The legislation includes $85 million in local grants and $10 million for prescription drug monitoring programs, which Guinta and Kuster hope will become the framework for the broader House bill slated to reach the floor next month. (Ferris, 4/21)

CBS News: Popular Drugs For Colds, Allergies, Sleep Linked To Dementia
Taking over-the-counter medications for colds, flu and allergies may seem harmless, but a new study warns that certain drugs are linked to an increased risk of dementia. The class of medications, called anticholinergics, are sold over-the-counter and by prescription for many chronic conditions. They include sleep aids, hay fever pills, and flu symptom relievers. (Marcus, 4/21)

NPR: Half Your Brain Stands Guard When Sleeping In A New Place
When you sleep in unfamiliar surroundings, only half your brain is getting a good night's rest. "The left side seems to be more awake than the right side," says Yuka Sasaki, an associate professor of cognitive, linguistic and psychological sciences at Brown University. The finding, reported Thursday in the journal Current Biology, helps explain why people tend to feel tired after sleeping in a new place. And it suggests people have something in common with birds and sea mammals, which frequently put half their brain to sleep while the other half remains on guard. (Hamilton, 4/21)

The Seattle Times: Seattle Experts To Help Launch Largest-Ever Autism Research Study In U.S.
Autism experts at the University of Washington are bracing for a flood of interest starting Thursday as they help launch the nation’s largest-ever autism research study, which will seek DNA and other information from 50,000 U.S. families. (Aleccia, 4/21)

Kaiser Health News: Cities Begin To Count The Scars Of Childhood, And Try To Prevent New Damage
Kimberly Cervantes has spent much of her young life learning to outwit the perils of Compton. At 19, she’s street smart and savvy, but Cervantes’ maturity was born out of a violent childhood. In high school, she was assaulted on a public bus. In middle school, she witnessed the deaths of two students. The steady exposure to violence has led Cervantes to some dark places — including crippling anxiety and thoughts of suicide. ... In an unprecedented move, Cervantes and four other students are suing the Compton Unified School District, arguing that the trauma they have faced makes it difficult to learn and demanding that the district offer them additional support, in much the same way schools must accommodate students with autism, dyslexia and other disabilities. (Varney, 4/21)

Meanwhile, a researcher delves into the effects of second-hand marijuana smoke and scientists find an association between a particular genome and the age a person first has sex —

The Sacramento Bee: Second-Hand Pot Smoke Can Give You More Than Just A Contact High
Matthew Springer, a researcher in cardiovascular disease, was attending a Paul McCartney concert at AT&T Park in San Francisco in 2010 when he took particular note of the “haze of smoke over the whole audience.” Springer, a professor of medicine at UC San Francisco, had studied the effects of second-hand tobacco smoke on heart and vascular function. But this smoke was marijuana, a fact that McCartney noted from the stage as the performer commented on the familiar herbal scented San Francisco air, Springer recalled. (Hecht, 4/21)

The Orlando Sentinel: How DNA Influences Your Sex Life
Your DNA doesn’t determine when you lose your virginity, but it may play a larger role in the matter than scientists had thought. A new study identifies 38 specific places in the human genome that appear to be associated with the age at which people first had sex. These spots affect a range of genes, including some that seem to affect the timing of puberty and others that have been linked with risk-taking behavior. (Kaplan, 4/21)

Politico: Trump Girds For Showdown With Anti-Abortion Groups
As Donald Trump hurtles toward the Republican convention, he is on a collision course with the anti-abortion movement — a crucial conservative constituency that contends Republicans must own that issue to win a general election. Leaders of the movement are suspicious, if not outright opposed, to the three-time married billionaire who only recently came to oppose abortion and whose gaffes suggest he does not understand the issue. The latest flap exploded Thursday after Trump vowed he would "absolutely" change the Republican platform opposing abortion "for the three exceptions" — rape, incest and to protect the life of the mother. The platform is silent on exceptions, but anti-abortion groups such as March for Life shot back that Trump's revisions would undermine the party's "solidly pro-life" position. (Haberkorn, 4/21)

Politico: Trump Vows To Put Abortion Exceptions In GOP Platform
Donald Trump would “absolutely” change the Republican Party’s platform on abortion to include exceptions for rape, incest and life of the mother. “Yes, I would,” Trump told NBC’s “Today” on Thursday when asked if he would change the party’s provision. “Yes, I would. Absolutely. For the three exceptions, I would.” The real estate mogul demurred when asked if he would include an exception for threats to the health of the mother — not just to her life — sticking to conservatives' traditional exceptions. (McCaskill, 4/21)

The Washington Post: NIH Hospital Needs Sweeping Reform To Better Protect Patient Safety, Panel Says
Practices at the National Institutes of Health Clinical Center, the hospital where cutting-edge medical research is conducted, require sweeping reform to better protect patient safety, a task force appointed by the agency reported Thursday. The panel of experts, appointed by NIH Director Francis S. Collins, found that the hospital’s research focus sometimes took priority over the safety of the critically ill patients treated there. It also said that the center has many “outdated or inadequate facilities” and that personnel lack expertise on regulations that apply to the hospital and its research and drug-manufacturing units. (Bernstein and McGinley, 4/21)

NPR: Task Force Calls For More Safety Oversight At NIH Research Hospital
That's the conclusion of a sweeping review by a task force of independent experts convened by the NIH. The team has made a slew of recommendations, including the creation of an outside hospital board to oversee the clinical center, and a new central office to coordinate research quality and safety oversight. "The emphasis on research is so great, and on trying to save people's lives, that there became a cultural attitude that overshadowed handling some of the details that are important details," says Norman Augustine, former CEO of Lockheed Martin, who chaired the task force. (Greenfieldboyce, 4/21)

The New York Times: A Marriage Gone Bad: Walgreens Struggles To Shake Off Theranos
Many boldface names enabled the stratospheric rise of the blood-testing start-up Theranos: two former secretaries of state, a former secretary of defense, two former senators, a retired admiral, venture capitalists, scientific luminaries and a prestigious clinic. None has been more important to Theranos than Walgreens. (Stewart, 4/21)

NPR: New Overtime Rules May Put Squeeze On Caregivers For Those With Disabilities
In coming weeks, the White House is expected to finalize key new rules on overtime pay that could benefit an estimated 6 million lower-paid salaried workers. Workers' advocates say it's a long-awaited change. Most employer groups vocally oppose the new rules, because they might have to raise their minimum salaries, pay overtime — or limit their workers' hours. Much of the debate has pitted workers against employers. But at least one group is sympathetic to both sides: the American Network of Community Options and Resources, or ANCOR, an association that represents employers offering support services to intellectually disabled people. (Noguchi, 4/21)

Kaiser Health News: Some Firms Save Money By Offering Employees Free Surgery
Lowe's home improvement company, like a growing number of large companies nationwide, offers its employees an eye-catching benefit: certain major surgeries at prestigious hospitals at no cost to the employee. How do these firms do it? With "bundled payments," a way of paying that's gaining steam across the health care industry, and that Medicare is now adopting for hip and knee replacements in 67 metropolitan areas, including New York, Miami and Denver. (Tomsic, 4/22)

The New York Times/ProPublica: New York Hospital To Pay $2.2 Million Over Unauthorized Filming Of 2 Patients
NewYork-Presbyterian Hospital has agreed to pay a $2.2 million penalty to federal regulators for allowing television crews to film two patients without their consent — one who was dying, the other in significant distress. Regulators said on Thursday that the hospital allowed filming to continue even after a medical professional asked that it stop. At the same time, regulators clarified the rules regarding the filming of patients, prohibiting health providers from inviting crews into treatment areas without permission from all patients who are present. That could end popular television shows that capture emergencies and traumas in progress, getting permission from patients only afterward. (Ornstein, 4/21)

In other hospital news —

The Associated Press: Los Angeles Hospital Settles Over Leaving Patient On Street
A fourth Los Angeles-area hospital in less than three years has settled a lawsuit over a chronic problem in the nation's second-largest city — turning homeless patients out on the streets after they have been discharged, sometimes while still needing medical attention. Without acknowledging fault, Good Samaritan Hospital near downtown Los Angeles settled for $450,000 and agreed to follow protocols to properly release homeless patients, City Attorney Mike Feuer said Thursday. That brings the amount of such settlements with area hospitals to $1.9 million since January 2014. (4/21)

The News and Sentinel: Authority Blocks Marietta Memorial Bid To Establish Care Facility In Parkersburg
Marietta Memorial Hospital will not be able to establish an ambulatory care facility in Parkersburg, following a ruling from the West Virginia Healthcare Authority. (Dunla, 4/21)

The San Antonio Express News: Appeals Court Upholds Texas’ Medicaid Cuts
A state appeals court Thursday upheld hundreds of millions of dollars in Medicaid cuts imposed by the Legislature, dealing a setback to providers and patients who said the cuts would be devastating for disabled children. (Ketterer, 4/21)

The Austin American Statesman: Appeals Court Tosses Lawsuit Blocking Texas Medicaid Cuts
The ruling by the Austin-based 3rd Court of Appeals also lifted a temporary injunction that had blocked Texas from implementing cuts that were intended to begin Oct. 1, 2015, but state officials haven’t yet determined when the new reimbursement rates will take effect, a spokesman for the Texas Health and Human Services Commission said Thursday. (Lindell, 4/21)

The Dallas Morning News: Texas Can Cut Disabled Kids’ Therapists’ Medicaid Pay, Appeals Court Rules
Some have warned the cuts would disrupt care for tens of thousands of disabled children, especially in rural Texas. But the the three Republican judges who heard the case said providers and patients lacked jurisdiction to sue. The plaintiffs have no vested right to a certain reimbursement fee, the judges ruled. “Medicaid benefits are entitled to constitutional protection, but this protection does not mandate that a Medicaid participant has access to a particular provider or that a participant’s provider will continue to receive payment or reimbursement rates at a previously set amount,” Justice Melissa Goodwin wrote. (Garrett, 4/21)

The Texas Tribune: Court Tosses Lawsuit Over Medicaid Cuts To Therapy
The reduced payments to therapists were ordered by the Legislature last year but were temporarily halted by a state district judge on the grounds that they might irreparably harm children. Speech, physical and occupational therapists argued they would be forced to stop treating children under the state’s current two-year budget, which includes a roughly 25 percent cut to the amount of money some pediatric therapists are paid by Medicaid, the joint federal-state insurer for the poor and disabled. Dan Richards, the lead attorney challenging the state, said he was “extremely disappointed” with the ruling and would ask federal health officials to intervene. (Walters, 4/21)

The Houston Chronicle: Appeals Court Clears Way For Disputed Medicaid Therapy Cuts
The decision is a major victory for the state, signaling a possible end in the monthslong debate over the Medicaid reductions. Lawyers who sued the state previously argued that the cuts would affect 60,000 mentally ill and disabled Texas children who rely on Medicaid coverage. The state countered, saying the number of state Medicaid therapy providers grew 30 percent between 2009 and 2014, and that their reimbursement rates were higher than in many other states. (Ketterer, 4/21)

And in Medicaid news from Ohio —

The Columbus Dispatch: Opponents: Medicaid Fee Plan Would Hurt Poorest
About a dozen people spoke out against a state plan that would implement new fees for those receiving government health coverage, saying the proposal would disproportionately penalize the poorest in the state and cause tens of thousands of Ohioans to lose coverage. (Perkins, 4/21)

The Cleveland Plain Dealer: Proposal To Make Medicaid Recipients Pay For Their Care Roundly Criticized In Columbus
A state proposal to make Medicaid recipients pay for a portion of their medical care was roundly criticized in Columbus Thursday, with citizens and advocates for low-income residents arguing it would undermine care and increase costs. (Ross, 4/21)

The Texas Tribune: Texas Health Commissioner Reportedly Retiring
Texas Health and Human Services Executive Commissioner Chris Traylor plans to retire at the end of May after 11 months on the job, according to sources briefed on the decision. Traylor was named the agency's chief last June just as he was poised to retire from the health and human services agency. He is a former commissioner of the Texas Department of Aging and Disability Services. (Walters, 4/21)

The Houston Chronicle: Top Texas Health Official To Retire Next Month
For the second time in a year, Texas is losing its top health and human services official. Chris Traylor, who has led the Texas Health and Human Services Commission since last summer, is planning to retire next month, according to three sources briefed on the decision. (Rosenthal, 4/21)

The Associated Press: Medical Center, Insurer Negotiating Contract Dispute
A rift between a medical center and a health care company threatens to suspend coverage for thousands of patients. The News Journal of Wilmington reports that the current contract between Bayhealth Medical Center and Highmark Blue Cross Blue Shield of Delaware to reimburse the hospital for its care of the insurer’s customers expires May 15. The medical center and the insurer say they want a resolution but are preparing for a contract lapse. A portion of the 18,000 Highmark customers that use Bayhealth would be affected. (4/21)

NPR/Nashville Public Radio: Overcrowding Forces Tennessee VA Clinic To Stop Accepting New Patients
It's been nearly two years since the Department of Veterans Affairs came under fire for the amount of time veterans had to wait to see a doctor. The agency scrambled to find a fix, including allowing vets the option of seeing a private doctor via a program they call Veterans Choice. But the fix isn't working, so some VA clinics are coming up with other ideas to reduce wait times. In the city of Clarksville, Tenn., the VA clinic decided it simply couldn't take any new patients. (Siner, 4/22)

Health News Florida: New Tool To Help Floridians Learn More About Healthcare Prices
Consumers skeptical about the real cost of healthcare will soon have a resource where they can ask and share with their neighbors the price of common medical procedures. Starting Thursday, WLRN, WUSF and Health News Florida are teaming up with ClearHealthCosts.com, a health cost transparency company, to launch PriceCheck, a database that blends together prices of common healthcare procedures collected with information from consumers living in South Florida and the Tampa Bay area. (4/21)

The Tampa Bay Times: USF Doctor Named To Run State Health Plan Under Fire For Removing Sick Kids
The Florida Department of Health on Wednesday announced the new senior official over a health coverage program for the state's sickest kids. Dr. John Curran, a regional medical director for the Children's Medical Services program and associate vice president of the University of South Florida College of Medicine, will take over the job as deputy secretary for CMS. (Auslen, 4/21)

The Oregonian: LifeWise Health Plan Of Oregon Is Pulling Out Of The State
LifeWise Health Plan of Oregon is pulling out of the state's competitive insurance market. The company, headquartered in a Seattle suburb, will continue covering its individual customers through the end of the year and will eliminate group plans at the end of their term this year or in 2017. (Terry, 4/21)

Modern Healthcare: Chicago-Area HIE Sues IT Vendor Over Shutdown Plans
The hospital association that operates a major Chicago-area health information exchange is suing its health information technology vendor that abruptly announced it will go out of business. (Conn, 4/21)

The Houston Chronicle: Houston-Area Woman First Expectant Mother Here Testing Positive For Zika Virus
A pregnant Fort Bend County woman who traveled from El Salvador earlier this year has tested positive for the Zika virus, Legacy Community Health announced. (Hawryluk, 4/21)

The Washington Post: ‘Both Of Them Made This Decision': The Apparent Murder-Suicide Of A Death-With-Dignity Advocate And His Ailing Wife
One gunshot. Then another. Within minutes, a prominent death-with-dignity advocate was shot dead along with his ailing wife in an assisted living center in Florida. Eighty-one-year-old Frank Kavanaugh — who served on the national advisory board for the Final Exit Network, an advocacy organization in the right-to-die debate — was discovered dead in the early morning hours Tuesday alongside his wife, 88-year-old Barbara Kavanaugh. (Bever, 4/22)

The St. Louis Post-Dispatch: St. Louis Nonprofit Helps Keep AIDS Patients, Pets Together
It was the late 1980s and the mysterious deadly disease striking gay men had become a four letter word. Beyond a name however, little was known about AIDS. Doctors could only offer comfort and tell those with the new diagnosis to get their affairs in order. The disease also brought isolation, with friends and family falling away. (Moore, 4/21)

The New England Journal of Medicine: Readmissions, Observation, And The Hospital Readmissions Reduction Program
Some policy analysts worry that reductions in readmissions [mandated by the Affordable Care Act] are being achieved by keeping returning patients in observation units .... We analyzed data from 3387 hospitals. From 2007 to 2015, readmission rates for targeted conditions declined from 21.5% to 17.8%, and rates for nontargeted conditions declined from 15.3% to 13.1%. ... Stays in observation units for targeted conditions increased from 2.6% in 2007 to 4.7% in 2015, and rates for nontargeted conditions increased from 2.5% to 4.2%. ... Readmission trends are consistent with hospitals’ responding to incentives to reduce readmissions, including the financial penalties for readmissions under the ACA. We did not find evidence that changes in observation-unit stays accounted for the decrease in readmissions. (Zuckerman et al., 4/20)

Pediatrics: Characteristics Of Rural Children Admitted To Pediatric Hospitals
[Researchers analyzed] 672190 admissions between January 1, 2012, and December 31, 2012, to 41 children’s hospitals .... Rural children accounted for 12% of all admissions ... to the children’s hospitals. Compared with nonrural children, rural children lived farther from the hospital ... and more often resided in low-income ZIP codes (53% vs 24%) and Health Professional Shortage Areas (20% vs 4%) .... Rural children had a higher prevalence of complex chronic conditions (44% vs 37%) ... and medical technology assistance (15% vs 12%) .... In multivariable analysis, rural children experienced higher inpatient costs (mean: $8507 vs $7814) ... and higher odds of 30-day readmission. (Peltz et al., 4/11)

JAMA Internal Medicine: Primary Care Practitioners’ Views On Incorporating Long-Term Prognosis In The Care Of Older Adults
Clinical practice recommendations increasingly advocate that older patients’ life expectancy be considered to inform a number of clinical decisions. ... Twenty-eight primary care practitioners [in a large group practice who were interviewed for the study] ... reported considering life expectancy, often in the range of 5 to 10 years, in several clinical scenarios in the care of older adults .... patient age was found to modulate how prognosis affects the primary care practitioners’ decision making, with significant reluctance among them to cease preventive care that has a long lag time to achieve benefit in younger patients despite limited life expectancy. The participants assessed life expectancy based on clinical experience rather than using validated tools .... Participants often considered prognosis without explicitly discussing it with patients. (Schoenborn et al., 4/11)

The Kaiser Family Foundation: Characteristics Of Remaining Uninsured Men And Potential Strategies To Reach And Enroll Them In Health Coverage
As of the beginning of 2015, there were still over 27 million uninsured nonelderly adults in the U.S. More than half of these uninsured adults were men – or nearly 15 million. An estimated 44% of these men, or nearly 6.5 million, are currently eligible for financial assistance under the ACA. Targeted outreach and enrollment efforts will be key for reaching and enrolling these uninsured men into coverage and achieving continued coverage gains. (Hinton and Artiga, 4/14)

Urban Institute: Uninsurance Among Young Children, 1997–2015: Long-Term Trends And Recent Patterns
This brief uses data from the National Health Interview Survey to explore trends in health insurance coverage for children age 5 and under between 1997 and 2015. Previous studies have shown that children’s health insurance coverage is associated with improved access to care and that early childhood offers a critical opportunity to promote long-term health and development. In this analysis, we find a 75 percent decrease in uninsurance for young children since the creation of the Children’s Health Insurance Program in 1997, though some subgroups of young children continue to have disproportionately high uninsurance rates. We also find that insured young children have greater access to care and service use, and their families struggle with fewer affordability problems than those of young children who are uninsured. (Karpman et al., 4/19)

Urban Institute: Uninsurance Among Children, 1997–2015 : Long-Term Trends And Recent Patterns
Using data from the National Health Interview Survey, this brief examines changes in the share of children age 18 and under without health insurance between 1997 and 2015. We also explore the characteristics and health care experiences of the remaining uninsured children in 2014. We find that the uninsurance rate for children has fallen steadily since the introduction of the Children’s Health Insurance Program in 1997 and that uninsurance continued to drop following implementation of the Affordable Care Act’s key coverage provisions. However, some groups of children are disproportionately likely to be uninsured, and uninsured children face large gaps in health care access, affordability, and service use compared with their insured peers. (Gates et al., 4/19)

The Kaiser Family Foundation: An Overview of Medicare
Medicare plays a key role in providing health and financial security to 55 million older people and younger people with disabilities. ... Many people on Medicare live with health problems including multiple chronic conditions, cognitive impairments, and limitations in their activities of daily living, and many beneficiaries live on modest incomes. In 2011, two-thirds of beneficiaries (66%) had three or more chronic conditions, more than one quarter of all beneficiaries (27%) reported being in fair or poor health, and just over 3 in 10 (31%) had a cognitive or mental impairment. ... Two million beneficiaries (5%) lived in a long-term care facility. In 2014, half of all people on Medicare had incomes below $24,150 per person and savings below $63,350. (4/1)

Cato Institute: Menu Mandates and Obesity: A Futile Effort
One provision of the Patient Protection and Affordable Care Act (ACA) that has been delayed until 2017 is a federal mandate for standard menu items in restaurants and some other venues to contain nutrition labeling. ... Menu mandates have been implemented at the state and local level within the past decade, allowing for a direct examination of the short-run and long-run effects on outcomes such as body mass index (BMI) and obesity. Drawing on nearly 300,000 respondents from the Behavioral Risk Factor Surveillance System (BRFSS) from 30 large cities between 2003 and 2012, we explore the effects of menu mandates. We find that the impact of such labeling requirements on BMI, obesity, and other health-related outcomes is trivial, and, to the extent it exists, it fades out rapidly. (Yelowitz, 4/13)

Here is a selection of news coverage of other recent research:

MedPage Today: Study: Carotid Imaging Without Prior Stroke Often Has No Clear Indication
The most common reasons for carotid imaging leading to revascularization in seniors without history of stroke are not adequately addressed in guidelines, a veterans study suggested. ... Only 5.4% of the imaging was done for indications deemed clearly appropriate, while 11.3% of screens were deemed inappropriate, the researchers reported in JAMA Internal Medicine. Thus, "the majority of patients who undergo carotid revascularization for asymptomatic carotid disease received a diagnosis on the basis of results of tests ordered for uncertain or inappropriate reasons," [the researchers] wrote. (Lou, 4/18)

Reuters: Stigma Keeps Some Cancer Patients From Getting Palliative Care
Some cancer patients may turn down care that could ease their pain and improve their quality of life because they think this type of “palliative” treatment amounts to giving up and simply waiting to die, a small Canadian study suggests. (Rapaport, 4/18)

Reuters: 'Nonurgent' Patients Might Still End Up Being Hospitalized
Patients assigned a “nonurgent” status on arrival in the emergency room might still be sick enough to be hospitalized, a new study shows. Patients deemed by triage nurses to be “nonurgent” often receive diagnostic services and procedures, and some are even admitted to critical care units, researchers found. Triage was never intended to completely rule out severe illness, only to give patients an estimate of how long they may have to wait to see a doctor, the researchers note. (Doyle, 4/18)

Bloomberg: Trumpism Makes Social Security And Medicare Less Safe
Donald Trump says Paul Ryan is wrong about Social Security and Medicare. The Republican speaker of the House wants to “knock Medicare way down,” according to Trump, and do the same to Social Security. Trump says this approach would cost Republicans the election, and also be unfair to people who have paid into these programs. (Ramesh Ponnuru, 4/21)

Forbes: Health Plan Industry's Worst Nightmare: Employers Realizing They Are Actually The Insurance Company
The best book I’ve read to help understand the underlying dynamics of healthcare’s under-performance is David Goldhill’s “Catastrophic Care: Why Everything We Know About Health Care is Wrong.” Goldhill goes into great depth on the destructive dynamics of having what he calls “surrogates” — i.e., insurance companies — between us and clinicians. It’s not the simplistic demonization of insurance companies one often sees. In fact, Goldhill argues that health plans are acting quite rationally within an irrational set of circumstances. (Dave Chase, 4/19)

The Wall Street Journal: Little Sisters Of The Poor Say ‘Yes’ To The Court
I have said “yes” many times in my life. I said “yes” as a young woman, when I felt God was calling me to serve the elderly poor. I have said “yes” since then, day and night, to accompanying men and women in their last hours before God calls them to Himself. Last week, I said “yes” to an unexpected solution that the Supreme Court proposed to the case involving our religious order. Following oral arguments last month, the justices took an unusual step: They asked if there were ways for the government to provide contraceptives and other services to our employees without involving our health plan and violating our conscience. The government, in its response, said that it would not consider alternative options. (Loraine Maguire, 4/21)

Time: Theranos Is The Collision Of Hope And Greed
Had your blood drawn lately? If not chances are good you will soon. About 10 billion tests are done every year on our blood. Diagnostic blood tests are a huge component of American health care, costing $73 billion a year—roughly $10 billion of which comes from Medicare and Medicaid. Not only do blood tests cost a fortune, the results of these tests determine a huge proportion of what happens next to patients. Whether you get a prescription, undergo further testing, enter the hospital, begin chemotherapy and hundreds of other decisions rely on the results of testing your blood. (Dr. Arthur L. Caplan, 4/20)

Los Angeles Times: In Search Of Fair Drug Prices
When CVS Health in February began taking over pharmacy operations at more than 1,600 Target stores, CVS Pharmacy President Helena Foulkes called the changeover "an important milestone." "Our heart is in every prescription we fill, and providing accessible, supportive and personalized healthcare is part of our DNA," she said. (David Lazarus, 4/22)

The Wall Street Journal: The FDA Vs. Austin Leclaire
No government agency controls the fate of more people than the Food and Drug Administration, which has the power to deny children a treatment that could help them walk. The FDA is reviewing an experimental drug for muscular dystrophy, and the outcome could determine the quality of life for thousands—and whether companies continue to invest in curing rare diseases. (4/21)

The Boston Globe: Nursing Home Workers Are Worth More
Alyson Williams, an immigrant from Trinidad and Tobago who lives in Dorchester, has always known one profession: taking care of the elderly. When she was 19, her grandmother fell prey to the usual depredations of old age. “She raised me; she took care of me growing up. Then she got sick. I felt like I owed her, had so much gratitude for what’s she had done for me that I said, ‘I’m going to take care of her.’” Now, Williams, who’s in her early 40s, is a certified nursing assistant and has been working at Marina Bay Skilled Nursing Center for the last three years. (4/22)

The Columbus Dispatch: Threat Of Zika Virus Has Grown
The link between the Zika virus and microcephaly in babies was confirmed last week by scientists at the Centers for Disease Control and Prevention, the latest in a series of increasingly troubling revelations about the mosquito-borne disease. First, it’s not just mosquito-borne; it can also be passed among humans via sexual contact. Since symptoms are so mild, if present at all, many carriers of the virus might pass it along without realizing they were infected. (4/22)

The Columbus Dispatch: Suicide Prevention Everyone's Business
Since 2000, more than 20,000 Ohioans have taken their lives. That’s appalling on its face, but even worse is that, unlike other leading causes of death, suicide is considered 100 percent preventable. With public awareness, early intervention and an effective mental-health system, people could be helped before they ever reached the point of contemplating suicide, or stopped if they are on the verge. (4/22)

The Washington Post: Why Africa’s HIV Crisis Continues To Devastate Young Women
Mary, who is 24 but looks barely 18, has already experienced more than enough betrayal for any lifetime. Shyly but deliberately, she told of feeling sick at 16 and being diagnosed with HIV. After her mother — her only provider — was sent to prison, an aunt took Mary in, but forced her to sleep in an open-walled shed behind the house. Then she was raped by a boyfriend. “I went home crying and bleeding,” she recalled. Mary told no one, fearing she would be turned out on the street. “I kept quiet, by myself.” Four months later, she learned she was pregnant. (Michael Gerson, 4/21)