Politico Pro: Survey: Many Employers Aren’t Ready For Obamacare Mandate
Most companies are not prepared for Obamacare’s employer mandate, and nearly two-thirds of large employers are increasing workers’ share of their health care costs, according to a report released Thursday. (Norman, 1/15)

Politico Pro: Obamacare Reform Effort Hampered By Technology
An Obamacare program that was supposed to spearhead movement toward prioritizing health over medical procedures is stuck with the same big problem as the rest of the health care system: The information isn’t flowing smoothly, so doctors have trouble coordinating the care of their patients. Doctors and hospitals who work in accountable care organizations, which were created under the Affordable Care Act, are finding it hard to share electronic records with each other or with other hospitals and providers. (Pittman, 1/16)

Bloomberg: Obamacare Will Make Filing Taxes An Even Bigger Headache For Millions
Obamacare is about to collide with the U.S. tax-filing season, adding frustration for millions of taxpayers trying to figure out how to comply and how much they will owe the government. Tax filing for 2014 opens Jan. 20. The biggest change for most taxpayers is on Line 61 of Form 1040: a box to check if you have health insurance and a tax to pay if you don’t. Millions who received insurance through Obamacare’s exchanges will have a more complicated set of calculations to complete. (Rubin, 1/15)

The Miami Herald: Airport Companies Move Workers Onto Employer Health Plans -- Like It Or Not
Two companies that employ baggage handlers and other workers at Miami International Airport forced employees to sign up for company-sponsored healthcare plans and pay part of the cost from their hourly wages even if the workers already had coverage through an outside source such as a spouse or the military. Workers at the two companies, Ultra Aviation Services and Eulen America, were automatically enrolled in the employer plans starting Jan1. (Nehamas, 1/15)

ML Live/Kalamazoo Gazette: Planned Parenthood Closing Battle Creek Clinic At End Of January; Obamacare Cited As Factor
Planned Parenthood Mid and South Michigan is closing its Battle Creek clinic, citing "increasing competition and declining patient demand" as a result of the Affordable Care Act. The last day of operation will be Jan. 31. Spokeswoman Desiree Cooper said the need for Planned Parenthood's health-care services has declined because of the ACA, which has greatly improved access to subsidized contraceptives and women's health-care services. (Mack, 1/13)

Still, many health care executives say they think the law is here to stay --

Reuters: U.S. Health Care Execs Say Obamacare Not Going Anywhere
U.S. healthcare executives say Obamacare is likely here to stay, despite repeated calls from Republican lawmakers for repeal of the 2010 law aimed at providing health coverage for millions of uninsured Americans. Top executives who gathered in San Francisco this week for the annual J.P. Morgan Healthcare conference, say that while President Obama's signature domestic policy achievement may well be tweaked, it is too entrenched to be removed. (Beasley and Morgan, 1/15)

Huffington Post: Key Obamacare Official Stepping Down
Marilyn Tavenner will resign as administrator of the Centers for Medicare and Medicaid Services, effective at the end of February, officials in President Barack Obama’s administration told The Huffington Post. Andrew Slavitt, the agency’s second-ranking official, will take over in an acting capacity. An announcement is planned for Friday. Tavenner is the latest high-profile resignation after the botched early implementation of the Affordable Care Act. (Cohn and Young, 1/16)

Bloomberg: Medicare’s Tavenner To Depart After Obamacare Error Revealed
Marilyn Tavenner, head of the U.S. Centers for Medicare and Medicaid Services, plans to step down at the end of February, she told her staff in an e-mail. ...In November, Tavenner acknowledged that her agency had made a mistake in its calculation of the number of people enrolled under Obamacare. About 393,000 individuals with both health and dental coverage were “inadvertently counted twice,” she said in a letter to Representative Darrell Issa, a California Republican whose committee discovered the error. (Wayner, 1/16)

The Wall Street Journal: Top U.S. Health Official Marilyn Tavenner To Step Down
Marilyn Tavenner, the top official at the U.S. agency overseeing the troubled rollout of the health law and the Medicare insurance program for the elderly, is leaving her post in February, agency officials confirmed Friday. (Radnofsky, 1/16)

The New York Times: Head Of Medicare And Medicaid Is Stepping Down
Ms. Tavenner ... had given no public indications that she would be stepping down. She joined the administration in February 2010, a few weeks before President Obama signed the Affordable Care Act. (Pear, 1/16)

In other HHS news -

The Wall Street Journal's Washington Wire: Burwell Lists Likely Common Ground With GOP, But Not The Health Law
Health and Human Services Secretary Sylvia Mathews Burwell headed to a left-leaning think tank Thursday to say she was offering a olive branch to the new Republican-led Senate. “I count myself among those who do not believe that disagreements in some areas – even significant disagreements – should prevent us from moving forward on others,” Ms. Burwell said at the New America Foundation. (Radnofsky, 1/15)

Kaiser Health News: Burwell Calls For Congress To Work With Her On Health Issues
Department of Health and Human Services Secretary Sylvia M. Burwell Thursday called on Congress to look beyond the Affordable Care Act to find compromise on health care. In remarks at the New America Foundation, Burwell cited several areas – including opioid abuse, Ebola, medical research and innovation – where Republicans and Democrats have sponsored legislation to work together to solve problems in the nation’s health care system. (Carey, 1/15)

The Hill: Burwell Urges GOP To 'Move Beyond' ObamaCare Arguments
Health and Human Services (HHS) Secretary Sylvia Mathews Burwell on Thursday promised a "vigorous" defense of ObamaCare this Congress as she outlined policy priorities she said could receive bipartisan support, such as addressing prescription drug abuse and accelerating the development of medical cures. She also downplayed Republican plans to target pieces of the healthcare law now that the GOP is in control of both chambers on Capitol Hill. (Viebeck, 1/15)

The Wall Street Journal: States Stand Pat Ahead Of Supreme Court Health-Law Ruling
A push in states to protect consumers’ insurance tax credits in the face of a Supreme Court challenge is losing steam because of political and practical obstacles to reworking the health law’s exchanges, raising the stakes in the court battle. At issue are subsidies for millions of consumers under the Affordable Care Act that make health plans cheaper. In 37 mostly Republican-controlled states, the federal government has a hand in running the exchanges where consumers buy insurance. About 4.7 million people in those states got billions of dollars of tax credits to offset the cost of insurance premiums for 2014, and more are expected to get them this year. (Radnofsky, 1/15)

Los Angeles Times: California Rejects UnitedHealth's Bid To Sell Obamacare Statewide
California's Obamacare exchange rejected a bid from the nation's largest health insurer to start selling coverage statewide next year. The Covered California board adopted new rules Thursday that sharply limit where industry giant UnitedHealth Group Inc. could offer policies to individuals. Many consumer advocates backed the exchange's decision. But California Insurance Commissioner Dave Jones panned it, saying Californians deserve more choice and competition statewide. (Terhune, 1/15)

Kaiser Health News: Limited Insurance Choices Frustrate Some Patients In California
When Dennie Wright went to sign up for Affordable Care Act insurance last year, it wasn’t a hard decision. His insurance agent told him he had only one insurer – Anthem Blue Cross – that he could buy from on the exchange, Covered California. Wright lives in a modest house overlooking a pasture in Indian Valley. It’s a tiny alpine community at the northern end of the Sierra Mountains, close to the border with Nevada. He lives in one of 250 zip codes where Blue Shield of California stopped selling individual insurance policies in 2014. (Bartolone, 1/15)

The Associated Press: About 75,900 Kansans Sign Up For Federal Health Plan
A federal report says about 75,900 Kansans either signed up or automatically re-enrolled in a health care plan through the Affordable Care Act’s Health Insurance Marketplace. The U.S. Department of Health and Human Services says those who signed up by Thursday will receive their coverage starting Feb. 1. The final open enrollment deadline for this year is Feb. 15. (1/15)

Los Angeles Times: California: Latino Enrollment In Obamacare Opens Strong
California's health exchange said it has seen a strong turnout among Latinos for Obamacare coverage after nearly two months of open enrollment. Covered California struggled at times to reach uninsured Latinos during the initial rollout of the Affordable Care Act, and it was roundly criticized by state lawmakers for marketing missteps. (Terhune, 1/15)

The San Jose Mercury News: Obamacare: Latino Enrollment Numbers In California Show Mixed Results
A retooled, multi-million-dollar marketing effort by the state's health care exchange to persuade more of the state's Latino residents to obtain insurance under the nation's health care law is showing mixed results, according to enrollment data released Thursday. ... During a presentation to the exchange's board of directors Thursday, Covered California's executive director, Peter Lee, told the board that half of the roughly 300,000 people who have been determined eligible for coverage are Latinos but have not yet selected a plan. (Seipel, 1/15)

The California Health Report: Left Behind By The Affordable Care Act
More than 3 million previously uninsured Californians gained health insurance since the start of the ACA’s first enrollment period, according to a July study from the Kaiser Family Foundation. Almost 30 percent of the remaining uninsured, however, are undocumented immigrants who are ineligible for both Medi-Cal and assistance through Covered California. (Dayton, 1/15)

AARP looks into the enrollment issues for Asian Americans.

NBC News: Report Exposes Health Coverage Gap Across Asian-American Seniors
A new AARP report finds that among all Asian American and Pacific Islanders (AAPI) 50 years and older, up to 20 percent lack health insurance due to cost concerns. But the organization says because of the diversity within the community, coverage rates vary widely across ethnicities. (Guillermo, 1/15)

Georgia Health News: Legislator: Medicaid Expansion May Get A Look
A Republican state senator said Thursday that he believes the General Assembly will hold hearings this year on the idea of Medicaid expansion in Georgia. “I think there’s a number of Republican [legislators] who are looking for a solution,’’ said Sen. Chuck Hufstetler (R-Rome), after speaking on a legislative panel at an event sponsored by the consumer group Georgians for a Healthy Future. ... Another state senator and panel member, Dr. Dean Burke (R-Bainbridge), told the Atlanta audience Thursday that the chances of expansion occurring in Georgia have increased. (Miller, 1/15)

Stateline: States Gear Up To Help Medicaid Enrollees Beat Addictions
Under the Affordable Care Act, millions of low-income adults last year became eligible for Medicaid and subsidized health insurance for the first time. Now states face a huge challenge: how to deal with an onslaught of able-bodied, 18- to 64-year olds who haven’t seen a doctor in years. ... Until now, the vast majority of Medicaid beneficiaries were pregnant women, young children, and disabled and elderly adults. Relatively few able-bodied adults without children qualified, so states did not set up their Medicaid programs to treat them. (Vestal, 1/15)

The Miami Herald: Report: Florida Hospitals At Risk Of Losing $1.3B
Florida is at risk of losing about $1.3 billion in federal funds used to reimburse hospitals that treat large numbers of poor and uninsured patients — including Miami-Dade’s Jackson Health System — jeopardizing the medical centers’ ability to continue serving those populations, according to a report released Thursday by state healthcare officials. The 244-page report was required by federal regulators who wanted Florida healthcare officials to explain how the state will ensure that hospitals can continue treating patients with Medicaid, the federal-state program for the poor and disabled, without relying on a special pot of supplemental money known as the Low Income Pool or LIP program. (Chang, 1/15)

The Wall Street Journal's Washington Wire: GOP's Top Priority: Passing A Budget Resolution
Republicans are still wrestling with how to use a contentious procedural budget tool known as “reconciliation” that enables lawmakers to attach related measures to the budget and pass them as well with a simple majority. Some lawmakers view reconciliation as an opportunity to try to repeal the Affordable Care Act, while others think that would be a waste, given that President Barack Obama would veto any attempt to undo the health law. Overhauling the tax code could be a better use of the procedure, some Republicans have suggested. (Peterson, 1/15)

The Hill: GOP Plotting Response To Obamacare Scotus Case
House Republicans are crafting an Obamacare backup plan in light of a Supreme Court case this summer that could strike down a key piece of the health care law. The case, King v. Burwell, was a central topic at the House GOP’s closed-door health care meeting during its retreat in Hershey, Pa., according to an aide attending the session. (Ferris, 1/15)

CQ HealthBeat: Medicare Adviser Renews Call For Permanent 'Doc Fix'
Nearing the end of his term, Congress' top adviser on Medicare exhorted lawmakers to put an end to a widely disparaged budget mechanism that routinely threatens to slash doctors' pay from the big government health program. Medicare Payment Advisory Commission Glenn Hackbarth, who will leave the post this year, noted that Congress has frequently overcome in other instances the same hurdle that has blocked a so-called permanent "doc fix." A bipartisan effort to overhaul the system of payments was scuttled last year due to disagreements over whether and how to offset its costs. (Young, 1/15)

The Associated Press: Obama Tries Again To Get Paid Leave For More Workers
The White House said Obama will push the issue anew in the State of the Union address he delivers Tuesday night to a joint session of Congress. Obama wants Congress, states and cities to pass measures to let workers earn up to a week of paid sick time a year. He’ll also ask for more than $2 billion to encourage states to create paid family and medical leave programs. Obama also will propose that Congress pass legislation giving federal workers an additional six weeks of paid parental leave. (1/15)

Marketplace: President Obama Aims To Pass The Healthy Families Act
[President Barack] Obama is calling on Congress to pass the Healthy Families Act, which would allow workers to earn an hour of paid sick time for every 30 hours they work. (Allington, 1/15)

The Washington Post: Obama Tells Agencies To Advance Sick Leave For Feds With New Children
President Obama signed a memo Thursday directing agencies to advance up to six weeks of paid sick leave to federal employees with a new child. He also is urging Congress to pass legislation providing them an additional six weeks of paid administrative leave. (Davidson, 1/15)

The Associated Press: Booking A Trip To The ER On Your Smartphone? It's A Breeze
Hospitals and doctors increasingly are subscribing to the services to simplify appointment scheduling for patients who dislike waiting on hold and are comfortable doing everything from shopping to banking online. With most of the services, booking is as simple as going to a website, entering a zip code and the kind of care needed, and checking available times. (1/15)

ProPublica: For Nonprofit Hospitals Who Sue Patients, New Rules
Last month, ProPublica and NPR detailed how one nonprofit hospital in Missouri sued thousands of lower income workers who couldn't pay their bills, then seized their wages, all while enjoying a big break on its taxes. Since then, the IRS has released long-awaited rules designed to address such aggressive debt collection against the poor. Largely because these new rules fill a void — there were hardly any rules at all — patient advocates agree they are a major step forward. (Kiel, 1/15)

Modern Healthcare: MedPAC Calls For Cutting Inpatient Rehab Facility Payments
A federal panel's recommendation that reimbursement for rehabilitation be the same for inpatient rehabilitation facilities and skilled-nursing facilities is getting immediate pushback from industry stakeholders who say patient care will suffer.The Medicare Payment Advisory Commission recommended that Congress direct the HHS secretary to eliminate the differences in payments between IRFs and SNFs for selected conditions. (Dickson, 1/15)

The Wall Street Journal: Lawmakers Vow To Keep Close Watch On Veterans Affairs Progress, Spending
Key members of Congress are vowing to ensure the Department of Veterans Affairs follows through on reforms designed to alleviate long wait times at VA facilities that brought down the organization’s top leadership last year. Top legislators in the House and Senate veterans committees said they would scrutinize how the VA’s new leaders spend more than $16 billion in emergency funding approved last year to reform the ailing department. (Kesling, 1/15)

The Associated Press: VA To Look Into Overmedication Report At Tomah Center
The U.S. Department of Veterans Affairs is launching an investigation into reports of overmedication and retaliatory management practices at the VA Medical Center in Tomah, the agency said Thursday. Veterans Health Administration specialists plan to visit the western Wisconsin facility within two weeks to review medication prescription practices, the federal agency said in a statement Thursday afternoon. They also plan to send representatives from the Office of Accountability Review to look into allegations of retaliatory behavior. (1/15)

The Washington Post: CDC: Flu Vaccine Only 23 Percent Effective This Season, But Still Better Than Nothing
So it turns out this season's flu vaccine was kind of a dud. Getting it reduced a person's chance of having to visit the doctor because of the flu by only 23 percent -- and possibly even less for many adults -- according to data released Thursday by the Centers for Disease Control and Prevention. (Dennis, 1/15)

NPR: This Year's Flu Vaccine Is Pretty Wimpy, But Can Still Help
As expected, this year's flu vaccine looks like it's pretty much of a dud. The vaccine only appears to cut the chances that someone will end up sick with the flu by 23 percent, according to the first estimate of the vaccine's effectiveness by the federal Centers for Disease Control and Prevention. The CDC had predicted this year's vaccine wouldn't work very well because the main strain of the flu virus that's circulating this year, known as an H3N2 virus, mutated slightly after the vaccine was created. That enables the virus to evade the immune system response created by getting vaccinated. (Stein, 1/15)

The Des Moines Register: Branstad Seeks To Close Two Mental Institutes
Gov. Terry Branstad has proposed closing two of the state's four institutes for people with mental illnesses. The proposal startled legislators of both parties, although the idea of closing at least one of the institutes has been debated off and on for decades, as their populations dwindled and costs soared. (Leys, 1/15)

The Des Moines Register: Plan Means Fewer Beds In Southern Iowa For Mentally Ill
The proposed closure of two state mental institutions would eliminate more than half the inpatient psychiatric beds available in the southern third of Iowa, a Des Moines Register analysis shows. Gov. Terry Branstad announced this week that he wants to close the Mental Health Institutes located in the southern Iowa communities of Mount Pleasant and Clarinda. A state spokeswoman said Thursday the two facilities have a total capacity of 113 psychiatric beds. (Leys, 1/15)

The Associated Press: Wis. Assembly Speaker Anticipates More Mental Health Legislation
Assembly Speaker Robin Vos says he wants to revisit mental health issues this legislative session [in Wisconsin] with a focus on improving access to care. Vos, a Rochester Republican, created a task force last session to examine mental health needs in the state and has formed a new Assembly committee to work on mental health reform this session. (1/15)

The Associated Press: SC Prisons, Advocates Reach Deal On Inmate Mental Health
South Carolina's prisons would hire more mental health specialists, create safer surroundings and offer more monitoring for mental illness among inmates, under a preliminary agreement with an advocacy group that was announced Thursday. The state and the advocates have been in mediation since last year, when a judge sided with inmates and Protection and Advocacy for People with Disabilities, which had sued the Department of Corrections in 2005. Their lawsuit alleged a lack of effective counseling and too much reliance on tactics like isolation and force to subdue mentally ill prisoners, all in violation of the Constitution. (Kinnard, 1/15)

The Miami Herald: Notorious Miami-Dade Psychiatric Jail Ward Finally Shuttered
The Miami-Dade County Jail’s notorious ninth-floor psychiatric ward — which became a national symbol for the shoddy treatment of the mentally ill behind bars — is no more. After years of criticism and a stinging federal investigation, jailers have quietly shuttered the floor, moving hundreds of mentally ill inmates to newly refurbished and more comfortable units at the Turner Guilford Knight Correctional Center. (Ovalle, 1/15)

The Minneapolis Star-Tribune: Minn. Home Health Care Workers Agree On Contract; Ratification Pending
Just a few months after voting to unionize, home health care workers announced Thursday they have agreed on a contract that would raise their pay floor to $11 an hour, provide funding for training and offer pay protections, SEIU Healthcare Minnesota said. The contract is now heading for a ratification vote by members and still needs approval by the Legislature, which in 2013 pushed through legislation allowing the union certification vote. (Lopez, 1/15)

The Associated Press: Medicaid Management Changes Get Backing Of NC Lawmakers
The Department of Health and Human Services would no longer supervise day-to-day operations of North Carolina's Medicaid program under a bill that received key support Thursday. A General Assembly subcommittee endorsed a measure to shift the state Medicaid office from direct control of the department — run by Gov. Pat McCrory's administration — to a new eight-member Health Benefits Authority. (Robertson, 1/15)

The Sacramento Bee: California Doctors Use Loophole To Raise Drug Prices, Study Finds
Some California physicians who treat workers with job-related injuries and dispense drugs to their patients are exploiting a loophole in state regulations governing drug costs to increase their reimbursements by as much as 400 percent, a new study has found. (Walters, 1/15)

The Texas Tribune: Sources: Abbott Will Wait To Decide On Janek's Future
Amid calls for Texas Health and Human Services Executive Commissioner Kyle Janek to resign over a contracting scandal, sources close to Gov.-elect Greg Abbott said Thursday Abbott won't make a decision about Janek's future until after the completion of state investigations. Also on Thursday, Janek's chief of staff, Erica Stick, told Janek she would leave her job Feb. 6, citing in her resignation letter the ongoing reviews of the agency. Stick, whose husband, an agency executive, resigned in the wake of the scandal, had been placed on paid leave during the investigations. (Langford and Hamilton, 1/15)

The Kansas Health Institute News Service: Brownback Notes Poverty Fight, Medicaid Reform In State Of The State Address
In his first State of the State address since being re-elected, Gov. Sam Brownback said Thursday night that his efforts to fight poverty and reform Medicaid have been a success and outlined a controversial second-term agenda. Brownback, a Republican who defeated Democrat Paul Davis in November, acknowledged that the state has a budget problem. But he pointed to indicators like the state’s unemployment rate — 10th lowest in the country — as evidence that his sweeping income tax cuts are working. (Marso, 1/15)

The New England Journal of Medicine: Practical, Legal, And Ethical Issues In Expanded Access To Investigational Drugs
The expanded-access system [for patients with serious conditions to receive investigational drugs] has become increasingly controversial. Recently, the family of Josh Hardy, a 7-year-old with a life-threatening infection, sought an experimental antiviral drug — brincidofovir — that was recommended by his doctors. ... The question of making untested drugs or vaccines available has also entered public debate in the context of the treatment or prevention of Ebola virus disease .... Each year, thousands of patients wanting to expand their treatment options seek access to incompletely evaluated treatments, but not all obtain them. We discuss the practical, legal, and ethical issues associated with expanded access and use of investigational drugs. (Darrow, Sarpatwari, Avorn and Kesselheim, 1/15)

The New England Journal of Medicine: Trends In Opioid Analgesic Abuse And Mortality In The United States
An estimated 25 million people initiated nonmedical use of pain relievers between 2002 and 2011. The number of deaths per year attributed to prescription opioid medications reached 16,651 in 2010. In response to the epidemic, hundreds of local, regional, state, and federal interventions have been implemented. ... We used the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System to describe the diversion and abuse of prescription opioid analgesics .... Our results show a parallel relationship between the availability of prescription opioid analgesics through legitimate pharmacy channels and the diversion and abuse of these drugs and associated adverse outcomes. (Dart et al., 1/15)

American Journal of Managed Care: Health Information Exchange And The Frequency Of Repeat Medical Imaging
Medical imaging, which is expensive, is frequently repeated for the same patient within a relatively short period of time due to lack of access to previous images. Health information exchange (HIE) may reduce repeat imaging by facilitating provider access to prior images and reports. We sought to determine the effect of an HIE system on the occurrence of repeat imaging. ... We conducted a cohort study of adult patients who consented to participate in a community-based HIE system in an 11-county region in New York. ... Overall, 7.7% of images were repeated within 90 days. If the HIE system was accessed within the 90 days following an initial imaging procedure, imaging was significantly less likely to be repeated (5% repeated with HIE access vs 8% repeated without HIE access. (Vest et al., 1/14)

JAMA Surgery: A Checklist-Based Intervention To Improve Surgical Outcomes In Michigan
There is widespread enthusiasm for the use of checklists to improve hospital outcomes. Perhaps one of the most widely known and successful examples is the Keystone ICU (Intensive Care Unit) Patient Safety Program. ... In this study, we performed a controlled evaluation of a checklist-based quality improvement intervention—Keystone Surgery—that focused on reducing surgical site infections. We were unable to find a significant association between program implementation and adjusted rates of superficial surgical site infection, wound complication, any complication, and 30-day mortality in patients undergoing general surgery in participating hospitals. This finding was robust across multiple analyse. (Reames, Krell, Campbell and Dimick, 1/14)

JAMA Psychiatry: Changes In Drug Coverage Generosity And Untreated Serious Mental Illness
More than 1 in 5 disabled people with dual Medicare-Medicaid enrollment have schizophrenia or a bipolar disorder (ie, a serious mental illness). The effect of their transition from Medicaid drug coverage, which varies in generosity across states, to the Medicare Part D drug benefit is unknown. Many thousands make this transition annually. ... we estimated changes in medication use before and after transitioning to Part D, comparing states that capped monthly prescription fills with states with no prescription limits. ... Transition to Part D in states with strict drug benefit limits may reduce rates of untreated illness among patients with bipolar disorders, who have high levels of overall medication use. Access to antipsychotic treatment may decrease after Part D for patients with a serious mental illness living in states with relatively generous uncapped Medicaid coverage. (Madden et al., 1/14)

The New England Journal of Medicine: Medicare At 50 — Origins And Evolution
Many Americans have never known a world without Medicare. For 50 years, it has been a reliable guarantor of the health and welfare of older and disabled Americans by paying their medical bills, ensuring their access to needed health care services, and protecting them from potentially crushing health expenses. However, as popular as Medicare has become, Congress created the program only after a long and deeply ideological struggle that still reverberates in continuing debates about its future. ... As we mark the beginning of Medicare's 50th anniversary year, this first report in a two-part series recounts the history of this remarkable health care initiative. (Blumenthal, Davis and Guterman, 1/15)

Health Affairs: Medicare Per Capita Spending By Age And Service: New Data Highlights Oldest Beneficiaries
Medicare per capita spending for beneficiaries with traditional Medicare over age 65 peaks among beneficiaries in their mid-90s and then declines, and it varies by type of service with advancing age. Between 2000 and 2011 the peak age for Medicare per capita spending increased from 92 to 96. In contrast, among decedents, Medicare per capita spending declines with age. (Neuman, Cubanski and Damico, 1/14)

The Kaiser Family Foundation: Explaining Armstrong V. Exceptional Child Center: The Supreme Court Considers Private Enforcement Of The Medicaid Act
On January 20, 2015, the United States Supreme Court will hear oral argument in Armstrong v. Exceptional Child Center, a case that has the potential to impact the future ability of private parties to sue states in federal court to enforce the requirements of the Medicaid Act. The case raises the issue of whether Medicaid providers can challenge a state law in federal court on the basis that it violates the federal Medicaid Act and therefore is preempted by the Supremacy Clause of the U.S. Constitution. This issue brief examines the major questions raised by the Armstrong case, explains the parties’ legal arguments, and considers potential effects of a U.S. Supreme Court decision. (Musumeci, 1/14)

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

Healthday: Neck Artery Stents May Not Be Worthwhile In 'Real World' Setting
Placing stents in the neck arteries, to prop them open and help prevent strokes, may be too risky for older, sicker patients, a new study suggests. In fact, almost a third of Medicare patients who had stents placed in their neck (carotid) arteries died during an average of two years of follow-up. "Death risks in older Medicare patients who underwent carotid artery stenting was very high," said lead researcher Dr. Soko Setoguchi-Iwata, an assistant professor of medicine at Harvard Medical School in Boston. Placing a stent in a carotid artery is a way to prevent strokes caused by the narrowing of the artery. A stent is a tiny mesh tube that is placed into an artery to keep blood flowing, in this case to the brain. (Reinberg, 1/14)

MedPage Today/HealthLeaders Media: Patients Clueless About Treatment Risks; Docs Little Help
Patients are dangerously clueless about the true value of many common medical interventions, and physicians aren't doing enough to correct their misunderstandings. That's according to a first-of-its kind meta-analysis of 36 studies, which ran last month in JAMA Internal Medicine. (Clark, 1/12)

The Detroit Free Press: Research Looks At Why Oldest Seniors Are Hospitalized
A new look at hospital discharge data of extremely elderly patients — those 85 or older — underscores how many visits might be avoidable. The National Center for Health Statistics looked at 10 years of discharge data ending in 2010. (Erb, 1/14)

Medscape: Occupationally Acquired HIV: Healthcare Workers' Risk Low
Only a single confirmed case of occupationally acquired HIV infection in a US healthcare worker has been reported to the Centers for Disease Control and Prevention (CDC) since 1999, and fewer than 60 cases have been reported since 1985. The low number of cases may reflect widespread adoption of universal precautions, the development of effective antiviral therapies, and advances in postexposure management, M. Patricia Joyce, MD, from the CDC's Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention and colleagues report in the January 9 issue of the Morbidity and Mortality Weekly Report. (Phillips, 1/12)

Reuters: Cancer Survivors Plagued By Lack Of Personal Control
After treatment for cancer, survivors often complain about a loss of personal control, a new study found. ... “Cancer survivors are often caught off guard about the lingering problems once treatment is complete,” said Mary Ann Burg, a medical sociologist and clinical social worker at the University of Central Florida in Orlando. She and her colleagues write in the journal Cancer that in earlier studies, between a fifth and a third of cancer survivors ended up with physical or mental health concerns at least five years after treatment. (Seaman, 1/12)

The Washington Post: Obamacare’s Employer Mandate Must Go
Republicans are right: The employer health insurance mandate is dumb. But gently rejiggering it, as the GOP is trying to do, is not the solution. The mandate should instead get full death-panel treatment and be euthanized once and for all. (Catherine Rampell, 1/15)

The Wall Street Journal's Washington Wire: Harvard And Growth In Health-Care Cost Sharing
Like a quiet revolution in health insurance, deductibles have been steadily increasing for many years. But a mountain was made out of a mole hill when Harvard University’s plan for employees to pay modest deductibles and other forms of cost sharing kicked off a firestorm at the university and a broader discussion about whether Harvard was somehow affirming conservative principles by giving its employees a little more skin in the game. (Drew Altman, 1/15)

The Wall Street Journal: The Other Debt Bomb In Public-Employee Benefits
Public-pension funds have garnered attention in recent years for being underfunded, but a more precarious situation has received much less notice: health-care obligations for public retirees. Unlike pension plans, governments are not required to contribute to separate trusts to support health-care promises. As a result, only 11 states have funded more than 10% of retiree health-care liabilities, according to a November 2013 report from the credit-rating agency Standard & Poor’s. For example, New Jersey has almost no assets backing one of the largest retiree health-care liabilities of any state—$63.8 billion. (Robert C. Pozen, 1/15)

The Wall Street Journal: Disabling A Budget Con
Congress last year unanimously closed a loophole that allowed surviving Nazi war criminals to claim Social Security benefits, but that’s where the entitlement reform consensus ends. Now the political left is melting down over a modest budget change that could require Congress to be honest about the Social Security disability program’s fiscal problems and employment distortions. (1/15)

Los Angeles Times: Four Ways To Make Black, Brown And All Lives Matter
In California we stand at a once-in-a-generation crossroads. If we take action in four key areas, we will transform the lives of young people of color in our state for the better. ... Not too long ago, California was home to more than 800,000 uninsured children. Obamacare is projected to cut that disgraceful number in half. California needs to finish the job by passing State Sen. Ricardo Lara's Health for All Act. Every child, including the undocumented, should have access to healthcare.(Robert K. Ross, 1/15)

The Wall Street Journal: Saving Blood, Dollars And Lives
One pint of donated blood can help save as many as three people’s lives—a fact that you may have heard recently, since January is national blood-donor month. But unknown to many donors, recipients and physicians, blood is sometimes used capriciously and, if given when not needed, can cause patient injury and even death. The evolution of blood transfusions and their efficacy is a good example of the struggle in health care to apply the latest scientific findings to help patients and reduce costs. (Tim Hannon and Rishi Sikka, 1/15)

The New England Journal of Medicine: Guiding Choice — Ethically Influencing Referrals In ACOs
ACOs are accountable for all their patients' expenditures, whether incurred within or outside their organization, and many patients receive specialty care outside their ACOs. Influencing where patients receive care may be a mechanism for assuring quality and controlling cost by reducing duplicative, unnecessary, or high-priced care or by increasing the use of high-quality care — and may therefore be critical to achieving ACOs' cost and quality targets. (Matthew DeCamp and Lisa Soleymani Lehmann, 1/15)

The New England Journal of Medicine: Addressing The Challenge Of Gray-Zone Medicine
Is a given health care intervention effective or not? Is it appropriate in a given clinical context or not? Should it be covered by health insurance or not? The search for answers to these questions leads to investment in comparative effectiveness research, the development of guidelines and appropriateness criteria, and payment systems aimed at ensuring delivery of appropriate care and reducing inappropriate care. Although such work is useful, the output has become overwhelming — without resulting in a high-value health care system. (Amitabh Chandra, Dhruv Khullar and Thomas H. Lee, 1/15)