Modern Healthcare: Obama Administration Likely To Appeal Preliminary ACA Ruling
The White House isn't likely to wait long to challenge Wednesday's ruling allowing House Republicans to sue the Obama administration for spending federal funds on the Affordable Care Act's cost-sharing assistance. The administration is expected to seek what's called an interlocutory appeal, which would allow a higher court to consider the issue of whether the House has standing to sue before the lower court addresses the merits of the case. It's a somewhat rare legal move, but some legal experts say the case might just be unusual enough to warrant it. (Schenker, 9/10)

The Associated Press: Pelosi: Judge's Ruling In Health Care Lawsuit 'Astounding'
House Democratic leader Nancy Pelosi said Thursday she is astonished by a judge's ruling that clears the way for a Republican challenge to President Obama's health care law to move ahead. Pelosi told reporters at her weekly news conference she's confident that Wednesday's ruling by U.S. District Court Judge Rosemary Collyer will be overturned. Collyer said the House can pursue its claim that the Obama administration violated the Constitution when it spent public money not appropriated by Congress. (9/10)

The Fiscal Times: House GOP Scores A Major Win In Obamacare Legal Challenge
The GOP-controlled House scored an important victory on Wednesday in its long-standing complaint about executive overreach by President Obama. A federal court judge in Washington, D.C., granted the House legal standing to bring a lawsuit against the administration for illegally spending billions of dollars on cost-sharing provisions of the Affordable Care Act without specific congressional authorization. (Pianin, 9/10)

The Boston Globe: Health Connector Customers To See Changes For 2016 Enrollment
Consumers buying health insurance through the Massachusetts Health Connector this fall can expect a different shopping experience than existed a year ago, Connector officials promised Thursday. When open enrollment starts Nov. 1, there will be a smaller roster of plans to choose from, with higher premiums for some plans and lower premiums for others. And there will be higher deductibles in one category of plans. (Freyer, 9/11)

WBUR: Health Connector Sees Rate Hikes For Some, Reductions For Others
Health insurance premiums for Massachusetts residents who purchase unsubsidized health insurance through the Health Connector Authority will see average increases next year of between 2.2 percent and 9.3 percent, according to rates approved by a state board Thursday. (Young, 9/10)

The Connecticut Mirror: Buy Your Own Health Insurance? Here’s How Your Premiums Will Change Next Year
Insurance prices will change in 2016 for the nearly 170,000 Connecticut residents who buy their own health plans. So what will people be paying? Here's a look, broken down in two ways. First, you can see some sample premiums and how they're changing from 2015 to 2016. Second, you can see how a specific plan's premium will change next year. (Levin Becker, 9/10)

The Associated Press: Rhode Island Uninsured Rate Drops By Over Half Since 2012
The number of uninsured people in Rhode Island has dropped by more than half since 2012, according to a survey released Thursday by the state's health insurance exchange. Fewer than 50,000 people in Rhode Island now lack health insurance, compared with 113,000 in 2012, said Anya Rader Wallack, director of HealthSource RI. The rate of uninsured people dropped from 11 percent in 2012 to 5 percent in 2015, the survey found. (McDermott, 9/10)

The Kansas Health Institute News Service: Surcharge Means Higher Insurance Costs For Some Kansans Who Smoke
The federal health reform law known as the Affordable Care Act prevents insurers from considering pre-existing health conditions when setting premiums for consumers. But they are able to consider age, location and tobacco use. And that means some Kansans who smoke are charged higher insurance rates, which may discourage low-income smokers from getting health coverage, according to a new issue brief from the Kansas Health Institute. (9/10)

The New York Times: House Hearing On Insurers’ Mergers Exposes Health Care Industry Divide
Doctors, hospitals and health insurance companies clashed Thursday over the merits of mergers planned by four of the five biggest insurers in the United States. The confrontation came at a hearing of a House Judiciary subcommittee that is investigating competition in the industry and how it would be affected by mergers combining Aetna with Humana and Anthem with Cigna. (Pear, 9/10)

The Connecticut Mirror: Congress Scrutinizes Aetna-Humana And Anthem-Cigna Deals
Congressional Republicans are blaming the Affordable Care Act for a wave of mergers and consolidations by hospitals, pharmaceuticals and insurers, which, they say, are costing consumers money and choice. That new interest in consolidation in the health care field is bringing unwanted political attention to the proposed Aetna-Humana and Anthem-Cigna mergers, which came under congressional scrutiny Thursday. (Radelat, 9/10)

Politico Pro: Insurers, Providers Spar Over Competition Concerns
Everybody’s worried about consolidation in the health care sector. But hardly anyone can agree on which areas of competition merit the most concern. Hospitals are raising alarms about a pair of blockbuster insurance mergers that would reduce the number of major national players from five down to three. Insurers point to hospitals, citing studies showing that hospital mergers increased 44 percent between 2010 and 2014, with more than 400 acquisitions completed. Doctors complain that they’re stuck in the middle, with independent medical practices an endangered species. (Demko, 9/10)

Marketplace offers this report on the insurance industry -

Marketplace: Why Health Insurance Execs Are A Stressed-Out Bunch
Now that a federal judge has ruled the latest challenges to the Affordable Care Act can proceed, it means another round of legal uncertainty that the giant healthcare sector will need to grapple with. Carnegie Mellon economist George Loewenstein, who has spent a lot of time with health insurance executives lately, says they are not a very happy crowd. (Gorenstein, 9/10)

In other health law news -

BenefitsPro: IRS Under Fire For Sub-Par PPACA Data Collection
Implementation of the fine print of the Patient Protection and Affordable Care Act has resulted in a bit of a squabble among money interests in the federal government. As part of its role in the PPACA rollout, the Internal Revenue Service is charged with monitoring taxpayer returns to make sure they’re in compliance with section of the act. For instance, are taxpayers’ household incomes too high or low to justify any premium subsidies they may have received? Have they purchased or at least applied for coverage as require by law? IRS’s solution to gathering and analyzing this data: the Coverage Data Repository, where states were to funnel the necessary data for the 2014 tax season. But how well was IRS performing this role? Another branch of Treasury dropped by to find out. (Cook, 9/10)

Politico: Senate GOP Readies 20-Week Abortion Ban
The Senate could vote as soon as this month on a bill to place a federal ban on abortions after 20 weeks, according to senior Republican sources. Though the Senate's calendar has not been finalized, Majority Leader Mitch McConnell (R-Ky.) and his leadership may try to squeeze in a vote on the abortion legislation after the Senate concludes its debate on Iran and before the chamber considers must-pass spending legislation. (Everett, 9/10)

The Hill: Senate Eyeing Vote On 20-Week Abortion Ban
The Senate could vote this month on a bill that would ban abortions after 20 weeks of pregnancy, amid a continued firestorm over Planned Parenthood funding. "There's going to be a number of things,” Senate Majority Whip John Cornyn (R-Texas) told reporters Thursday. “Senator McConnell's already talked about some pro-life legislation he'll be filing for cloture on at the end of next week." (Sullivan, 9/10)

Politico Pro: Paul Rallies To Defund Planned Parenthood
GOP presidential hopeful Sen. Rand Paul headlined a rally Thursday to cut off Planned Parenthood funding — but didn't reveal whether he had signed on to a letter demanding defunding being circulated by Sen. Ted Cruz, a rival in the Republican primary. (Ehley, 9/10)

Politico: Is This The Moment For Long-Stalled Mental Health Overhaul?
After a summer of slayings, lawmakers and mental health advocates say they have more momentum than at any time in recent history to push through an overhaul of the nation's broken mental health system. The opening they see involves timing, bill tweaking and sheer perseverance — a House lawmaker obsessed with the issue for many years teaming up with a powerful chairman, Fred Upton (R-Mich.) of the House Energy and Commerce committee. In the Senate, meanwhile, a bipartisan bill drew strong interest over recess from lawmakers facing pressure from people back home to do something. (Ehley, 9/10)

ProPublica: Congressional Leaders Ask FDA About Coumadin Safety
The bipartisan leadership of the House Energy and Commerce Committee is asking the Food and Drug Administration how it monitors the safety of the popular blood thinner Coumadin, particularly in light of deaths and hospitalizations of nursing home residents taking the drug. Our analysis of government inspection reports found that, between 2011 and 2014, at least 165 nursing home residents were hospitalized or died after errors involving Coumadin or its generic version, warfarin. In some cases, homes gave residents too much of the drug, which caused internal bleeding. In other cases, they gave residents too little, leading to blood clots and strokes. (Ornstein, 9/10)

CQ Healthbeat: Sanders, Cummings Push For Lower Prescription Drug Prices
On a day new polling showed him pulling ahead in Iowa, Democratic presidential candidate Sen. Bernard Sanders was at the Capitol, pushing to cut prescription drug prices. The independent from Vermont who caucuses with the Democrats was joined by Rep. Elijah E. Cummings, D-Md., to unveil a wide-ranging overhaul of policies regarding the pharmaceutical business, including transparency requirements, a proposal to end the practice of “pay-for-delay” patent settlements and Medicare price bargaining. (Lesniewski, 9/10)

Bloomberg: Sifting DNA Databases For The Right Diagnosis
In 1982, doctors told Jackie Smith’s parents to take the 3-year-old girl home and enjoy her while they could. Her rare muscle disease, likely passed on from a mutation in her parents’ DNA, would probably kill her before she was old enough to drive, they said. Smith, now 35, has lived in the shadow of that diagnosis her whole life, as a small army of physicians failed to diagnose what accounts for her weak limbs and turned-in ankles. This past February, Claritas Genomics gave her the answer in less than three weeks. (Cortez, 9/10)

Kaiser Health News: New Hope Beats For Heart Patients And Hospitals
Inch by inch, two doctors working side by side in an operating room guide a long narrow tube through a patient’s femoral artery, from his groin into his beating heart. They often look intently, not down at the 81-year-old patient, but up at a 60-inch monitor above him that’s streaming pictures of his heart made from X-rays and sound waves. The big moment comes 40 minutes into the procedure at Morton Plant Hospital. Dr. Joshua Rovin unfurls from the catheter a metal stent containing a new aortic valve that is made partly out of a pig’s heart and expands to the width of a quarter outside the catheter. The monitor shows it fits well over the old one. Blood flow is normal again. "This is pretty glorious," Rovin said. (Galewitz, 9/11)

Kaiser Health News: Medical Schools Teach Students To Talk With Patients About Care Costs
Time for a pop quiz: When it comes to health care, what’s the difference between cost, charge and payment? "Does anyone want to take a stab at it?" Sara-Megumi Naylor asks a group of first-year residents at the David Geffen School of Medicine at UCLA. Naylor answers her own question with a car metaphor. "Producing the car might be $10,000, but the price on the window might be $20,000, and then you might end up giving them [a deal for] $18,000, so that’s cost versus charge versus payment," she explains. (Plevin, 9/10)

Also, the Associated Press looks at accountable care organizations and if they are saving money, and The Columbus Dispatch examines the limitations of consolidating health care in a visit to the doctor office --

The Associated Press: New Health Care Model Saving Money, Report Says
A new model of health care run by doctors and hospitals is growing and saving money in the taxpayer-funded Medicare program, according to a new report from the federal government. However, experts say most patients still don’t understand how an Accountable Care Organization works. And while early data shows financial improvements, experts say it’s too early to know the long-term financial impact. (Kennedy, 9/10)

The Columbus Dispatch: Some Health Care Visits Can Be Consolidated, But Not All
In some cases, doctors and hospitals work with patients to consolidate treatments, tests and consultations that might otherwise take place during separate appointments. But there are other times when what seems logical to a patient doesn’t make sense to the doctor. (Crane, 9/11)

CNN: Do Million-Dollar Medicines Deliver Enough Bang For The Buck?
If you think prescription drugs have become way too pricey, you are not alone. About three quarters of Americans think that the cost of medications is unreasonable, according to a survey by the Kaiser Family Foundation, a nonprofit health organization. Some of the priciest medications are ones that just hit the market -- cancer drugs such as Stivarga and drugs for the hepatitis C virus such as Sovaldi. However, costs have also been rising for tried and true drugs, such as for diabetes and multiple sclerosis. (Storrs, 9/10)

The Associated Press: First ‘Biosimilar’ Of A Biologic Drug Reaches U.S., Finally
Years after discounted versions of some of the most expensive drugs ever went on sale in other countries, they’re finally coming to the world’s biggest medicine market. Last week brought the first U.S. launch in a new category called “biosimilars.” They’re near-copies of powerful prescription drugs known as biologics “manufactured” in living cells. (Johnson, 9/10)

The Wall Street Journal: Express Scripts Names Eric Slusser CFO
Express Scripts Holding Co. named health-care sector veteran Eric Slusser as its chief financial officer. The move comes a day after the company said longtime Chairman and Chief Executive George Paz plans to retire from the helm next year and named company President Tim Wentworth as his successor. (Stynes, 9/10)

The New York Times: U.S. Makes Final An Array Of Rules On Food Safety
Far-reaching food industry rules aimed at reducing food-borne illness in the United States have become final, the federal government announced on Thursday, nearly five years after Congress passed a law requiring an overhaul of the nation’s food safety system. About 48 million Americans a year become sick from food-borne diseases and 3,000 die, according to federal data, tallies that many health officials say could be significantly reduced if the food industry took a more proactive role in monitoring and reducing risks. But carrying out the law, the Food Safety Modernization Act, which was the first significant update of the Food and Drug Administration’s food safety authority in 70 years, has been criticized as slow. (Tavernise, 9/10)

The Associated Press: New Federal Food Safety Rules Issued After Deadly Outbreaks
The rules, once promoted as an Obama administration priority and in the works for several years, ran into delays and came out under a court-ordered deadline after advocacy groups had sued. Even then, the Food and Drug Administration allowed the Aug. 30 deadline to pass without releasing the rules to the public. (Jalonick, 9/10)

The Washington Post: Can The FDA Actually Prevent Foodborne Outbreaks Instead Of Just Reacting To Them? We’re About To Find Out.
The Food and Drug Administration on Thursday finalized long-awaited rules that will require U.S. food manufacturers to make detailed plans to identify and prevent possible contamination risks in their production facilities. The new regulations, which will apply to the production of both human and animal foods, mark the first step in a broader effort to make the nation's food safety system more proactive, rather than merely reacting to outbreaks after they occur. (Dennis, 9/10)

Also, an update on the ongoing salmonella outbreak -

The Washington Post: Two Dead, 70 Hospitalized In Multi-State Salmonella Outbreak Linked To Cucumbers
U.S. officials said a second person had died from consuming cucumbers contaminated with salmonella poona and that the number of cases has increased to 341 people in 30 states. (Cha, 9/10)

The Associated Press: Uncertainty Reigns Over Possible End Of 9/11 Health Programs
Fourteen years after the 9/11 attacks, a new round of uncertainty looms for people exposed to the million tons of toxic dust that fell on New York when hijacked jets toppled the World Trade Center. Two federal programs that promised billions of dollars in compensation and medical care to sick 9/11 responders and survivors are set to expire next year, five years after they were created by Congress. (Caruso, 9/10)

The New York Times: Some NYC Ambulance Crews Still Fight For Sept. 11 Benefit
No one disputes that his illnesses are likely caused by his work at the World Trade Center on Sept. 11. While Mr. Bethea has received some compensation stemming from his work at Ground Zero, the U.S. Department of Justice won’t give him a settlement awarded to other first responders and their families who were either killed or catastrophically injured in the line of duty because Mr. Bethea was employed by St. Vincent’s Medical Center—and not the city’s FDNY. (Gay, 9/11)

Reuters: 3M Exploring Sale Or Spinoff Of Health Software Unit
U.S. diversified manufacturer 3M Co said on Thursday it was exploring a sale or spinoff of its healthcare data and software business. The decision comes as Chief Executive Officer Inge Thulin reviews 3M's broad business portfolio, which includes Post-it notes as well as adhesives, abrasives and other products for a variety of industries. At the same time, the company has struck acquisition deals to expand in other areas. (9/10)

The Associated Press: 3M Says It May Sell Or Spinoff Health Care Software Business
3M said Thursday that it may sell or spin off its health care software business as it seeks to reduce the products and services it offers. The company’s health information systems business provides software to doctors, government agencies and others to collect data and help cut health care costs. 3M Co., based in St. Paul, Minnesota, also makes Post-it notes, industrial coatings and ceramics. (9/10)

Los Angeles Times: Get Your Electronic Health Record: It's Your Right
Virtually all other industries, such as banking and travel, make online tools available that help consumers more easily manage their information. Not so in the healthcare business, where individual hospitals and doctors might have electronic health records but generally don't make it easy for patients to access them. "Healthcare currently has a very fragmented delivery system, and there's no question that that fragmentation leads to patient frustration," says Darren Dworkin, chief information officer at Cedars-Sinai Health System. A growing number of mobile apps seek to help patients gather and organize medical information into a unified digital health record. (Zamosky, 9/11)

KARE: Walz Calls For Nationwide Inquiry Into VA Brain Injury Exams
A Minnesota congressman is calling for a nationwide investigation to determine how many unqualified Veteran's Administration doctors have been doing traumatic brain injury (TBI) exams. The request comes in the wake of disclosures that unqualified doctors performed hundreds of TBI exams at the Minneapolis VA's Compensation and Pension (C&P) Department. Those exams resulted in veterans being improperly denied benefits. (Lagoe and Eckert, 9/10)

The Denver Post: San Luis Valley Vets Say They Have Been Months Without A Doctor
Veterans in the San Luis Valley have been driving hundreds of miles for doctor appointments for five months despite a congressional plea to the Department of Veterans Affairs secretary to help them. The only doctor at the VA clinic in Alamosa departed in April, and the agency has been unable to fill the vacancy. A spokesman said the VA has been providing telehealth services and sending doctors part-time from other clinics while it searches for a permanent replacement. (Olinger, 9/9)

The Associated Press: GOP Senators Pledge Help If Court Bars Health Law Subsidies
Three leading Republican senators are promising to help millions of people who may lose federal health insurance subsidies if the Supreme Court invalidates a pillar of President Barack Obama's health care law. (3/1)

The Fiscal Times: GOP Considers Plan To Spare Millions From Anti-Obamacare Decision
For months, Republicans have rallied around the latest Supreme Court challenge to Obamacare—embracing it as their last real opportunity to bring down the president’s health care law once and for all. ... Now, with a week before oral arguments, they’re scrambling to come up with ways to quell the potential backlash of an adverse ruling—before they get blamed. (Ehley, 2/27)

In other Capitol Hill news -

The Associated Press: Congressional Republicans Name New Budget Referee
Congressional Republicans Friday named economist Keith Hall to serve as Capitol Hill’s budget referee as director of the nonpartisan Congressional Budget Office. ... Hall replaces Doug Elmendorf, who was appointed by Democrats but earned the respect of lawmakers in both parties. He led CBO as it scored both the controversial Affordable Care Act and House Republicans’ contentious plan to overhaul Medicare. (2/27)

Georgia Health News: Cancer Hospital Bid To Ease Rules Takes New Route
When Cancer Treatment Centers of America dropped its legislative bid earlier this year to ease state restrictions on its Newnan hospital, the company indicated that its quest was not over. That effort took on a dramatically new shape Thursday, with a controversial proposal that won initial approval from the board of the state Department of Community Health. (Miller, 9/10)

Kaiser Health News: Calif. Lawmakers Approve Bill Requiring Drug Labeling In 5 Foreign Languages
California’s pharmacists would be required to provide prescription drug labels or medication instructions in five languages besides English under a bill passed unanimously Thursday by California lawmakers. The bill, AB 1073, will be sent to Gov. Jerry Brown for his signature and would take effect Jan. 1 if signed into law. Upon request from patients or their caregivers, pharmacists would need to provide medication instructions in Spanish, Tagalog, Chinese, Vietnamese or Korean, the most common languages in California after English. The instructions could be on prescription labels or in patient handouts. (Feder Ostrov, 9/11)

Modern Healthcare: Fraud Case Highlights Hazards For Hospitals With Insurance Plans
A whistle-blower lawsuit accusing two North Carolina hospitals of using their managed-care organization to fraudulently boost Medicare reimbursements shows complications that can arise as hospitals increasingly move into the insurance business. According to the lawsuit, North Carolina Baptist Hospital, Winston-Salem, and Charlotte-based Carolinas HealthCare System co-owned a managed-care organization, MedCost, which they used for their self-funded health plans. MedCost, the lawsuit alleges, imposed excessive costs on hospital employees and drove up what's known as the wage index, which helps determine Medicare payments. (Schencker, 9/10)

Stateline: After Same-Sex Marriage Ruling, States Reconsider Domestic Partner Benefits
Now that the U.S. Supreme Court has legalized same-sex marriage nationwide, some states that offer health and retirement benefits to their employees’ domestic partners are considering changing those policies, in large part to save money or avoid discrimination lawsuits. Before the ruling, 34 percent of state and local governments allowed unmarried same-sex couples to receive health care benefits, while 28 percent did so for domestic partners of the opposite sex, according to a study of public sector benefits by the Bureau of Labor Statistics. (Beitsch, 9/10)

California Healthline: New Tobacco Tax Bill Touches All Bases
A bill introduced on Wednesday in the California Legislature's special session on health care touches on almost all of the health policy concerns originally raised by the governor when he convened the special session in June. (Gorn, 9/10)

The News Service Of Florida: Scott Signs Order Tracking Mental Health Services
As the state Department of Children and Families convened its annual child-protection summit Wednesday, Gov. Rick Scott signed an executive order aimed at better coordinating mental health services --- something DCF Secretary Mike Carroll said will help his agency provide improved care for children. The directive issued Wednesday adds to a partnership Scott established in July --- also by executive order --- creating a pilot program in Broward County to conduct a countywide inventory of all state programs that address mental health needs. (Menzel, 9/10)

The San Francisco Chronicle: California Government Leaders Reach Deal To Regulate Medical Pot
State lawmakers announced late Thursday that they have struck a deal to regulate and license the multi-billion dollar medical marijuana industry, with the news coming ahead of a final push to finish dozens of end-of-session bills ahead of a Friday deadline. (Gutierrez, 9/10)

The Associated Press: Rauner Administration Rejects Ailments For Medical Marijuana
Gov. Bruce Rauner's administration issued a broad rejection Thursday of expanding the list of diseases that can be treated with medical marijuana in Illinois, refusing to add osteoarthritis, migraine, post-traumatic stress disorder and eight other health problems. Separately, the governor vetoed a bill that would have added PTSD via a legislative route. (Johnson, 9/10)

Health News Florida: Flakka Training Draws 500 To North Florida
With South Florida emergency rooms overflowing and body counts rising, the only way to halt an epidemic of the designer drug Flakka is education and community outreach. That’s the discouraging message Broward County Sheriff’s officials brought Wednesday to the Florida Public Safety Institute in Havana. Five hundred police officers, sheriff’s deputies and EMTs, wearing the uniforms of more than 100 agencies, shifted in their seats as Broward Sheriff’s Detective William Schwartz kicked off the daylong Flakka seminar. (Ash, 9/10)

Health News Florida: Advocates Encourage Suicide Talk
In an office decorated with signs proclaiming “Safe Space,” Peggy Saddler meets with students overwhelmed by classes, fighting with friends and family or struggling with deeper problems. The Wauchula High School guidance counselor has worked with students in rural counties for more than 30 years and said sometimes students are “shutting the door every night (with) a little bit more than teenage angst.” (Miller and Matos, 9/10)

JAMA Pediatrics: Reasons Why Physicians and Advanced Practice Clinicians Work While Sick
When clinicians work with symptoms of infection, they can put patients and colleagues at risk. ... [In a survey] ... in a large children’s hospital in Philadelphia. ... 446 respondents (83.1%) reported working sick at least 1 time in the past year, and 50 (9.3%) reported working while sick at least 5 times. Respondents would work with significant symptoms, including diarrhea (161 [30.0%]), fever (86 [16.0%]), and acute onset of significant respiratory symptoms (299 [55.6%]). ... Reasons deemed important in deciding to work while sick included not wanting to let colleagues down (521 [98.7%]), staffing concerns (505 [94.9%]), not wanting to let patients down (494 [92.5%]), fear of ostracism by colleagues (342 [64.0%]), and concern about continuity of care (337 [63.8%]). (Szymczak et al., 9/8)

JAMA Internal Medicine: Breast Cancer Screening, Incidence, And Mortality Across US Counties
Screening mammography rates vary considerably by location in the United States, providing a natural opportunity to investigate the associations of screening with breast cancer incidence and mortality .... Across US counties, there was a positive correlation between the extent of screening and breast cancer incidence ... but not with breast cancer mortality. ... An absolute increase of 10 percentage points in the extent of screening was accompanied by 16% more breast cancer diagnoses .... the clearest result of mammography screening is the diagnosis of additional small cancers. Furthermore, there is no concomitant decline in the detection of larger cancers, which might explain the absence of any significant difference in the overall rate of death .... Together, these findings suggest widespread overdiagnosis. (Harding et al., 9/8)

Health Affairs: Health Savings Accounts: Growth Concentrated Among High-Income Households And Large Employers
Between 2005 and 2012, the share of employers whose employees had health savings accounts (HSAs) and the share of employees working at these employers grew more than tenfold. High-income and older tax filers both established HSAs and fully funded their HSAs at least four times as often as did low-income and younger filers. (Helmchen et al., 9/8)

Health Affairs: Increased Use Of Prescription Drugs Reduces Medical Costs In Medicaid Populations
We used data on more than 1.5 million Medicaid enrollees to examine the impact of changes in prescription drug use on medical costs. For three distinct groups of enrollees, we estimated the effects of aggregate prescription drug use—and, more specifically, the use of medications to treat eight chronic noncommunicable diseases—on total nondrug, inpatient, outpatient, and other Medicaid spending. We found that a 1 percent increase in overall prescription drug use was associated with decreases in total nondrug Medicaid costs by 0.108 percent for blind or disabled adults, 0.167 percent for other adults, and 0.041 percent for children. Reductions in combined inpatient and outpatient spending from increased drug utilization in Medicaid were similar to an estimate for Medicare by the Congressional Budget Office. (Roebuck et al., 9/8)

Annals of Internal Medicine: The Financial Effect Of Value-Based Purchasing And The Hospital Readmissions Reduction Program On Safety-Net Hospitals In 2014
[Researchers sought to] determine whether safety-net hospitals incur larger financial penalties than other hospitals under VBP [Medicare's value-based purchasing] and HRRP [Hospital Readmissions Reduction Program]. ... Safety-net hospitals were defined as being in the top quartile of the Medicare disproportionate share hospital (DSH) patient percentage and Medicare uncompensated care (UCC) payments per bed. ... Safety-net hospitals in the top quartile ... were more likely to be penalized under VBP than other hospitals (62.9% vs. 51.0% under the DSH definition and 60.3% vs. 51.5% under the UCC per-bed definition). This was also the case under the HRRP (80.8% vs. 69.0% and 81.9% vs. 68.7%, respectively). Safety-net hospitals also had larger payment penalties ($115 900 vs. $66 600 and $150 100 vs. $54 900, respectively). (Gilman et al., 9/8)

JAMA Surgery: Effect Of Delirium And Other Major Complications On Outcomes After Elective Surgery In Older Adults
To evaluate the association of major postoperative complications and delirium, alone and combined, with adverse outcomes after surgery [researchers used a prospective] ... cohort study in 2 large academic medical centers of 566 patients who were 70 years or older without recognized dementia or a history of delirium and underwent elective major orthopedic, vascular, or abdominal surgical procedures .... Forty-seven patients (8.3%) developed major complications and 135 (23.9%) developed delirium. ... major complications only contributed to prolonged LOS [length of stay in the hospital] ...; by contrast, delirium only significantly increased all adverse outcomes, including prolonged LOS ..., institutional discharge ... and 30-day readmission .... The subgroup with complications and delirium had the highest rates of all adverse outcomes. (Gleason et al., 9/9)

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

Reuters: Reference Payment For Colonoscopy Saved California Millions Of Dollars
Two years after offering colonoscopy patients full coverage for their screening if they had it done at lower-priced facilities, the California Public Employees’ Retirement System (CalPERS) saved $7 million, according to a new study. The initiative sought to counter the unpredictable, but generally rising, prices for the procedure at different facilities while also making sure members kept access to colon cancer screening. (Doyle, 9/8)

The New York Times: Lung Screening May Not Push Smokers To Quit
The results of an admittedly small but telling new study suggest that Medicare and other insurers could be spending billions of dollars on screening smokers for lung cancer that would be better spent on helping them quit and keeping others from starting. Although screening is considered “a teachable moment” that could be used to foster smoking cessation, the new study indicated that it more often bolstered smokers’ beliefs that they had dodged a bullet and could safely continue to smoke. (Brody, 9/7)

Reuters: Smoking Worsens Diabetes Complications, But Quitting May Help
People with type 2 diabetes who smoke have significantly higher risks of heart disease, stroke, and death than diabetic non-smokers, a new study shows. They also had higher risks of clogged arteries, heart failure, and reduced blood flow to the limbs. The risks were lower for diabetics who quit smoking, but still moderately higher than risks among never smokers, the researchers write in the journal Circulation. (Kennedy, 9/9)

Medscape: Insurance Expansion Means Boom in Chronic Illness Diagnoses
Insured people are significantly more likely — by 14 percentage points — than similar uninsured people to be diagnosed with diabetes and high cholesterol, a new study indicates. The probability of being diagnosed with high blood pressure was 9 points higher among the insured. Daniel R. Hogan, a technical officer at the World Health Organization in Geneva, Switzerland, and coauthors found that among those already diagnosed, having insurance was linked with significantly healthier levels of blood sugar, total cholesterol, and systolic blood pressure. The results were published in the September issue of Health Affairs. (Frellick, 9/9)

Reuters: Patients Steered To Fewer Pharmacies May Fill More Prescriptions
When patients have drug benefits that encourage them to save money by using certain pharmacies, they may end up filling more prescriptions, a company-funded study suggests. Narrow pharmacy networks that cover prescriptions only at certain retailers and drug benefits that offer consumers lower out-of-pocket fees at a subset of preferred pharmacies have become more common in recent years as a way to limit premium increases and curb drug spending. (Rapaport, 9/8)

Reuters: Less Invasive Heart Valve Surgery Safe For Patients In Their 90s
A modern technique for replacing heart valves without major surgery is safe even for very elderly patients, researchers say. The procedure can yield "excellent short- and mid-term outcomes in a patient population with a lethal disease that without this technology would undoubtedly die,” Dr. Vinod H. Thourani from Emory University, Atlanta, Georgia told Reuters Health by email. (Boggs, 9/8)

Reuters: Shingles Vaccine Not Cost Effective Before Age 60
The shingles vaccine might not be cost-effective for people in their fifties, a new analysis suggests. The Centers for Disease Control and Prevention (CDC) does not recommend the shingles vaccine for that age group, and the authors of the new analysis say their findings support that policy. "Even though the vaccine is effective, it may not be cost effective," lead author Phuc Le of the Cleveland Clinic told Reuters Health. (Seaman, 9/7)

The Associated Press: More Kids Kept Safe From Household Medicines, ER Trend Says
New research suggests parents are doing a better job of keeping household medicines out of the hands of young children. Emergency room visits by children who swallowed medicine while unsupervised have declined substantially, reversing an earlier trend, the study found. By contrast, ER visits for bad reactions from medicines meant for kids and given by parents increased during the same time. (Tanner, 9/7)

Health News Florida: USF Researcher Looks At Cost vs. Quality In Diabetic Healthcare
It’s an age-old question plagues us even as our nation’s healthcare system continues to change: are higher costs in health care for patients always associated with higher quality goods and services? One University of South Florida College of Public Health researcher took on that question – focusing in specifically on a disease that affects millions and millions of Americans: diabetes. (Schreiner, 9/7)

Reuters: Vaginal Mesh Slings For Incontinence Fail In About 3 Percent
About one in 30 women who get a common type of vaginal surgery to address urinary incontinence will need repeat procedures within 10 years to remove or replace mesh slings inserted to prevent leaking urine, a study finds. This risk is considered low, the authors note. Patients fared best when they had slings inserted by surgeons who did the highest volume of these procedures. These patients were 37 percent less likely to need repeat procedures, the study found. (Rapaport, 9/9)

The Wall Street Journal: A Win For Congress And A Setback For ObamaCare
When the House of Representatives filed a lawsuit last year contesting President Obama’s implementation of ObamaCare, critics variously labeled it as “ridiculous,” “frivolous” and certain to be dismissed. Federal District Judge Rosemary Collyer apparently doesn’t agree. On Wednesday she ruled against the Obama administration, concluding that the House has standing to assert an injury to its institutional power, and that its lawsuit doesn’t involve—as the administration had asserted—a “political question” incapable of judicial resolution. (David B. Rivkin Jr. and Elizabeth Price Foley, 9/10)

The New York Times: The House Stretches Legal Logic On Health Reform
In truth, this lawsuit seems to be an effort to get around a legislative defeat — basically a typical, garden-variety political dispute — that has no business being in the court system. If the Republicans want to end all cost-sharing subsidies, they could make that explicit by rewriting the health reform law. ... It would be a travesty if this lawsuit ends up creating the same havoc as other baseless challenges to the Affordable Care Act, which took up enormous resources and time, only to be struck down by the Supreme Court. (9/11)

Huffington Post: Here's The Potential Fallout If This New Obamacare Lawsuit Succeeds
Another far-fetched lawsuit against the Affordable Care Act won a victory in the lower courts on Wednesday. And while few members of the legal establishment have taken this lawsuit seriously, few members of the legal establishment took the last one seriously. That case, King v. Burwell, made it all the way to the Supreme Court before failing. So what happens if this latest legal assault does that -- and more? What if it actually prevails? At the moment, it's really hard to tell. (Jonathan Cohn, 9/10)

Los Angeles Times: Help May Be On The Way For Healthcare Shoppers In California
The Affordable Care Act has helped slow the overall growth of healthcare costs in the U.S., but for many Americans, health insurance premiums have continued to rise at an alarming rate. To lower their rates, consumers may have to switch insurers, which may also mean switching doctors. That's not an easy decision, but two bills are pending in the Legislature to make the process less fraught for Californians. (9/10)

Bloomberg: Courts Can't Mend A Parent's Broken Heart
How much should you know before your baby is entered into a medical study? That complicated and heartbreaking question has been at the center of a controversy about a clinical trial that tested the effects of different oxygen levels on premature infants with extremely low birth weights. A federal judge in Alabama rejected last month the legal claims of parents whose children suffered adverse effects after participating. The court's decision was correct -- but not because the consent form given to parents was adequate for them to understand the risks, which as an ethical matter it probably wasn't. The judge was right because subtle and complicated problems of medical ethics have no place in a court of law. (Noah Feldman, 9/10)

Reuters: One Last Push To Stop Medicare Premium Increases
Should 30 percent of Medicare beneficiaries shoulder a 52 percent premium hike next year while the other 70 percent pay no more at all? Advocates for seniors do not think so, and they are making a push to convince Congress to stop it from happening. The Medicare population vulnerable to shouldering the larger premium includes some federal and state government employees, people who sign up for Medicare for the first time next year, low-income seniors whose premiums are paid by state Medicaid plans and high-income seniors who already pay premium surcharges. (Mark Miller, 9/10)

The Philadelphia Inquirer: Happy 50th Birthday To Medicare's Essential Partner - Medicaid
This summer marks the 50th anniversary of a monumental change for our country: President Lyndon Baines Johnson signing into law the bill that created Medicare and Medicaid. While there has been much publicity over the past several months about this milestone for Medicare and its positive impact on the health of the elderly, it’s disappointing that there has been less attention paid to Medicaid, which has been providing access to health care for the poor and chronically ill for the same 50 years. (Liz Williams, 9/10)

The Hill: Time To Bring The Medicare Program Into The 21st Century
Two things are notable about our current Medicare system. First, while Medicare has undergone a number of changes and expansions of the program since 1966, one thing that has not changed in 50 years are the paper cards that beneficiaries use to access services. Those cards are outdated and unsafe, exposing seniors to potential identity theft, because a beneficiary’s identification number is his or her Social Security number—and it’s printed right on the front of the card. Second, the Medicare program currently reimburses providers using a ‘pay-and-chase’ model. That means the government pays out claims first and asks questions later, after the money has already been spent. However, not only does Medicare have no way of approving transactions before paying providers, the program also lacks the ability to electronically confirm when a patient actually received care. (Kelli Emerick, 9/10)

Los Angeles Times: To Help Smokers Quit, Make Them Vapers
The FDA is considering proposals to regulate e-cigarettes that would discourage their use. The Los Angeles City Council has banned them in public places, and the California Legislature may vote on an anti-"vaping" law this week. Blanket laws discouraging the use of e-cigarettes are the wrong policy move. E-cigarettes have already shown themselves to be an appealing alternative to many smokers who are trying to quit. Because almost 500,000 Americans die annually from tobacco-related diseases, a lot is at stake. (Stephen D. Sugarman, 9/10)

news@JAMA: Chronic Illness Spells Financial Burden, Even With Insurance
The highly skewed distribution of health spending is a phenomenon well known to health economists. About 5% of the population accounts for half of spending and the most costly 1% accounts for one-fifth of it. Less widely known is the extent to which high spending persists over time, despite the important health policy and financing consequences that follow from it. For many of those costly patients, their health coverage may provide inadequate protection against the burden of persistent and substantial medical expenses. (Austin Frakt, 9/10)

The Hill: Costly New Medicaid Regs Will Cripple Nursing Homes
Roughly two-thirds of nursing home patients are on Medicaid, the federal-state partnership for the medically indigent. Medicaid rates, which are set entirely by states and then matched by the federal government, have historically fallen far below care costs. ... Not only has the federal government refused to require states to adequately meet Medicaid costs, it recently pushed, successfully, in the U.S. Supreme Court to make it impossible for providers to challenge the adequacy of Medicaid payments. Because government’s expectations drive care costs, this ruling frees government to pile on new expectations without paying for them. (Brendan Williams, 9/10)