USA Today: Speaker John Boehner To Resign From Congress
In a shocking announcement, John Boehner told his GOP colleagues he will step down as House speaker and resign his Ohio congressional seat on Oct. 30. ... His resignation comes the day after Pope Francis became the first pontiff to address a joint meeting of Congress — a crowning achievement of Boehner's career — and amid a congressional fight over federal funding of Planned Parenthood that threatens another government shutdown. (Shesgreen and Allen, 9/25)

NBC News: House Speaker John Boehner To Resign
Boehner has been under prolonged pressure from conservatives in his party, who have accused him of failing to fight the Obama administration on issues important to the GOP. Foes within his party had been pushing to oust him if he presented any legislation that would continue to fund the government and avoid a government shutdown without stripping federal funding for Planned Parenthood. (9/25)

The New York Times: John Boehner Will Resign From Congress
Most recently, Mr. Boehner, 65, was trying to craft a solution to keep the government open through the rest of the year, but was under pressure from a growing base of conservatives who told him that they would not vote for a bill that did not defund Planned Parenthood. Several of those members were on a path to remove Mr. Boehner as speaker, though their ability to do so was far from certain. (Steinhauer, 9/25)

Politico: Speaker John Boehner Retiring From Congress At The End Of October
Speaker John Boehner, who rose from bartender's son to the most powerful man in Congress, will retire at the end of October, ending a tumultuous five-year tenure atop the House of Representatives. ... Now that he doesn't have internal political considerations to weigh, Boehner is certain to push through a government-funding bill next week that funds Planned Parenthood, and keeps the government open. Boehner's decision, relayed in a closed Republican meeting Friday morning, will set off one of the most intense leadership scrambles in modern Congressional GOP politics. (Sherman, 9/25)

Los Angeles Times: Senate Fails To Advance Bill That Would Cut Planned Parenthood Funding
With a federal shutdown days away, Senate Republicans tried -- and failed -- on Thursday to advance legislation that would eliminate money for Planned Parenthood but keep government offices and services open. Democrats blocked the bill with a filibuster, refusing to cut funds for the large family planning organization after secretly recorded videos disclosed officials discussing the practice of providing fetal tissue from abortions for research. The debate has become a national conversation on abortion. (Mascaro, 9/24)

USA Today: Democrats Block Planned Parenthood Defunding; McConnell Offers 'Clean Bill'
Senate Democrats blocked a bill Thursday to keep the government funded through Dec. 11 because of a Republican provision to strip Planned Parenthood of federal money for a year. Senate Majority Leader Mitch McConnell, R-Ky., moved immediately after the vote to try to avert an Oct. 1 government shutdown by filing a new bill that funds federal agencies but does not include the divisive Planned Parenthood provision. A vote on that bill could come as early as Monday. (Kelly, 9/24)

The Associated Press: McConnell Moves Ahead With Bipartisan Stopgap Spending Bill
In the House, GOP leaders called a meeting of their fractious rank and file for Friday morning to discuss whether to accept the Senate’s move or reject it at the risk that continuing the fight over Planned Parenthood would lead to a government shutdown. The White House signaled President Barack Obama would sign the measure, called a continuing resolution, into law — if the House steps aside from the fight tea party Republicans want over “defunding” Planned Parenthood. (Taylor, 9/24)

Politico: Boehner Plots Shutdown Move As Critics Weigh Options
House Republican leaders will move next week to approve a "clean" government spending bill — and avert a shutdown — but only after they hold a vote on a measure to bar federal funding for Planned Parenthood, according to multiple sources familiar with the GOP's plan. The move, which comes as conservatives are weighing whether to try to remove John Boehner as House speaker, was discussed at a closed GOP leadership meeting Thursday. It involves a legislative tactic called an "enrollment correction," which essentially changes the text of a bill that has passed the House and the Senate. But it would ultimately be a meaningless exercise: The Senate would reject the measure, and President Barack Obama has said he will veto any spending bill that tries to defund Planned Parenthood. (Sherman, Palmer and Bresnahan, 9/24)

The Associated Press: House GOP May Opt Against Shutdown Over Planned Parenthood
House GOP leaders have summoned their divided conference for a make-or-break discussion on how to fight taxpayer funding of Planned Parenthood without having the battle lead to a government shutdown next week. ... Friday's meeting is likely to center on immediate action to use a special filibuster-proof budget bill to send legislation defunding Planned Parenthood to Obama's desk for the first time — rather than a futile bid to attach the anti-Planned Parenthood measure to a stopgap spending bill. The temporary measure is needed to avoid a shutdown at midnight on Wednesday. It would fund the government through Dec. 11. (Taylor, 9/25)

In other Capitol Hill action -

McClatchy: Senate Democrats Introduce Legislation To Repeal Obamacare 'Cadillac Tax'
The call to repeal one of the Affordable Care Act's most controversial provisions got louder on Thursday when a group of prominent Democratic senators introduced legislation to abolish the so-called "Cadillac Tax" on high-cost, employer-sponsored health plans. The action further solidified growing bipartisan opposition to the tax, which has already drawn the ire of employers, insurers, unions and benefits groups. They claim the tax would burden working families with higher costs and force employers to cut benefits. (Pugh, 9/24)

The Associated Press: Audit Finds Slipshod Cybersecurity At Healthcare.gov
The government stored sensitive personal information on millions of health insurance customers in a computer system with basic security flaws, according to an official audit that uncovered slipshod practices. The Obama administration said it acted quickly to fix all the problems identified by the Health and Human Services inspector general's office. But the episode raises questions about the government's ability to protect a vast new database at a time when cyberattacks are becoming bolder. (Alonso-Zaldivar, 9/24)

NBC News: Monthly Cost Is Top Concern For Health Insurance Shoppers: Survey
Americans, long used to seeking bargains, look mostly at price when they're shopping for health insurance, a new survey shows. More than half of those who looked but didn't buy anything on the new Obamacare exchanges said they couldn't find a plan they could afford, the survey found. And two-thirds who switched coverage said price was the main factor. (Fox, 9/25)

Salt Lake Tribune: Utah Republican Lawmakers To Huddle Behind Closed Doors On Medicaid Expansion
House and Senate Republicans will meet next week in closed-door caucuses for briefings on a proposal to use Medicaid funds to help provide health insurance to tens of thousands low-income Utahns. The plan they will hear is the product of hours of negotiations between leaders in the House and Senate and Gov. Gary Herbert, launched after Herbert's Healthy Utah plan failed to win support earlier this year in the Republican-dominated House. Depending on the reception the plan receives — particularly from skeptical House members — the governor could call a special session in mid-October to vote on the plan. (Gehrke, 9/24)

KSL: Details Of Medicaid Expansion Plan Plan Due Next Week
Details of the much-anticipated new plan for Medicaid expansion from Gov. Gary Herbert and legislative leaders will be rolled out Tuesday to lawmakers in closed-door meetings before being unveiled publicly. But the governor has yet to sign off on a final proposal, his spokesman, Jon Cox, said Wednesday. "There are still details that need to be negotiated by the group," Cox said. (Riley Roche, 9/24)

Politico Pro: Utah's Medicaid Expansion Hits Funding Roadblock
One red state’s unprecedented effort to finance Medicaid expansion through a broad array of health care sectors — from hospitals and doctors to drug makers and pharmacies — is running into serious roadblocks. Utah Gov. Gary Herbert and legislative leaders in July announced a deal to expand Medicaid, agreeing on a framework that would require “providers and benefactors of Medicaid dollars to pay their fair share.” But months later, Utah leaders are still facing objections from industry groups who argue they’re being asked to pay too much. (Pradhan, 9/24)

Also, Oregon is converting its Medicaid eligibility system to the one used by Kentucky -

Portland Business Journal: Oregon Medicaid On Track To Convert To Kentucky System, Will Cost $58M
The Oregon Health Authority plans to debut its new Medicaid eligibility system, imported from Kentucky, on Dec. 15. The transition project came in under budget at $58 million, said Sarah Miller, project director for OHA’s MAGI Medicaid System Transfer Project. The original estimate of $62 million. Miller said the new system will afford several advantages over the current one. (Hayes, 9/24)

Meanwhile, on the topic of health exchanges -

The Associated Press: Arkansas Governor Asks Panel To Put Exchange Plans On Hold
Gov. Asa Hutchinson said Thursday he wants Arkansas to halt work on setting up its own insurance exchange for consumers while lawmakers look at the future of the state's hybrid Medicaid expansion. The Republican governor said he's asked the Arkansas Health Insurance Marketplace board to wait for a legislative task force's recommendations on the "private option" expansion later this year. (DeMillo, 9/24)

Reuters: U.S. Insurance Mega Mergers Could Hurt Care - Psychiatric Group
The American Psychiatric Association warned U.S. antitrust regulators this month that two proposed health insurance deals could worsen access to mental health care services, adding to public opposition from several prominent doctors groups. Anthem Inc would become the largest U.S. health insurer through a proposed $47 billion acquisition of Cigna Corp, announced in late July. Earlier that month, Aetna Inc said it would buy Humana Inc and become the largest provider of Medicare plans for older people. (Humer, 9/24)

In other industry news -

The Philadelphia Inquirer: Blue Cross Plans Helping Corporate Clients Cut Health Costs
The Blue Cross Blue Shield Association on Thursday unveiled an expanded database that will help individual Blues, like Philadelphia's Independence, drill down into the cost of care for their corporate customers who have operations nationwide. he Blue Cross Blue Shield Association, whose members cover 105 million Americans, has maintained a claims database for a decade, and Independence has contributed for years. But now all 36 Blue Cross companies are required to share claims data, which are converted into 1,600 common treatments and elective procedures - up from 300 previously. (Brubaker, 9/25)

The Washington Post: Novartis CEO Talks About Drug Costs, Paying Doctors And ‘Doing The Right Thing’
As stories of jacked-up drug costs make news, and discussions of health-care reform pepper the campaign trail, Novartis CEO Joseph Jimenez sat down with The Washington Post to talk about how he views his responsibility as leader of one of the world's largest pharmaceutical companies. (Cunningham, 9/24)

NBC News: Turing Isn't The Only Drug Company Hiking Prices By Leaps And Bounds
Turing Pharmaceuticals CEO Martin Shkreli was lambasted this week by medical groups, a presidential candidate and his own industry for raising the price of a 62-year-old drug by more than 5,000 percent. He reversed course under pressure Tuesday night, but not before the national attention struck fear into the hearts of biotech investors over increased scrutiny of drug prices, sending stocks plummeting. Turing may have been an egregious example, but it's not the only one raising eyebrows for skyrocketing price tags. Bernstein analyst Ronny Gal pointed out many companies ratchet up drug prices when the market presents an opportunity. (Tirrell, 9/24)

U.S. News & World Report: Budget Breakers
Prescription drugs are costly and most Americans agree that they pay too much for them. Recent headlines illustrate that point clearly – from presidential candidates' promising to tackle the issue, to a CEO initially announcing a jump in the cost of a parasitic-fighting medicine. And with America's total spending on prescription medicine reaching its highest rate in 13 years, policy groups are listening and are coming up with their own plans for reining in costs. But while citizens are feeling the burden of drug costs, so is the government through publicly funded insurance plans. (Leonard, 9/24)

Meanwhile, antitrust enforcers suffer a rare court defeat when challenging a merger -

The Wall Street Journal: Federal Judge Declines To Block Steris From Acquiring Synergy Health
A federal judge on Thursday handed a rare court loss to U.S. antitrust enforcers, declining to block Steris Corp., a U.S. infection-prevention company, from acquiring U.K.-based Synergy Health PLC. U.S. District Judge Dan Polster in Cleveland rejected a request by the Federal Trade Commission to issue a preliminary injunction halting the merger, saying the FTC hadn’t met its burden of showing the deal was likely to damp competition in the U.S. (Kendall, 9/24)

CQ Healthbeat: ICD-10 Transition To Proceed Even If Government Shuts Down
A nationwide changeover to a new set of medical billing codes will proceed on Oct. 1 even if Congress triggers a partial government shutdown that day by missing an appropriations deadline, according to a top federal official. The Centers for Medicare and Medicaid Services already is establishing contingency plans for managing the transition to ICD-10 codes against the potential disruption of a shutdown, said Patrick H. Conway, principal deputy administrator of the agency, on a Thursday call with reporters. Managing the switch from the older ICD-9 codes is among the top priorities for the agency, and CMS has some flexibility in its staffing that can be used to keep the work on track in case of a shutdown, he said. (Young, 9/24)

Politico Pro: Docs Battle Proposal To Curb 'Surprise' Medical Bills
A contentious fight over “surprise” medical bills is complicating an effort to revise a longstanding model state law on health care provider networks. The American Medical Association and other physician groups are pushing the National Association of Insurance Commissioners to drop draft language addressing what happens when patients visit facilities that are in their insurance networks but receive treatment from out-of-network providers. (Demko, 9/24)

McClatchy: Telemedicine Holds Promise Of Cheaper, Wider Medical Care
Samantha Cunningham was halfway through a five-hour road trip to a music festival in Bradley, Calif., when she realized she'd left her asthma inhaler back home in Sacramento. Her options seemed limited: go back, pick it up and be late for the concert; pay a $100 minimum fee to get a new prescription at a walk-in clinic; "or go without the inhaler and hope that they had a rescue machine at the festival on the off chance I had an asthma attack, which, of course, wasn't a very inviting prospect," Cunningham said. (Pugh, 9/24)

CNN: Fiorina's Long-Held Support For Mandatory Health Insurance
Carly Fiorina, who has joined other leading Republican presidential candidates in denouncing Obamacare, once backed an individual mandate to buy health insurance that could put her at odds with others in the GOP. (Moody, 9/24)

NPR: Carly Fiorina Doubles Down On Opposition To Abortion In South Carolina
Republican presidential candidate Carly Fiorina campaigned at a Christian pregnancy care center in South Carolina Thursday. Opposition to abortion has become a prominent message in her campaign recently. (McCammon, 9/24)

Kaiser Health News: Clinton Seeks To Build On Health Law, But Does She Have The Rx For Rising Health Costs?
While the Republicans running for president are united in their desire to repeal the federal health law, Democrat Hillary Rodham Clinton is fashioning her own health care agenda to tackle out-of-pocket costs – but industry experts question whether her proposals would solve the problem. In addition to defending the Affordable Care Act, Clinton released two separate proposals this week. One would seek to protect people with insurance from having to pay thousands of dollars in addition to their premiums for prescription drugs; the other would set overall limits on out-of-pocket health spending for those with insurance. (Rovner, 9/25)

The Seattle Times: Premera Sued Over Security Breaches
With less than a week left to apply, about 830,000 of almost 11 million current and former insurance customers have registered for credit monitoring and identity-theft protection after their personal and medical information may have been compromised in a security breach that Premera announced in March. Mountlake Terrace-based Premera maintains that it does not “have any evidence that there was any criminal activity on anyone’s account as a result of the cyberattack,” company spokeswoman Melanie Coon said in an email statement. (Garnick, 9/24)

The Chicago Tribune: Outage Of Walgreens Pharmacy Computer Database Causes Prescription Delays
Getting a prescription filled at Walgreens may take a lot longer than usual over the next few days due to an ongoing outage of the drugstore chain’s pharmacy computer database. Pharmacists have been filling prescriptions manually since the system went down Tuesday morning, causing delays for customers at all 8,200 Walgreens drugstores across the U.S., a company spokesman said Thursday. (9/24)

NPR: FDA Advisers Call For More Safety Data On Sterilization Device
The Food and Drug Administration should gather more information to try to get a better sense of the safety of the Essure sterilization device, a panel of experts assembled by the agency recommended Thursday. (Stein, 9/24)

Bloomberg: Startup's Cancer Test For The Healthy May Harm Public, FDA Says
The Food and Drug Administration said Thursday that a health-care startup’s cancer detection kit sold to healthy individuals is high-risk, could harm public health, and hasn’t been validated by science. The FDA wrote to Pathway Genomics Corp. on Sept. 21 about the test, which retails for as much as $699. Patients get the test ordered by their doctor or one working for Pathway, then the company analyzes a blood sample for circulating traces of cancer. The company, which is backed by IBM Corp. and the venture capital firm Founders Fund, has touted the test as a less-expensive, faster way of detecting tumors. (Edney and Chen, 9/24)

The Connecticut Mirror: Hospital CEO Pay: Red Herring Or Key In State Funding Debate?
As hospital leaders warn of potential job and service reductions in response to state funding cuts, the six- and seven-figure pay packages of Connecticut hospital executives have emerged as a point of contention. (Levin Becker, 9/25)

NPR: California Counties Add Health Care For Immigrant Adults
A California county voted Tuesday to restore primary health care services to undocumented adults living in the county. Contra Costa County, east of San Francisco, joins 46 other California counties that have agreed to provide non-emergency care to immigrants who entered the country illegally. (Romero, 9/24)

News Service Of Florida: Bondi, Hospital System Reach $3.5M Settlement
Two days after the U.S. Department of Justice announced a $115 million legal settlement with Adventist Health System, Florida Attorney General Pam Bondi said Wednesday her office has reached a $3.5 million settlement with the Altamonte Springs-based hospital system. Both settlements, which stem from whistleblower lawsuits filed by Adventist employees, involve allegations that the hospital firm had improper financial arrangements with physicians. (9/24)

The Milwaukee Journal-Sentinel: Assembly Passes Measure Cutting Taxpayer Funding Of Planned Parenthood
The state Assembly voted Thursday to strip Planned Parenthood of about $3.5 million in government funding a year. The measure passed, 60-35, with all Republicans backing it and all Democrats opposing it. It now goes to the Senate, which like the Assembly is controlled by Republicans. (Marley, 9/24)

The Wall Street Journal: Lawmakers Fail To Override Christie Veto
New Jersey Democrats unsuccessfully attempted on Thursday to override Gov. Chris Christie’s veto of a gun-control bill when most GOP supporters of the legislation decided not to buck the presidential candidate. The legislation would have prevented people with a documented history of mental illness from expunging that record to buy a gun. (Haddon, 9/24)

The New York Times: Alabama Vote Is Rare Win In The South For The U.A.W.
The 2-to-1 margin of victory at the small factory, which makes seats for trucks, represents an unusual win in the uphill battle to organize autoworkers in the South. But it was unclear whether the vote signaled a broader breakthrough for labor and the U.A.W. in a region that has historically been allergic to most unions. Employees at C.V.G. cited low pay, which tops out at $15.80 an hour, the growing use of temporary workers at even lower wages and rising health insurance costs as reasons they voted to join the union. (Cohen, 9/24)

Kaiser Health News: D.C. Women To Get Access To Full Year’s Worth Of Contraceptives
Under a new law, District of Columbia women will be able to scratch one item off their list of things to worry about: running out of birth control pills. Under the law, which passed its congressional review period this month, women will be able to get a year’s supply of pills at once. Prescriptions for birth control pills typically have to be renewed every 30 or 90 days, potentially resulting in women missing scheduled pills. The yearlong provision will begin in 2017. (Andrews, 9/25)

The Associated Press: Utah Unveils Tool Showing Impact Of Federal Budget Crisis
Lawwmakers worried about Utah's reliance on U.S. government funds unveiled an online calculator Thursday that shows how the state would be hit by various federal budget disasters like a shutdown. ... The calculator comes with several built-in scenarios that the commission says are "extreme but possible," such as broad federal spending cuts and or deep slashes to Medicaid money. On the website, the public can access a slimmed down version of a more sophisticated tool that legislative budget staff can use. (Price, 9/24)

The Kansas Health Institute News Service: Mental Health Advocates Question 72-Hour Involuntary Hold Proposal
Several advocates for people with mental illness on Wednesday panned a proposal that would allow treatment facilities to hold people in crisis situations for up to 72 hours as involuntary patients. “This is a deprivation of liberty,” Mike Burgess, a spokesperson with the Disability Rights Center of Kansas, said during a meeting of the Kansas Mental Health Coalition. It would be better, he said, to expand access to voluntary treatment. (Ranney, 9/24)

Health News Florida: Orlando Health To 5,000 Patients: Redo Mammograms
Orlando Health mailed letters today to more than 5,300 patients who may have gotten bad mammograms. Women who went to the Boston Diagnostic Imaging location on Orange Avenue from May of 2013 to July of 2015 are asked to call Orlando Health. It’s unclear why the Boston Diagnostic center has lost its accreditation, but Orlando Health bought the center last December. (Aboraya, 9/24)

Health News Florida: Isolation Increases Florida's Rural Suicide Rates
Florida's rural counties are seeing suicide rates for youth almost double that of the state's large cities. And experts say isolation, poverty, access to firearms and a lack of mental health resources are to blame. ... the teen suicide rate in Florida's small towns has doubled in the past 20 years. From 2012 through 2014, almost 8,000 youth younger than 21 killed themselves in Florida. Of those, 520 come from rural communities -- a significant number given their populations. Also, experts say the number of teen suicides could be much higher, in part because medical examiners and law enforcement don't have an objective set of criteria to decide whether to label a death as suicide. (Miller and Klingener, 9/24)

The Associated Press: Chiropractor Says Iowa Officials Wrong About Payment Rules
A chiropractor accused of improper Medicaid billings says Iowa officials are wrong about coverage eligibility for some conditions. Prosecutors said Thursday that Elizabeth Kressin, of Spencer, had submitted improper claims for more than seven years for what the prosecutors said were medically unnecessary chiropractic procedures for which payments weren't allowed. They include bed wetting, colic and ear infections. (9/25)

The Associated Press: Survey Shows Big Drop In Uninsured Nevada Kindergartners
An annual health survey of Nevada kindergartners shows a big drop in the percentage of children without health insurance, a change that researchers attribute to more use of Medicaid benefits. The seventh annual report from the Nevada Institute for Children's Research and Policy at the University of Nevada, Las Vegas, showed 7.6 percent of kindergartners were uninsured last school year, down from 12.6 percent a year earlier. (Rindels, 9/24)

The Charlotte Observer: New Charlotte VA Center Will Expand Veterans Health Care In Region
Charlotte’s new Veterans Affairs Health Care Center won’t open officially for more than six months. ... The Charlotte site is one of seven new VA health centers approved by Congress in 2010. The Salisbury hospital region is one of the fastest growing in the country, said VA spokesman Barthalomew Major. An estimated 140,000 veterans live in the Charlotte metropolitan area, about 60,000 in Mecklenburg County alone. Although the number of veterans nationwide is declining, the number of veterans enrolled in the VA health-care system in increasing, Major said. Over the past 10 years, the number of VA patients nationwide has increased by 23 percent, but in the Salisbury region, the increase has been 66 percent, he said. (Garloch, 9/24)

The Detroit Free Press: Doctor: Lead Seen In More Flint Kids Since Water Switch
Flint’s ongoing water woes are now associated with an immediate and irreversible danger — possible lead poisoning of some of the city’s children, according to a review of blood test results by a Hurley Children’s Hospital pediatrician. ... State officials say their own review of blood test results have not shown the same increase that [Dr. Mona] Hanna-Attisha found. Moreover, water tests have similarly shown lead within federally accepted levels, they say. (Erb, 9/24)

The San Antonio Express-News: Judge To Halt Medicaid Cuts For Therapy Services
A judge has decided to temporarily block tens of millions of dollars in planned Medicaid funding cuts, likely ensuring that thousands of children with disabilities will continue to access therapy services after Oct. 1. (Rosenthal, 9/24)

Annals of Internal Medicine: Medicare Chronic Care Management Payments And Financial Returns To Primary Care Practices--A Modeling Study
Physicians have traditionally been reimbursed for face-to-face visits. A new non–visit-based payment for chronic care management (CCM) of Medicare patients took effect in January 2015. ... If nonphysician staff were to deliver CCM services, net revenue to practices would increase despite opportunity and staffing costs. Practices could expect approximately $332 per enrolled patient per year... if CCM services were delivered by registered nurses (RNs), approximately $372 ... if services were delivered by licensed practical nurses, and approximately $385 ... if services were delivered by medical assistants. ... At a minimum, 131 Medicare patients ... must enroll for practices to recoup the salary and overhead costs of hiring a full-time RN to provide CCM services. (Basu et al., 9/22)

The Commonwealth Fund: The Experiences of State-Run Marketplaces That Use HealthCare.gov
This brief explores the experiences of four states—Idaho, Nevada, New Mexico, and Oregon—that established their own exchanges but have operated them with support from the federal HealthCare.gov eligibility and enrollment platform. Drawing on discussions with policymakers, insurers, and brokers, we examine how these supported state-run marketplaces perform their key functions. We find that this model may offer states the ability to maximize their influence over their insurance markets, while limiting the financial risk of running an exchange. (Giovannelli and Lucia, 9/17)

The Kaiser Family Foundation: Serving Low-Income Seniors Where They Live: Medicaid's Role In Providing Community-Based Long-Term Services And Supports
To better understand the low-income population with [long-term services and supports] LTSS needs, including those covered by Medicaid and those who are not, this issue brief examines the need for LTSS among seniors who live in the community and need LTSS. We use the 2011 National Health and Aging Trends Study (NHATS) to examine rates of need for LTSS and detail the characteristics of seniors who need these services. Throughout the brief, we compare dual eligible beneficiaries to low-income seniors without Medicaid. We also examine a third group, higher income seniors without Medicaid, to understand the role of income. Because LTSS needs increase with age, we also examine differences by age. (Garfield, 9/18)

National Governors Association: Using Data To Better Serve The Most Complex Patients: Highlights From NGA’s Intensive Work With Seven States
[C]omplex care patients, sometimes referred to as super-utilizers, have comorbid and often serious conditions. ... such conditions often span both physical and behavioral health and are often further complicated by social factors, such as housing instability, poverty, or limited education. ... complex care patients represent only a small proportion (5 percent) of [Medicaid] beneficiaries but account for more than half of program costs. ... the National Governors Association has worked with several states to develop statewide [data] initiatives for improving the management of care for super-utilizers .... The following lessons learned can help state leaders ...: Understand the characteristics of complex populations. ... Identify and target specific patients. ... Ensure effective management and evaluation. (Isasi, 9/23)

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

Reuters: Americans Overpaying Hugely For Cancer Drugs - Study
Americans are paying way over the odds for some modern cancer drugs, with pharmaceutical companies charging up to 600 times what the medicines cost to make, according to an independent academic study. The United States also pays more than double the price charged in Europe for these drugs - so-called tyrosine kinase inhibitors (TKIs), a potent class of cancer pills with fewer side effects than chemotherapy. The analysis by pharmacologist Andrew Hill of Britain's University of Liverpool, who will present his findings at the Sept. 25-29 European Cancer Congress in Vienna, is likely to fuel a growing storm over U.S. drug costs. (Hirschler, 9/22)

The Philadelphia Inquirer/Health Day: ERs Often 'Safety Net' Care For People With Schizophrenia: CDC
A new report finds that, too often, under-medicated Americans suffering from schizophrenia end up seeking care in the nation's hospital emergency rooms. The report, issued Wednesday by the U.S. Centers for Disease Control and Prevention, found that between 2009 and 2011, over 382,000 visits to ERs were recorded for people aged 18 to 64 with schizophrenia. (9/23)

Reuters: Weight-Loss Surgery May Not Increase Health Costs For Diabetes
Weight loss surgery may be a cost-effective way of lowering blood sugar for many diabetics, not just those who are severely obese, a Swedish study suggests. Researchers found that for people with diabetes, total healthcare costs did not rise in the years following weight-loss surgery, largely because of overall savings from less use of healthcare and medications. (Rapaport, 9/23)

Reuters: A Text Message A Day May Keep The Doctor Away
Texting patients regular reminders to do things like eat right, exercise more and smoke less may help them make lifestyle changes linked to a lower risk of heart attacks and strokes, an Australian study suggests. Researchers sent four texts a week to about 350 people with heart disease to supplement their regular care with reminders designed to encourage healthier habits. Another group of about 350 patients stuck with their usual care routines but didn’t receive texts. (9/23)

The New York Times: Consumers Are Embracing Full-Fat Foods
Public health authorities have long urged Americans to cut back on foods high in saturated fat like butter, meat and whole milk. But a new report on dietary-fat consumption suggests that the public is increasingly eating more, not less, of these foods. The new report, which was published last week by the Credit Suisse Research Institute, found that sales of butter in the United States rose 14 percent last year and climbed another 6 percent in the first three months of 2015. Sales of whole milk rose 11 percent in the first half of this year, while skim milk purchases fell 14 percent. The report also predicted that consumption of red meat and eggs would climb in the coming years. (O'Connor, 9/23)

Reuters: Telehealth Visits May Be An Option After Surgery
People may happily, and safely, forgo in-person doctors' visits after surgery by opting instead for talking with their surgeons by phone or video, suggests a small study of U.S. veterans. Most patients preferred the virtual visits and the doctors didn't miss any infections that popped up after surgery, the researchers report in JAMA Surgery. (Seaman, 9/23)

Medscape: Many Poor Kids With Mental Illness Miss Out On Benefits
A "sizable" number of US children with mental disorders who are from low-income households do not receive federal benefits under the Social Security Administration's Supplemental Security Income (SSI) program, according to a new report from the National Academies of Sciences, Engineering, and Medicine, in Washington, DC. However, the number of these children who are receiving SSI funds is growing at a pace consistent with the mental health trends in the general population, the report indicates. (Brooks, 9/21)

Medscape: DNR After In-Hospital Cardiac Arrest May Not Match Prognosis
Among patients who had an in-hospital cardiac arrest and successful restoration of spontaneous circulation, do-not-resuscitate (DNR) orders were generally issued quickly and reflected predicted prognosis, a new study reports. However, the study, which was published in the September 22/29, 2015 issue of the Journal of the American Medical Association, also identified room for improvement. (Busko, 9/23)

Los Angeles Times: Are Democrats Actually The Ones Trying To Shut Down The Government?
So, who's trying to shut down the government, Democrats or Republicans? The answer, naturally, depends on whom you ask. ... Put another way, it was Republicans who decided to tie the continued operation of government to the question of whether Planned Parenthood should receive Medicaid dollars. They took the hostage, they're responsible for the consequences. Feel free to debate the merits of Planned Parenthood all you like, but this fight isn't new. The recent videos didn't seem to persuade any of the organization's supporters in Congress to flip to the other side. So the outcome Thursday wasn't just predictable, it was a certainty. (Jon Healey, 9/24)

The Washington Post's Plum Line: Government Shutdown Fight May Again Shake Up GOP Presidential Race
With the big news out of Congress today the warm welcome received by Pope Francis, one might forget that our nation’s august legislature is headed for yet another government shutdown, this time over Republican demands that the government cut off all funding for Planned Parenthood, most of which comes in the form of Medicaid reimbursements for women’s health care. This comes at a particularly inopportune time for Republicans. Just when it was starting to look like their chaotic presidential primary might be heading to a more sane place, the shutdown controversy threatens to drag it backwards, boosting the candidates the party fears most. (Paul Waldman, 9/24)

The Washington Post's The Fix: Donald Trump Just Went After Martin Shkreli. Why In The World Isn’t The Rest Of The GOP?
Jumping into the prescription drug debate could help elevate those candidates' plans, because prescription drug prices is one of the few health-care issues where Americans agree that the status quo needs to change. In fact, 76 percent of Americans said dealing with prescription drug prices should be Washington's No. 1 health-care priority, according to an April poll from the Kaiser Family Foundation. ... GOP front-runner Donald Trump is regularly praised by liberal leaders, such as Sen. Elizabeth Warren (D-Mass.) and New York City Mayor Bill de Blasio (D), for his call to raise taxes on the wealthy. Want to out-Trump Trump? Why not start talking about an issue that matters deeply to so many Americans? (Amber Phillips, 9/24)

Huffington Post: Top LGBT Group Wants Congress To Investigate Drug Company That Proposed Massive Price Hike
One of the nation’s highest-profile LGBT advocacy organizations has joined the calls for Congress to investigate Turing Pharmaceuticals, the company that recently sparked a national backlash when it proposed hiking the price of a critical anti-infection drug. On Wednesday, The Huffington Post has learned, the Human Rights Campaign sent letters to the chairmen of three key House committees with jurisdiction over health care and the drug industry. In the letters, the organization calls upon the committees to investigate Turing’s recent announcement that it would raise the price of drug called Daraprim, a treatment for toxoplasmosis, from $13.50 to $750 a tablet. (Jonathan Cohn, 9/24)

The Philadelphia Inquirer: A 5,455 Percent Price Increase? Expect More Of It
After Pope Francis's visit to the U.S., possibly the biggest news item this week has been the depraved price increase that Turing Pharmaceuticals posted for its drug, Daraprim. Although the 5,455 percent that Turing hiked Daraprim's price is astounding, the absolute daily price is less than that of many other drugs and the practice of gouging prices on specialty drugs is consistent with practices across the industry. (Daniel R. Hoffman, 9/24)

Bloomberg: Let Medicare Tackle High Drug Costs
Yes, the U.S. pays 40 percent more for drugs than other countries do, and last year those costs rose 12.6 percent. But the increase is expected to slow, and drugs still account for just 10 cents of every dollar Americans spend on health care. What has rightly made drug costs a political issue, however, are the astronomical prices of a few specialty medicines. ... The best strategy to push down such prices -- the one endorsed by [Hillary] Clinton and one of her rivals for the Democratic presidential nomination, Bernie Sanders -- is to give Medicare, which pays for 29 percent of all U.S. prescription drug purchases, the ability to negotiate prices with drugmakers. That Medicare doesn't already do this is Congress's fault. (9/24)

Tribune News Service: Patients Win As Larger Insurers Seek To Cut Costs With Better Service
The planned mergers of several of America's largest health insurers Aetna combining with Humana, and Anthem with Cigna is almost certain to be good for the insurers, reducing overhead and improving their bargaining position as they attempt to negotiate better rates with providers. But what's in it for you and me? The answer may surprise you: In all likelihood, the mergers will lead to better medical care at lower costs. (Jon Kaplan, 9/24)

The Washington Post: Want To Fight Poverty? Expand Access To Contraception.
Pope Francis’s visit has brought renewed attention to some of our nation’s toughest economic challenges: inequality, poverty and income (im)mobility. These are pressing issues that leaders of both political parties say they want to tackle, but they disagree on useful, or even acceptable, policy tools. I have a humble suggestion for an antipoverty policy that, if framed correctly, could appeal to both left and right (though probably not Francis). That policy: better access to contraception. (Catherine Rampell, 9/24)

Forbes: Utah Proposes Tax On The Sick To Pay For Obamacare Medicaid Expansion
After the legislature blocked his Obamacare Medicaid expansion plans in 2014 and 2015, Utah Governor Gary Herbert (R) began working with legislative leaders to negotiate some kind of “compromise” to expand the program to more than 100,000 able-bodied adults. Although the deal is being negotiated in secret, some details have been leaked to the public. According to the few specifics made public, the biggest component of the negotiated framework is to levy a new “assessment” on medical providers in Utah to help pay for the state’s share of expansion. But the so-called assessment is simply a new Obamacare tax on the sick that will not only raise health care costs for all Utahns, but add significantly to the national debt. (Nic Horton, Jonathan Ingram and Josh Archambault, 9/24)

The Washington Post's Wonkblog: We Must Act On Global Health Because Millions Of Lives Are At Stake
The report made a strong case that the benefits of the right health investments far exceed the costs. Indeed, I believe the moral and economic case for investments in health care--both prevention and treatment--is as or more compelling than in any other area in the developing world. The dramatic declines in child mortality and increases in life expectancy demonstrate that policy can make an immense difference. (Lawrence Summers, 9/24)

Bloomberg: Pope Moves The Needle In U.S. Politics
Pope Francis hasn't changed any church policies on economics, social justice, war, abortion or gay marriage. As if to underscore that point, on Wednesday he visited the Little Sisters of the Poor, which took the U.S. government to court to fight a requirement that religious organizations cover birth control in the health insurance they provide to employees. Yet in his emphasis on the plight of the poor, immigrants and the environment, this pope has changed the Catholic Church's tone and rebalanced its priorities. That bothers conservative activists in the U.S., where the Catholic hierarchy for three decades has largely been identified with Republicans and the culture wars because of its stress on abortion and gay marriage. (Albert R. Hunt, 9/24)

The New England Journal of Medicine: Physician Payment After The SGR — The New Meritocracy
The “doc fix” — a permanent replacement for the unworkable sustainable growth rate formula (SGR) enacted in 1997 for calculating Medicare's physician fees — had been a long time coming .... At the heart of the legislation is the new Merit-Based Incentive Payment System (MIPS), which replaces the Physician Value-Based Payment Modifier to move physician payment under Medicare further into the territory of value-based purchasing. ... When it is implemented, the MIPS will become the largest physician pay-for-performance scheme in the world and the first to create a single value-based purchasing framework covering the full spectrum of physician specialties. This new meritocracy will need to be flexible enough to account for the heterogeneous practice styles of the professionals who care for Medicare beneficiaries and the settings in which they work. (Meredith B. Rosenthal, 9/24)

The New England Journal of Medicine: Leap Of Faith — Medicare's New Physician Payment System
These changes mark a new era, in which Medicare offers powerful incentives for physicians to participate in ACOs and other innovative payment and delivery models. ... This revamping reflects a broader movement in U.S. health care toward paying for medical services on the basis of value rather than volume — a movement built on the prevailing view in the health policy community that cost-containment efforts can succeed only if we move away from fee-for-service payment. But there are several important problems with this belief and the reforms it inspires. (Jonathan Oberlander and Miriam J. Laugesen, 9/24)