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Traditional fee-for-service (FFS) Medicare’s prospective payment systems for postacute care provide little incentive to coordinate care or control costs. In contrast, Medicare Advantage plans pay for postacute care out of monthly capitated payments and thus have stronger incentives to use it efficiently. We compared the use of postacute care in skilled nursing and inpatient rehabilitation facilities by enrollees in Medicare Advantage and FFS Medicare after hospital discharge for three high-volume conditions .... we found lower intensity of postacute care for Medicare Advantage patients compared to FFS Medicare patients discharged from the same hospital, across all three conditions. Medicare Advantage patients also exhibited better outcomes than their FFS Medicare counterparts. (Huckfeldt et al., 1/9)

[A] recent proposal would encourage rare disease research by providing six months of extended exclusivity for any existing drug that is granted subsequent FDA approval for a new rare disease indication. ... We found that for the thirteen FDA-approved drugs that gained supplemental approval for a rare disease indication from 2005 through 2010, the median projected cost of clinical trials leading to approval was $29.8 million. If the exclusivity extension had been in place, the median discounted financial gain to manufacturers would have been $94.6 million. Median net returns would have been $82.4 million, with higher returns for drugs with higher annual sales. Extending market exclusivity would provide substantial compensation to many manufacturers, particularly for top-selling products, far in excess of the cost of conducting these trials. (Kesselheim et al., 1/18)

Texas House Bill 2, enacted in 2013, was one of the most restrictive abortion laws in the country before the US Supreme Court ruled in June 2016 that 2 provisions were unconstitutional. Following introduction and passage of the bill, the number of Texas facilities providing abortions declined, from 41 in 2012 to 17 in June 2016. ... When the change in distance was 100 miles or more, the number of abortions decreased 50.3% .... abortions also declined among women in counties with an open facility in 2014, indicating that there were other factors related to the decrease, such as limited capacity to meet demand for services. (Grossman et al., 1/19)

Seven of the top 10 leading causes of death and disability in the United States today are chronic diseases (e.g., cancer and diabetes). Prevention and treatment of most of these conditions must address the close link with obesity. People who are overweight or obese account for more than two thirds of the U.S. population and are overrepresented in primary care practices. Some professional organizations now classify obesity, defined as a body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) of 30 or higher, as a disease. Management of overweight (BMI, ≥25) or obesity in the clinical setting, alone or in combination with a chronic disease, is the focus of this review. (Heymsfield and Wadden, 1/19)

[P]olicymakers should consider fixing the major problems they have with the ACA rather than repealing it; this would not disrupt the parts that are working effectively. To that end, we propose a range of policies that would address critics’ concerns and also strengthen the law, expand coverage, improve affordability, increase market stability, and lower the high premiums that exist in some markets. (Holahan and Blumberg, 1/16)

This brief provides a side-by-side comparison of the Medicare-related provisions in six bills and proposals that would repeal the ACA, excluding proposals that would not directly affect Medicare. Two of these proposals would repeal the ACA in its entirety, including all Medicare provisions, two would repeal some Medicare provisions in the ACA, one would retain all Medicare provisions in the ACA, and one does not specify. The first part of the side-by-side describes the Medicare provisions in the ACA that would be retained or repealed in each bill or proposal. The second part of the side-by-side describes the additional ways in which the bills and proposals would change Medicare, such as structural modifications to the Medicare program. (Jacobson et al., 1/18)

New guidelines tackle a question many older adults on blood pressure medication face: How low should you go? But finding the right blood pressure might not be so straightforward. The latest guidelines, released yesterday by two physicians' groups, have already drawn criticism for how high they set targets for adults 60 and older, even in light of recent data that some patients, especially those at higher risk for stroke and heart attack, may benefit from lower blood pressures. (Nedelman, 1/17)