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We provide an overview of sixty-four programs operating in jails, prisons, or community probation and parole systems that enroll individuals during detention, incarceration, and the release process. We describe the variation among the programs .... Seventy-seven percent of the programs are located in jails, and 56 percent use personnel from public health or social service agencies. We describe four practices that have facilitated the Medicaid enrollment process: suspending instead of terminating Medicaid benefits upon incarceration, presuming that an individual is eligible for Medicaid before the process is completed, allowing enrollment during incarceration, and accepting alternative forms of identification for enrollment. (Bandara et al., 12/7)

Programs created under the Affordable Care Act to connect consumers to health care coverage represent an unprecedented public-sector investment. State-level implementation of these programs has varied greatly .... assister programs play a vital role supporting consumers in the new Marketplaces, particularly when assisters maintain extended ongoing relationships with consumers; assisters come from and are situated within communities they serve; local programs are well coordinated; and postenrollment issues can be addressed. Stable funding commitments, year-round employment, and enriched training were identified as crucial long-run strategies for building a more professional assister workforce and stronger infrastructure. (Grob and Schlesinger, 12/7)

Of 23 CO-OPs launched [under the federal health law], all but two have fallen short of their enrollment or profitability projections. Twelve plans have or are about to shut down .... We examined plan, pricing, and enrollment data for six CO-OPs .... To meet the very short deadlines for filing rates and plans with state departments of insurance, CO-OPs were forced to outsource critical functions such as network design and claims processing. ... Setting the initial and subsequent prices of their products may have been the most important decisions CO-OPs faced. However, unlike their competitors, CO-OPs lacked historical claims and market data to help them estimate their costs. ... Over half of the CO-OPs fell short of their enrollment targets in 2014, making it difficult for them to cover fixed costs. (Corlette, Miskell and Giovannelli, 12/10)

Medicare Part D drug plans differ considerably in the drugs they list on their formularies, their use of formulary tiers, and the level and structure of cost sharing applied to those tiers. ... The financial consequences for Part D plan enrollees can be substantial. ... Part D enrollees can expect to pay thousands of dollars out of pocket for a single specialty drug in 2016, even after their drug costs exceed the catastrophic coverage threshold. ... Monthly out-of-pocket costs for commonly used brand and generic drugs tend to vary widely across Part D plans, even when included on plan formularies; for five of ten top brands, monthly costs vary by as much as $100 across plans. (Hoadley, Cubanski and Neuman, 12/2)

Nearly a quarter of primary care doctors in the United States say their practices are not well-prepared to manage patients with multiple chronic illnesses, according to an international survey. The 2015 Commonwealth Fund International Health Policy Survey of Primary Care Physicians, released Monday, surveyed doctors in 10 countries, including the United States, Canada, Germany, Australia and Sweden. Doctors in the United States and Canada felt least prepared among the countries surveyed to handle patients with multiple chronic conditions. (Samuel, 12/7)

Many Type 2 diabetes patients are being overtested and overtreated, according to a new finding from Mayo Clinic researchers. Their study, published Wednesday in the BMJ medical journal, found that six out of 10 patients who don't require insulin have their average blood sugar levels checked far more frequently than guidelines recommend, a practice that can lead to potentially harmful, excessive treatments. (Benson, 12/8)

Women surgeons working at university medical centers say they’ve faced more gender discrimination as staff surgeons than they did as medical students or residents, according to a new study in Canada. But the women surgeons still rated their career satisfaction highly, researchers found. (Doyle, 12/10)

Women with breast cancer may have better survival odds if they get surgery and chemotherapy more quickly, two large U.S. studies suggest. “We are not taking about providing care in days, but a woman should not have to wait months,” said Dr. Eric Winer, a researcher at Harvard University and director of the breast program at Dana-Farber Cancer Institute in Boston. (Rapaport, 12/10)

There are a number of options for women when they learn they have breast cancer in its earliest stages, when the tumor is relatively small and has not yet spread. Each option is similarly effective when it comes to killing cancer cells and preventing the disease from returning. (Neighmond, 12/11)

Injection drug users in rural and suburban areas have less access to needle exchange programs than those in cities do, even though addiction rates are rising in non-urban areas, a new study shows. Providing injection drug users with new, sterile needles and syringes in exchange for used ones reduces their risk of contracting or spreading infections such as HIV and hepatitis C, the researchers explained. (Preidt, 12/10)

If you were at high risk for a deadly, untreatable disease, would you want to know it? Would you want to join a clinical trial? Alzheimer's researchers are hoping that a lot of people are so eager to find a cure that they will answer yes to both those questions. GeneMatch, an ambitious, national effort to recruit people at high genetic risk for Alzheimer's disease, was launched Tuesday by the Banner Alzheimer's Institute in Phoenix and will include a key role for University of Pennsylvania researchers. (Burling, 12/8)