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One goal of the Affordable Care Act (ACA) was to increase preventive care and improve health behaviors by expanding access to health insurance. ... Using data from the Behavioral Risk Factor Surveillance System, and a difference-in-differences model that compares states that did and did not expand Medicaid, we examine the impact of the expansions on preventive care (e.g. dental visits, immunizations, mammograms, cancer screenings) and risky health behaviors (e.g. smoking, heavy drinking, lack of exercise, obesity). We find evidence consistent with increased use of certain forms of preventive care such as dental visits and cancer screenings but little evidence of changes in health behaviors and in particular ... no evidence that risky health behaviors increased in response to health insurance coverage. (Simon, Soni and Cawley, 5/22)

Recent and past oncology provider-patient discussions about prognosis/life expectancy were examined for their association with changes in illness understanding by patients. Patients (N = 178) with advanced cancers ... whom oncologists expected to die within 6 months were interviewed before and after a visit in which cancer restaging scan results were discussed. ... Before the restaging scan visit, nine (5%) of 178 patients had completely accurate illness understanding (ie, correctly answered each of the four illness understanding questions). ... 68 (38%) [patients] reported that they never had discussions of prognosis/life expectancy with their oncologists. ... Patients with advanced cancer who report recent discussions of prognosis/life expectancy with their oncologists come to have a better understanding of the terminal nature of their illnesses. (Epstein et al., 5/23)

The purpose of this brief is to consider how uninsurance rates are changing under the ACA. ... While reducing the number of uninsured people is just one measure of the ACA's effect, it is arguably the most important metric. Several government surveys can be used to study the number uninsured in the US population, including the Current Population Survey, the National Health Interview Survey, the American Community Survey, and the Medical Expenditure Panel Survey. The various surveys have different survey designs, field periods, health insurance coverage questions, reference periods, and survey modes, making the uninsurance estimates slightly different among each of the sources. (Goodell, 5/23)

[Researchers sought to] understand the expansion of health plan–provider accountable care organization (ACO) partnerships and the evolution of the characteristics of these partnerships. ... Our survey showed health plan expansion of ACO implementation with increased use of shared risk and widespread provision of analytic reports and other types of technical assistance to providers. The cohort of 8 health plans reported improvements in quality of care since 2011 while evolving their program components, such as use of more readily measureable provider eligibility criteria, ongoing emphasis on health plan–provided technical assistance, and greater collaboration between health plans and their provider partners, to continually re-evaluate quality and utilization measures. (Higgins, 5/14)

The majority of large employers that offer health benefits today also offer at least some wellness programs in an effort to promote employee health and productivity and reduce health related costs. ... Final regulations recently issued by the Equal Employment Opportunity Commission (EEOC) would change standards applicable to certain workplace wellness programs that use incentives to encourage workers and their spouses to provide personal health information. These new rules are intended to be more consistent with other standards implementing requirements in the Affordable Care Act (ACA) that apply to certain workplace wellness programs. Both rules seek to balance employer interest in incentivizing workers to participate in wellness programs against requirements that prohibit discrimination based on health status, disability, and genetic information. (Pollitz and Rae, 5/19)

Premature babies born with extremely low birth weights are more likely to face lifelong challenges, including health problems and social and economic difficulties, new research suggests. The study, published today in JAMA Pediatrics, found that while in general, these premature babies grow up to be productive members of society, they are more likely to be unemployed, earn less money, have lower self-esteem, and report more chronic health issues. (Welch, 5/23)

A major U.S. government study on rats has found a link between cellphones and cancer, an explosive finding in the long-running debate about whether mobile phones cause health effects. The multiyear, peer-reviewed study, by the National Toxicology Program, found “low incidences” of two types of tumors in male rats that were exposed to the type of radio frequencies that are commonly emitted by cellphones. The tumors were gliomas, which are in the glial cells of the brain, and schwannomas of the heart. (Knutson, 5/27)

Most Americans would not enroll in clinical trials over concerns they would experience side effects, encounter higher costs, or receive a placebo instead of an actual medicine, according to a new survey. Specifically, 35 percent say they would avoid participating in a study and, overall, just 40 percent have a positive view of clinical trials, according to the survey released on Monday and conducted by the Memorial Sloan Kettering Cancer Center, a leading hospital based in New York that also conducts hundreds of clinical trials. (Silverman, 5/25)

The treatment of hypertensive patients 75 years and older to a systolic blood pressure target of 120 mm Hg reduces the overall risk for mortality by one-third, according to new data from SPRINT. "It's a game-changer," said researcher Mark Supiano, MD, from the School of Medicine at the University of Utah in Salt Lake City. ... The study results were presented by Dr Supiano and one of his colleagues, first author Jeff Williamson, MD, from the Wake Forest School of Medicine in Winston-Salem, North Carolina, here at the American Geriatrics Society 2016 Annual Scientific Meeting, and published online simultaneously in JAMA. (Harrison, 5/20)

In an attempt to help stem a rise in suicide attempts in the US Army, a new study has pinpointed when soldiers are most likely to try to kill themselves — before, during, and after their deployments. For those who had not yet deployed, suicide attempts peaked in the second month of service, according to the paper, published Wednesday in JAMA Psychiatry. Deployed soldiers faced the highest risk in the sixth month of their deployment, and soldiers who had returned home after a deployment were most likely to attempt suicide in the fifth month. (Joseph, 5/25)

Neighborhoods designed for walking may decrease the rates of being overweight or obese and having diabetes by more than 10 percent, a new study concludes. Canadian researchers studied more than three million people in 8,777 neighborhoods in urbanized areas of Ontario, ranking them for “walkability” on a 100-point scale that measures population density, numbers of facilities within walking distance of residences and how well connected their webs of streets are. (Bakalar, 5/24)