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The August primary already is having a positive impact: The Legislature is expected to hold hearings and vote next session on Medicaid expansion – and it could pass. It remains to be seen whether Gov. Sam Brownback will loosen his opposition to expansion – or whether the loss of more of his allies in the Nov. 8 general election is needed to help change his priorities. (10/16)

One of the biggest ongoing scandals in North Carolina is that several hundred thousand people live every day without health insurance because Gov. Pat McCrory and legislative leaders have refused to follow the lead of 31 other states and expand Medicaid under the Affordable Care Act. ... Studies from the N.C. Institute of Medicine and other foundations and think tanks have found that expanding Medicaid would not just provide health care to people who need it, but create jobs too, 25,000 of them in the first few years of expansion and 18,000 sustained jobs after that. (Chris Fitzsimon, 10/16)

What you don't measure, you can't improve. But if you measure everything, you are at risk of sending false signals about what's important and what's not. This is especially true when measuring healthcare quality, a movement that began in earnest in the late 1990s and now has exploded into a mini-industry. Quality measurement helps determine physician and hospital reimbursement, Medicare star ratings, insurer networks and more. (Merrill Goozner, 10/15)

The Department of Veterans Affairs admits a suicide hotline it runs is failing to answer the phone. How can that be, when about 20 veterans commit suicide every day? Fix it. Now. The former director of the Veterans Crisis Line told The Associated Press that an average of 35 to 40 percent of the calls in May went unanswered by the crisis-trained health science specialists at its Canandaigua, New York location. The calls rolled to backup centers run by a contractor and staffed by workers, sometimes volunteers, who lack specialized training. (10/14)

This fall, as Americans make their choices in a host of local, state and national elections, including presidential, gubernatorial and congressional races, seniors and those eligible for Medicare in San Antonio must pay special attention to the decisions they face during another important election — the Medicare annual election period, or AEP. During this year’s AEP, which is underway until Dec. 7, it’s important for people with Medicare to understand that the choice they make can affect their health throughout 2017. As with any major decision, thoughtful research will go a long way toward the best care-coverage choice, one that maximizes value based on your individual health needs. (Dan Tufto, 10/16)

Prescription drug misuse has become a public health crisis. Though misusing any prescription medications can be dangerous, misusing opioids like oxycodone, hydrocodone, or methadone, can be fatal. One of the simplest and most effective things all of us can do to fight this epidemic is to properly dispose of unused or expired medications. (Betsy Walker, 10/16)

Although companies like Fitbit claim that their fitness trackers have positive outcomes for their customers, the scientific research on the effectiveness of the most wearable devices remains quite divided. A recent study by researchers at the University of Pittsburgh published in JAMA showed that patients, who tracked their activities levels using fitness trackers lost less weight than others who were not monitoring their activities using such devices.  On the other hand, a study published in AJPM showed that older women exercise more when they can track their activity using a Fitbit. (Vibhanshu Abhishek, 10/14)

The scientific community widely accepts that babies born prematurely — or at full term but small — are at a significantly increased risk for heart disease, high blood pressure and Type 2 diabetes later in life. On the surface, the association seems unlikely. But research has shown they are linked because conditions of fetal undernutrition permanently reprogram the body’s energy metabolic pathways. (John Barnard, 10/16)

The effectiveness of surgical procedures for back pain, especially spinal fusion, has come under fire in the media. A systematic review of spinal fusion, published in 2007, was interpreted by New York Times reporter Gina Kolata as concluding that the procedure is “no better than alternative treatments.” There has been a quiet campaign among medical experts over the past few years to rein in the use of the procedure. But let’s take a close look at that evidence. The 2007 review included just four trials of spinal fusion. In one trial, fusion was superior to conservative options like exercise or talk therapy. Two of the other trials weren’t large enough to detect a difference in pain between the fusion and non-fusion groups. The fourth was plagued with poor follow-up, making it difficult to interpret the results. That’s not exactly a resounding dismissal of spinal fusion. (Ahilan Sivaganesan, Matthew McGirt, Andrew Sumich and Clinton Devin, 10/14)

Recently, a study published in The New England Journal of Medicine suggested that outcomes of prostate cancer patients who underwent aggressive treatment were no different than those who chose the so-called “watchful waiting” approach for this typically slow-growing cancer. While those results may be true for patients in general, African-American men might choose the more aggressive approach. (Crystal Moore, 10/17)