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Medicare is steadily shifting from volume-based fee-for-service payments to value-based payment models, including accountable care organizations, episode-based bundled payments, and penalties for hospitals with relatively high Medicare readmission rates.1 These models typically provide financial bonuses or penalties related to the efficiency and quality of care, thereby shifting more financial risk to hospitals, medical groups, and other providers. Through a star rating system, bonuses are also provided to high-quality health plans in the Medicare Advantage program. (Melinda B. Buntin and John Z. Ayanian, 2/9)

Early evidence suggests that bundled payments reduce the cost of knee replacements by an average of almost $1200 per procedure. With a million such procedures performed in a year, that reduction could save over $1 billion. Moreover, these savings don’t seem to come at the expense of quality, at least as far as we can tell. ... Same quality at a lower price – who could be against that?! Well, caution is in order. Healthcare systems that enrolled in the bundled payment system increased the number of knee replacements they performed – about three procedures more per hospital. (Peter Ubel, 2/10)

Sorry (not sorry) if this comes across as condescending, but I’m running out of ways to describe what should be self-evident: Nobody is “pro-abortion.” Aside from a few psychotics, nobody wants there to be more abortions. In that sense, the recent Women’s March and The March for Life were both anti-abortion demonstrations. That’s what I think many are not getting or, rather, choosing not to get. (Coleman Larkin, 2/9)

“Policymakers should be loath to tamper, even at the edges, with [the] elegantly balanced system of free-market drug development in the United States – one that encourages innovation and investment while generally working to stabilize prices at their lowest level possible.” Those words, written by the National Taxpayers Union (NTU) in a letter to Congress just two weeks ago, were meant to express opposition to a prescription drug importation scheme proposed as an amendment to the Senate’s FY 2017 Budget Resolution. Yet, they also apply to a number of other developments about federal policy toward pharmaceuticals. (Peter Sepp, 2/10)

Physicians have a special vantage point from which they can see the way that poverty, housing insecurity, a lack of health insurance, and other factors affect health. But most don’t know what to do with this information, or envision how they can make a difference. To create a truly healthy America, we need a new kind of medical training, one that prepares physicians for roles as health advocates. (Gaurab Basu and Danny McCormick, 2/9)

Some trials testing whether statins could reverse Alzheimer’s failed to produce conclusive evidence. But they did not address whether taking statins decades before Alzheimer’s symptoms arise might prevent the disease. Pharmaceutical companies lack the incentive to pay for expensive clinical trials to get older drugs approved for new uses. Why? Because many of them, like statins, are already off-patent, meaning they are sold at a low price. (Julie Zissimopolous, 2/9)

No, the city of Santa Cruz is NOT considering whether to hand out free methamphetamine to homeless people. A flier is circulating around town, complete with city logo, announcing the City Council will consider the proposal at its upcoming meeting. It’s a hoax, surf city officials insist, spread by a group opposed to Santa Cruz’s controversial outdoor sleeping ban. (Prodis Sulek, 2/9)