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It was the messiest and most confrontational debate of the Republican presidential primary, repeatedly descending into free-for-alls of cross talk and name-calling. ... Challenged on health care, Mr. Trump reiterated a vague set of promises to replace the Affordable Care Act by making “many plans” available to consumers. (Burns, 2/26)

Trump said he would defund the women's health organization because he's anti-abortion, but he also lavished praise. "I'm totally against abortion having to do with Planned Parenthood, but millions and millions of women, cervical cancer, breast cancer, are helped by Planned Parenthood," Trump said. "So you can say whatever you want, but they have millions of women going through Planned Parenthood, that are helped greatly." ... Challenging each other on insurance proposals, Trump bragged that his would have “many different plans” before reiterating it would have “so many different plans” and adding it would have “many, many different plans.” He also repeatedly emphasized that the federal government should have gotten rid of “the lines around each state” to create more competition. “Now he’s repeating himself,” Rubio jeered. (McCaskill, 2/25)

Armed with the opposition research that's been lacking in the previous nine debates, Marco Rubio in Thursday night's debate came ready to take the strongest swings he could muster at Republican front runner Donald Trump. Rubio attacked Trump from every angle, charging that he's a fraudulent businessman who hires illegal immigrants. He slammed the businessman's limited plan for replacing Obamacare. And he questioned the front-runner's wisdom on foreign policy matters. (Condon, 2/26)

Florida Sen. Marco Rubio challenged Donald Trump at a Republican presidential debate Thursday to give more details about what he would put in place of the Affordable Care Act, but the front-running businessman said only that he would allow people to buy health insurance across state lines. “What is your plan on healthcare? You don't have a plan,” said Rubio, who advocated allowing employers to give their workers tax free funds to buy health savings accounts or private insurance. Others would be able to buy coverage with a refundable tax credit, Rubio said. (Muchmore, 2/25)

Donald Trump stood firm in his defense of Planned Parenthood services other than abortion during Thursday night's CNN Republican debate. "I am pro-life, I am totally against abortion having to do with Planned Parenthood, but millions and millions of women, [with] cervical cancer, breast cancer, are helped by Planned Parenthood," Trump said at the Houston event in the face of criticism from his rivals. (Kamisar, 2/25)

A look at statements in the debate and how they compare with the facts. "It is a health care law that is basically forcing companies to lay people off, cut people's hours, move people to part-time. It is not just a bad health care law, it is a job-killing law," [Marco Rubio said]. The claim that Obama's health care law is a job killer is hard to square with the fact that the economy has added more than 13.4 million jobs since the law took effect. The unemployment rate has fallen to 4.9 percent from 9.9. percent since Obama signed the act. Nor is there evidence that workers are being moved en masse to part-time hours. (2/26)

It’s not Mr. Kasich’s policies that distinguish him from the field. He’s an anti-abortion social conservative who signed a law this week in Ohio barring state contracts with Planned Parenthood. Mr. Kasich’s more potent distinction, his strategists believe, is his optimism. ... Mr. Kasich defends his decision to expand Medicaid under Mr. Obama’s health law, apostasy to Republican rivals, as a hand up to the drug-addicted and mentally ill that saves money. “I think my candidacy represents hope to people,” he said. (Harwood, 2/25)

Republican presidential candidate Ted Cruz on Thursday lifted a hold he placed on bipartisan legislation to address the water crisis in Flint, Michigan, where lead-contaminated pipes have resulted in an ongoing public health emergency. Senators had reached a tentative deal a day earlier for a $220 million package to fix and replace the city's lead-contaminated pipes, make other infrastructure improvements and bolster lead-prevention programs nationwide. (Daly, 2/25)

President Obama had one major challenge at his precision medicine summit on Thursday: avoid getting bogged down in jargon. Instead he kept his eyes on the horizon, focusing on the benefits he envisions 10 years from now if precision medicine moves forward: better, more effective medical treatments tailored to individuals, and eventually lower costs because there will be less spending on treatments that don’t work. (Nather, 2/25)

President Obama on Thursday waded into the complex and high-stakes debate over whether patients own their genetic information, saying that he believes that his tissues and any discoveries that stem from his DNA belong to him. “I would like to think that if somebody does a test on me or my genes, that that’s mine, but that’s not always how we define these issues,” Mr. Obama said during a White House forum on a major biomedical research initiative he began last year. The president said that the success of his Precision Medicine Initiative, which aims to collect genetic data on one million American volunteers so scientists can develop drugs and treatments tailored to individual patients, hinged at least in part on “understanding who owns the data.” (Hirschfeld Davis, 2/25)

The National Institutes of Health said on Thursday it hopes to enroll 79,000 volunteers by the end of 2016 toward what it hopes will be a one-million-patient “precision medicine” study of the genetic causes of diseases. The NIH and the White House launched the $215 million precision medicine initiative a year ago as an effort to find genetic patterns of cancer and other diseases. The centerpiece of that initiative is the one-million person cohort by the end of 2019, and the NIH said it has awarded an initial grant to Vanderbilt University to explore the best way to recruit volunteers for the study. (Burton, 2/25)

“For most of history, medicine has been based on trying to identify what works for the average person. We’re all different. This one-size-fits-all approach is far from optimal,” Dr. Francis Collins, NIH’s director, told reporters. The goal is to “empower any person, anywhere in the U.S., to raise their hand and volunteer to participate” in what’s called the PMI Cohort Program, he said. NIH said is it providing funding to Vanderbilt University for a pilot project to learn how best to attract those volunteers, how to collect the data, and what findings about their own health participants want in return. Vanderbilt will work in collaboration with advisers from Verily, formerly Google Life Sciences. (Neergaard, 2/25)

Republican lawmakers on Thursday expressed concern that eight health cooperatives set up under the Affordable Care Act have been put on some type of enhanced oversight or correction plan, saying the situation raises questions about their long-term viability. Some lawmakers questioned whether the co-ops help keep the price of health-insurance premiums in check by providing competition with large insurers. And they lambasted the Obama administration for awarding federal loans to co-ops that failed. (Armour, 2/25)

The CMS is closely monitoring the finances of eight of the remaining 11 not-for-profit co-ops created by the Affordable Care Act. House Republicans used the uncertain fate of the insurers as a punching bag for the law during a hearing Thursday. ... Republican lawmakers, who have not voted on or proposed an alternative to the ACA, were concerned the remaining co-ops would close and thereby waste taxpayer money. The CMS issued approximately $2.5 billion in loans to the startup insurers, which amounts to a nominal percentage of the overall HHS budget. Some Republicans said the loans are “propping up Obamacare” when there's no certainty the remaining insurers will be solvent in the future. (Herman, 2/25)

People are having to return to the hospital less for costly readmissions because of an Affordable Care Act program, according to a new study by the Department of Health and Human Services. The study, published in the New England Journal of Medicine, finds that an Affordable Care Act program has helped prevent 565,000 hospital readmissions over five years. (Sullivan, 2/25)

Providers would be banned from Medicare and Medicaid if they fail to disclose that they are working with individuals who may be barred from billing the programs or who may owe money to the government, according to a new rule proposed by the CMS. The rule, which also affects the Children's Health Insurance Program, was mandated under the Affordable Care Act. It also authorizes the CMS to deny or revoke a provider's or supplier's Medicare enrollment. It also increases Medicare program re-enrollment bans from three to 10 years. (Dickson, 2/25)

Blue Cross and Blue Shield of Illinois will eliminate sales commissions on new individual health plans that take effect April 1, the Tribune has learned. The state's largest health insurer notified insurance agents and brokers of the change via email Tuesday afternoon. Blue Cross' cutback follows commission reductions by other insurers operating in Illinois. Insurers are cutting costs because of losses in the individual insurance market. (Sachdev, 2/24)

Officials say more than 1 million Illinois residents have health insurance through programs launched by President Barack Obama's health care law. The number includes more than 388,000 Illinoisans who signed up during the recent marketplace enrollment period and more than 626,000 covered under the Medicaid expansion. It's the first time the figure has topped a million. (2/26)

President Barack Obama will be coming to Milwaukee Thursday to praise the city on its implementation of the Affordable Care Act. ... Milwaukee won the White House's Healthy Communities Challenge. The challenge was a contest among 20 cities to enroll people in health plans sold on the marketplace established by Obama's signature legislative achievement, the Affordable Care Act. (Glauber, 2/25)

In January, a government-appointed panel recommended that all pregnant women and new mothers be screened for depression. Public health advocates rejoiced, as did untold numbers of women who had not known that maternal mental illness even existed before it hit them like a freight train.But the panel did not mention one possible consequence of a diagnosis: Life and disability insurance providers have sometimes penalized women with these mental illnesses by charging them more money, excluding mental illness from coverage or declining to cover them at all. And it’s perfectly legal. (Lieber, 2/26)

On Wednesday, a three-judge panel of the Court of Appeals for the Fifth Circuit unanimously voted to allow a 2014 state law requiring abortion doctors to have admitting privileges at nearby hospitals to go immediately into effect. After the law passed, five of the six abortion doctors in the state — including the doctor who performs abortions at Delta Clinic — applied and were turned down at the hospitals near to at least one of the clinics where they work (several of the doctors work at multiple clinics). (Robertson, 2/25)

Abortion services in Louisiana will be restricted to one clinic in New Orleans unless the U.S. Supreme Court reverses an appellate court ruling, an abortion rights group said. On Wednesday, a ruling by the 5th U.S. Circuit Court of Appeals allowed a Louisiana law to take effect that requires doctors providing abortions to have admitting privileges at a hospital within 30 miles. (Burdeau, 2/25)

The United States' wave of abortion clinic closures continued Wednesday in Louisiana, where an appeals court issued an emergency order that abortion-rights groups say will shutter three of the state’s four providers. Louisiana's measure is just the latest abortion clinic restriction in a recent surge that has exacerbated the closures of clinics nationwide over the last five years. Between 2011 and 2014, state lawmakers have enacted 231 abortion restrictions, according to the Guttmacher Institute, a reproductive health research organization. The new laws include required waiting periods, state-mandated counseling, parental consent — and, under review now in Texas, an order that, among other physical updates, clinics must maintain certain hallway lengths. (Paquette, 2/25)

Abortion rights and anti-abortion advocates agree on at least one thing about a major Texas abortion case scheduled for hearing at the U.S. Supreme Court next week: It could have implications for state abortion laws across the country. The Supreme Court is slated to hear oral arguments in Whole Woman's Health v. Hellerstedt on Wednesday. Plaintiffs argue a Texas law unconstitutionally limits access to abortion by requiring doctors at abortion clinics to have admitting privileges at local hospitals and that the clinics meet the same standards as ambulatory surgical centers. (Schencker, 2/25)

Less than half of young men have heard of emergency contraception, a recent study found, even though it’s available over the counter at drug stores and is effective at preventing pregnancy after sex. The study, published in the March Journal of Adolescent Health, analyzed survey responses by 93 men between the ages of 13 and 24 who visited the adolescent medicine clinic at Children’s Hospital Colorado in Aurora for a physical exam, illness or injury between August and October 2014. Most had been sexually active. The computerized survey asked patients about their knowledge of contraceptives, and whether they had talked about birth control with their partners or health care providers. (Andrews, 2/26)

The U.S. Department of Veterans Affairs' inspector general failed to properly investigate a whistleblower's claims that a west suburban Chicago VA hospital had covered up delays in veterans' access to care, federal investigators said Thursday. Germaine Clarno, a social worker and union president at Hines VA Hospital, found out in 2011 that supervisors at the hospital were telling workers to "zero out" patient wait times and to avoid using the hospital's official electronic scheduling system in order to mask major delays in veterans receiving treatment. (Briscoe, 2/25)

The Department of Veterans Affairs ousted the head of its Ohio-based regional network Thursday and disciplined an official at the Cincinnati VA medical center in connection with a probe of the hospital’s management and veterans’ care. The agency said its findings are being referred for a possible federal criminal investigation. (Sewell, 2/25)

The Captain James A. Lovell Federal Health Care Center will be joining other VA hospitals across the country for a "stand down" Saturday, when health officials will analyze ways to reduce wait times for patients with urgent needs. The Lovell facility in North Chicago, which is a hybrid health model that treats veterans and active duty members and their families, currently ranks among the top five VA hospitals for shortest wait times, said Stephanie Caccomo, the center's public affairs specialist. (Abderholden, 2/25)

HIV rates have been on the decline in the U.S. for years now, but stark disparities remain, with some groups of people at high risk of infection. Here's the good part: The number of people diagnosed annually has dropped by about 20 percent in the last decade. But that leaves this bad part: Rates are increasing in African-American and Hispanic men who have sex with men, according to data released Tuesday by the Centers for Disease Control and Prevention. At current rates, half of black and one quarter of Latino gay or bisexual men will be diagnosed with HIV in their lifetimes. (Bichell, 2/25)

With the opioid epidemic reaching into every corner of the U.S., more people are talking about addiction as a chronic disease rather than a moral failing. For researcher A. Thomas McLellan, who has spent his entire career studying substance abuse, the shift is a welcome one, though it has come frustratingly late. (2/25)

One of the best ways to understand Zika virus might be to deliberately inject it into volunteers. That idea may sound a little crazy, but it's not unprecedented. And some researchers are hoping the approach could help speed up the search for an effective Zika vaccine. Right now, a bunch of labs are pursuing different ways of making a vaccine against Zika, mostly because of the concern that the virus might be linked to the birth defect called microcephaly. (Greenfieldboyce, 2/25)

Nursing home residents are entitled to hearings under federal law to determine whether they should be readmitted after hospitalization. The state Department of Health Care Services holds the administrative hearings, but has said it is not responsible for enforcing the rulings. But the state Department of Public Health, which oversees nursing homes, neglects to enforce the rulings and sometimes disagrees with them, according to advocates and court documents. That leaves residents with little recourse — and not many places to go. (Gorman, 2/26)

The Alabama Senate tonight passed a General Fund budget that would essentially level-fund most agencies next year, including Medicaid, which had requested a $100 million increase. The budget calls for spending $1.8 billion from the General Fund, about 4 percent more than this year. Gov. Robert Bentley's proposed budget would have given Medicaid $785 million from the General Fund, $100 million more than this year. But Bentley's plan depended on taking $181 million from education revenues. Senate President Pro Tem Del Marsh said there was no support for that, or for raising taxes. (Cason, 2/25)

Plans to reform Alabama's Medicaid program would end — and the state would lose hundreds of millions of dollars in federal matching funds — under the state budget passed by the Alabama Senate on Thursday. "We're going to have to decide how we want to fund Medicaid, or suffer the disastrous consequences," said Sen. Trip Pittman, R-Daphne, chairman of the Senate's General Fund budget committee. (Lockette, 2/25)

The budget also maintains state funding for Medicaid, the mitochondria of the state’s health care system, at $685.1 million. Medicaid officials warn that funding level would make it impossible to install regional care organizations (RCOs), aimed at moving Medicaid from a fee-for-service delivery model to one that rewards health outcomes. The funding level could also lead to service cuts. But Republican leadership in the Senate said the budget could not sustain ongoing increases in Medicaid, which now makes up 38 percent of total spending in the General Fund. (Lyman, 2/25)

Louisiana's credit rating was downgraded for the first time in more than a decade Thursday, in response to years of budget instability that leave public colleges and government services wallowing in continued financial uncertainty. ... The national rating agency dropped the state's rating by one notch, to Aa3. Moody's cited the steep drop in oil price's effect on state tax collections, years "of structural imbalance" in the budget and declining financial reserves. It raised concerns about state retirement debts and the growing cost of Louisiana's Medicaid program. (Deslatte, 2/25)

For many patients with complex diseases such as multiple sclerosis or rheumatoid arthritis, new drugs hold out the promise of a cure or, at least, keeping symptoms at bay. But for many of those patients, those same drugs can be wildly expensive. For patients with severe psoriasis, the new drug, Otezia, has an estimated wholesale price of $22,500. And Avonex, a drug to treat multiple sclerosis, has seen its price soar past $60,00 a year, up more than 350 percent since 2013. (Hoban, 2/25)

Iowa legislators met with psychologists and psychiatrists all over the Statehouse Tuesday — but not to discuss their personal issues. Psychologists were at the Capitol to seek authority to prescribe mental-health medications. Psychiatrists were lobbying to block the change. Psychologists traditionally focus on counseling. Psychiatrists, who are physicians, often write prescriptions for drugs to counter depression, anxiety, psychoses and other mental-health problems. (Leys, 2/24)

The Georgia House passed a bill Thursday that would allow an individual or corporation to get a state tax credit for donating money to a rural health care organization. (Miller, 2/25)

Area hospitals are riddled with cybersecurity flaws that could allow attackers to hack into medical devices and harm patients, a team of Baltimore-based researchers has concluded after a two-year investigation. Hackers at Independent Security Evaluators say they broke into one hospital's systems remotely to take control of several patient monitors, which would let an attacker disable alarms or display false information. (Duncan, 2/26)

Since 2009, the number of oncology practices affiliated with hospitals has doubled. And a new report says that has driven prices up by 30 percent in areas where there have been such tie-ups. (Gorenstein, 2/25)

Gov. Dannel P. Malloy has ordered the state Department of Public Health to postpone until next year any final decisions on certain hospital transactions – or reject them if state law requires a quicker decision – while a newly created task force examines the state’s oversight process for transactions and other major changes involving hospitals. (Levin Becker, 2/25)

A proposal to build a 72-bed psychiatric hospital in the Quad Cities ran aground Wednesday as it failed to gain approval from state regulators. Supporters said the $14 million project would provide critically needed mental-health services. But opponents warned that it would cripple existing hospitals by siphoning off patients and staff. The Iowa Health Facilities Council, which decides whether large health-care projects are needed, listened all day to testimony before voting 2-2. The vote had the effect of rejecting the proposal from Strategic Behavioral Health, a for-profit company that runs or is building 11 such hospitals in other states. (Leys, 2/25)

Work on a new microhospital in south Jefferson County is progressing, and the new facility should be open and serving patients by late spring. The small hospital at 8515 W. Coal Mine Ave. is being built on land that was previously owned by the Foothills Park and Recreation District and sold to Houston-based Emerus to build the hospital in partnership with SCL Health, a faith-based nonprofit out of Broomfield. (Vaccarelli, 2/25)

While the fate of Laurel Regional Hospital remains undecided, owner Dimensions Healthcare System Thursday disputed allegations from the CEO of the hospital's potential buyer, BridgePoint Healthcare, that Dimensions officials have withheld financial information promised to BridgePoint. In a letter addressed to Dimensions President and CEO Neil Moore on Feb. 19, BridgePoint President Marc Ferrell said the companies entered into a confidentiality and non-disclosure agreement in November 2015 that allows the free flow of financial documentation. Since then, however, Dimensions officials have sent only four out of the 12 financial documents that BridgePoint officials have requested, the letter stated. (Michaels, 2/25)

A mumps outbreak has prompted alerts to healthcare providers across Colorado, with at least four cases confirmed in Denver and two other probable cases under investigation, authorities said Wednesday. "We usually see about 2.5 cases per year (in the city)," said Dr. Heather Young, an infectious disease physician at Denver Health Medical Center who serves as the hospital's epidemiologist. "This is certainly an increase over what we would usually see." (Paul, 2/24)

Providers of home health care in New York say most of their services are reimbursed through Medicaid and they would need increases to meet Gov. Andrew Cuomo's proposal to gradually raise the minimum wage to $15 an hour. The Association of Health Care Providers, representing more than 350 licensed home care agencies, says there are hundreds of thousands of home care aides who earn between $10 and $11.50 an hour. The group says the proposed wage hike would cost agencies more than $1.1 billion the first two years. (2/26)

Illicit activity isn't the only driver of the nation's crisis with opioid medications and heroin, experts say. Expectations about how people should feel in the wake of medical procedures or other health challenges have long shared the blame. (Price, 2/26)

The University of Illinois plans to pay $10 million of a proposed $30 million medical malpractice settlement involving a catastrophic brain injury to a Chicago-area toddler due to surgical complications, the Tribune has confirmed. The proposed settlement was reached last week just as a civil trial was about to start in a lawsuit alleging negligence against Dr. Mark Holterman, a pediatric surgeon. The lawsuit said Holterman performed 24 experimental surgeries on a baby who was born in November 2009 with a leak in his esophagus. In the final surgery performed in 2011, Holterman used a suturing device that severed the boy's pulmonary artery, according to the suit, which was brought by the child's mother, Ethel Chavez. (Sachdev, 2/25)

The Maryland Department of Commerce will provide MedStar Health with $750,000 in state aid plus tax credits to support the relocation of its headquarters in Columbia. MedStar Health, the state's largest health care provider, plans to move later this year to a new and more spacious headquarters just over four miles from its current offices. The 97,000-square-foot building is under construction at Little Patuxent and Snowden River parkways. Known as the Crescent property, it's being developed by the Howard Hughes Corp. (Cohn, 2/25)

In the past six years, staffers at Family Care Health Center in St. Louis have doubled the number of women coming in for regular mammograms. It’s part of a region-wide push for “breast health navigators”: women who reach out to other women who aren’t getting mammograms and frequently don’t have health insurance. Then, they figure out how to get them in the door. (Bouscaren, 2/25)

Dan Diaz has lobbied lawmakers across the country and gone on Oprah, all to fulfill a promise to his late wife, Brittany Maynard, who put a face on the debate over allowing terminally ill patients to seek life-ending drugs. On Thursday, Diaz was in Albany to tell Maynard’s story again, this time to New York lawmakers considering a right-to-die bill. Maynard attracted national attention in 2014 when, at age 29, she moved to Oregon to legally end her life after she was diagnosed with a brain tumor and given six months to live. She died later that year. (Klepper, 2/25)

A toxic chemical found to have contaminated the water system of an upstate New York village has been found in five locations in the nearby Vermont community of North Bennington, Gov. Peter Shumlin and other top officials said Thursday. The contamination of the potentially cancer-causing chemical, known as PFOA, was found in water from private wells for three homes in North Bennington, a landscaping business and the non-potable water supply for a waste water treatment plant that were tested after Vermont officials heard news reports about the contamination found in nearby Hoosick Falls, New York. (Ring, 2/25)

A proposal to allow minors with certain medical conditions to use marijuana for palliative purposes is back before legislators this year, this time with the backing of onetime opponents: pediatricians. (Levin Becker, 2/26)

Meghan Trainer’s second child was born a boy, but at age 4 ½, Brody became Brie and now lives as a girl. For the Federal Way mother of four, there was never a question about supporting and accepting her transgender daughter, who turns 6 on Saturday. (Aleccia, 2/25)

Dakotas-based Sanford Health is pledging up to $3 million to help a Minnesota college pay for a $45 million science complex. Sanford CEO Kelby Krabbenhoft is a 1980 graduate of Concordia College and also serves on the private liberal arts school's Board of Regents. Sanford Health will match 10 percent of donations to the school's capital campaign, up to $3 million. (2/25)

U.S. authorities say a group of people in Puerto Rico who made more than $100,000 a year received Medicaid coverage as part of a $10 million health care fraud scheme. U.S. Attorney Rosa Emilia Rodriguez says several artists, lawyers, government employees and a well-known model participated in the scheme. She says only those who make $24,000 or less qualify for Medicaid. (2/25)

The Hospital Readmissions Reduction Program ... applies financial penalties to hospitals that have higher-than-expected readmission rates for targeted conditions. Some policy analysts worry that reductions in readmissions are being achieved by keeping returning patients in observation units .... We analyzed data from 3387 hospitals. From 2007 to 2015, readmission rates for targeted conditions declined from 21.5% to 17.8%, and rates for nontargeted conditions declined from 15.3% to 13.1%. ... Stays in observation units for targeted conditions increased from 2.6% in 2007 to 4.7% in 2015, and rates for nontargeted conditions increased from 2.5% to 4.2%. Within hospitals, there was no significant association between changes in observation-unit stays and readmissions after implementation of the ACA. (Zuckerman et al., 2/24)

Public controversy over whether nonprofit hospitals provided community benefits sufficient to justify their favored tax status gave rise to congressional scrutiny during 2005-09 and culminated in the inclusion of new community benefit requirements in the Affordable Care Act (ACA). ... there are disagreements over what should count as a community benefit and to what extent hospitals should be held accountable. ... Hospitals have long considered bad debt and Medicare shortfalls as part of the community benefits they provide, but federal regulations do not .... Data from new community benefit reporting requirements will allow analyses on types and amounts of community benefit expenditures; the impact of increased insurance coverage on reducing demands for charity care ... and geographic variations. (James, 2/25)

[Researchers sought to] determine the effectiveness of a text-based smoking cessation intervention among young people. ... The intervention group then received 157 text messages based on components of effective smoking cessation interventions for 12 weeks. The control group received 1 text every 2 weeks thanking them for participating in the study, with delayed access to the intervention. ... A total of 1590 participants, mainly between 21 and 30 years of age, were randomized into the study .... Eight-week prolonged abstinence was reported by 203 participants (25.9%) in the intervention group and 105 (14.6%) in the control group; 4-week point prevalence of complete cessation was reported by 161 (20.6%) and 102 (14.2%) participants, respectively. (Müssener et al., 2/22)

Using a large commercial database, we examined trends in global vaccine research and development and found that the proportion of new vaccine candidates entering all stages of clinical development increased by 3–5 percentage points over the past two decades. Small and medium-size companies accounted for nearly twice as many new Phase I vaccine trials compared to large companies, but late-stage (Phase III) vaccine trials were dominated by large companies. ... Small and medium-size companies, including spin-outs from academic research centers, play an important role in innovative research and discovery. Our findings suggest that policy making targeted at smaller companies, such as prizes or opportunities for public-private partnerships, could support the development of new vaccines. (Hwang and Kesselheim, 2/8)

Many patients recently discharged from an asthma admission do not fill discharge prescriptions. If unable to adhere to a discharge plan, patients with asthma are at risk for re-presentation to care. We sought to increase the proportion of patients discharged from an asthma admission in possession of their medications (meds in hand) from a baseline of 0% to >75%. ... Outpatient pharmacist delivery of discharge medications to patient rooms achieved the project aim of 75% of patients discharged with meds in hand. In a subset of patients for whom all insurance claims were available, those discharged with meds in hand had lower odds of all-cause re-presentation to the emergency department within 30 days of discharge, compared with patients discharged with usual care. (Hatoun et al., 2/24)

Among the most contentious and litigated elements of the Affordable Care Act (ACA) is the requirement that most private health insurance plans provide coverage for ... Food and Drug Administration (FDA) approved prescription contraceptives and services for women. ... over 200 corporations have filed lawsuits claiming that their religious beliefs are violated by the inclusion of that coverage or the “accommodation” offered by the federal government. The legal challenges have fallen into two groups: those filed by for-profit corporations and those filed by nonprofit organizations and both have reached the Supreme Court. ... This brief explains the legal issues raised by the nonprofit litigation, discusses the influence of the Hobby Lobby decision on the current case before the Supreme Court, and the potential impact of a tie decision. (Sobel and Salganicoff, 2/23)

The Affordable Care Act (ACA) established several initiatives to identify new payment approaches for health care that could lead to slower spending growth and improvements in the quality of care. Many of these new delivery system reforms are currently being implemented and tested in traditional Medicare. This Primer describes the framework and concepts of three broad alternative payment models—medical homes, ACOs, and bundled payments—and reviews their goals, financial incentives, size (number of participating providers and beneficiaries affected), and potential beneficiary implications. It also summarizes early results with respect to Medicare savings and quality. (Baseman et al., 2/22)

You've heard it before, and you'll hear it again: Despite repeated recommendations for adults to sleep at least seven hours each night, a new study shows that more than one-third of us are not getting enough shut-eye. And they've pinpointed which states are the most sleep deprived. The CDC study analyzed data from the 2014 Behavioral Risk Factor Surveillance System to determine whether adults are getting enough sleep. (Manella, 2/18)

A vaccine introduced a decade ago to combat the sexually transmitted virus that causes cervical cancer has already reduced the virus’s prevalence in teenage girls by almost two-thirds, federal researchers said Monday. Even for women in their early 20s, a group with lower vaccination rates, the most dangerous strains of human papillomavirus, or HPV, have still been reduced by more than a third. (Hoffman, 2/22)

Cancer deaths have dropped overall for black and white Americans, but disparities still exist, especially when it comes to two of the most common killers -- breast and colon cancer -- a new report shows. (Brophy Marcus, 2/23)

One out of every two black men who have sex with men, and one in four Hispanic men who have sex with men, will be diagnosed with HIV at some point in their lives if diagnosis rates remain the same, a new analysis released Tuesday by the Centers for Disease Control and Prevention shows. (Joseph, 2/23)

Getting expensive radioactive imaging tests to see if a cancer of the lung or esophagus has recurred is not linked to better survival, according to a new study. The likelihood that people with those cancers would be alive two years after their diagnosis was the same whether they went to a hospital that frequently used so-called PET scans or one that used the imaging test less often. (Seaman, 2/23)

An eight-week group program focused on mindfulness-based stress reduction may help with short-term function and long-term pain for people with chronic low back problems, according to a new study. “Most people would think mindfulness meditation would help stress,” said lead author Dr. Natalia Morone of the University of Pittsburgh. “They would not typically think it could actually lead to reduced pain or lead them to have less pain interference during their day to day activities.” (Doyle, 2/23)

As mysteries go, the responsibility for the failure of the Department of Health and Human Services’ rollout of the Affordable Care Act exchanges doesn’t exactly have the same inscrutability of an Ellery Queen novel. In fact, it doesn’t even reach the range and wit of an Encyclopedia Brown short-story whodunit for young readers. (Edward Morrissey, 2/25)

Sen. Marco Rubio (Fla.) made business mogul Donald Trump look silly during Thursday's GOP debate by pointing out that Trump had no real plan to replace the Affordable Care Act. It was one of Rubio’s best moments yet -- and probably distracted many viewers from the fact that Rubio doesn’t really have an alternative, either. (Jonathan Cohn, 2/25)

The country seems fragmented as never before. And yet there are two things that everyone can seemingly agree upon: Something needs to be done about the parlous condition of the working class, and we need to get a handle on health-care costs. (Megan McArdle, 2/25)

The House Republican Health Care Task Force is holding an "ideas forum" the same day. That's fortunate for the GOP conference, since the mission statement is light on ideas. Take care not to confuse this task force with the one from last year, or any of the other House-leadership-sanctioned exercises in failure to achieve consensus on an Obamacare "replacement." So, what do Budget Committee Chairman Tom Price (R-Ga.), Education and the Workforce Committee Chairman John Kline (R-Minn.), Energy and Commerce Committee Chairman Fred Upton (R-Mich.) and Ways and Means Committee Chairman Kevin Brady (R-Texas) have to show the American people? Let's begin with the preamble: (Jeffrey Young, 2/25)

We all know that health care has become increasingly complicated, costly, and limited — especially for our nation’s seniors, who rely on a confusing, overly strained Medicare program to receive their care. While traditional Medicare insures the majority of our nation’s seniors, the Medicare Advantage program is a growing choice within Medicare, allowing beneficiaries to choose a private plan to administer their Medicare benefits. (U.S. Rep. Brett Guthrie, 2/25)

Pfizer executive Erik Nordkamp ... called the United Kingdom “one of the worst countries in the world, if not the worst, for getting breakthrough drugs to those who need them.” People living in sub-Saharan Africa or India, where even basic cancer drugs are often out of reach, might not agree. Yet the comment draws attention to a problem all nations face: Deciding which medicines are worth paying for and which to ration. (Vinay Prasad, 2/25)

After a federal ruling last year threatened to cut aid for Medi-Cal by more than $1 billion, the Brown administration and lawmakers proposed a set of tax increases and reductions that would avert the cut without forcing higher costs onto state taxpayers or consumers. That deal is being challenged, however, by conservatives opposed to new taxes — even if the net cost is zero. Lawmakers should reject this ideological rigidity and keep the federal aid flowing. (2/25)

The federal government has once again delayed the plan to turn over Iowa Medicaid to out-of-state, for-profit companies. The Branstad administration believes the shift will mean better care at lower cost. Detractors think these managed care organizations (MCO) will generate profits at the expense of Iowans in need by denying care and services. Now, the plan to turn over 560,000 Iowans to MCO’s will go forward on April Fool’s Day. In ordering the first delay, federal administrators noted problems with signing up physicians, hospitals and other care providers, as well as signing up recipients. (State Rep. John Forbes, 2/26)

Polio was among the most dreaded childhood diseases of the 20th century. The virus spread from person to person, crippling, paralyzing and sometimes killing its victims. A life-saving vaccine was developed using fetal tissue. Researchers infected fetal kidney cells to produce mass quantities of the virus that were collected, purified and used for inoculations. They won a Nobel Prize for medicine in 1954. Sixty-two years later, some Iowa lawmakers desperately need a refresher on such history. House Study Bill 621 would ban “fetal body parts” from being obtained, provided, transferred or used in this state. Though clearly an anti-abortion stunt, the legislation would prevent fetal tissue from being used by researchers seeking treatments and cures for diseases. Violators — who would likely be none other than medical providers and scientists — could land in the slammer for up to 10 years. (2/25)

Washington is one of a small handful of states where a judge cannot order a juvenile offender to residential mental-health or substance-abuse treatment. Under current law, if a child is 13 or older, she or he must consent to treatment. This means that if you have a 15-year-old son who comes before me charged with a crime and is addicted to methamphetamine, and you want him to go to treatment and I want the same thing, I cannot order him to go as a condition of probation. He must consent. That makes no sense. (Barbara A. Mack, 2/24)

To put it bluntly, bowel would ooze out uncontrollably. And because the disease is also gnawing at her bones, she would be too fragile even to walk to the bathroom. It would fall to her husband and son to deal with the consequences. “I do not want my family to remember me like this at the end,” Holm testified. “I want them to not remember me as a tortured shell of my former self. ... There are things worse than death.” There were tears in the hearing room, but Holm had not come seeking pity. What she sought was the simple right to say “no more,” when her condition becomes unbearable. Under Iowa law, you can’t legally obtain the means to end your own life, even when its quality is so gravely compromised. (Rekha Basu, 2/25)

[I]mproving antibiotic use will require increased accountability and transparency at the societal level. A parallel can be drawn between antibiotic stewardship and infection prevention. ... no transformative progress in reducing health care–associated infections occurred until society began requiring public reporting of infection rates and linking such rates to pay-for-performance measures. This shift toward greater accountability and transparency in health care–associated infections has led hospitals to vest infection control programs with the authority to implement critical improvements. A similar shift could substantially accelerate efforts to improve antibiotic use. (Brad Spellberg, Arjun Srinivasn and Henry F. Chambers, 2/25)

The Senate could soon join the House to try to make it harder for consumers to know what is in their food by prohibiting state governments from requiring the labeling of genetically modified foods. This is a bad idea that lawmakers and the Obama administration should oppose. In July, Vermont will become the first state to require the labeling of genetically modified food. Many food companies and farm groups say such laws are problematic because they could dissuade consumers from buying foods that federal regulators and many scientists say pose no risk to human health. But that is an unfounded fear and states should be free to require labels if they want to. (2/25)

Every day, nearly 1,000 young women around the world become infected with H.I.V., the virus that causes AIDS. More than half of the 37 million people worldwide infected with H.I.V. are women, and most of them live in sub-Saharan Africa. These women too often lack the awareness, the financial means and the power over their own lives to protect themselves from the virus. Tragically, more women of reproductive age around the world die from AIDS than from any other cause. (2/26)