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Seven of the 10 most profitable U.S. hospitals are nonprofits, according to new research, including one in Urbana, Illinois, where hospital tax exemptions are headed for a contentious court battle that soon could determine whether medical facilities are paying their fair share of taxes. The "Top 10" list accompanies a study published Monday in the journal Health Affairs. (5/2)

The top three were nonprofits. Gundersen Lutheran Medical Center, part of the large Wisconsin-based health system, made the most money: $302.5 million just on its patients. California-based Sutter Medical Center, also part of a large system, came in second. Stanford Hospital, also in California, was third. Those hospitals share a key attribute, the authors argued. Whether because of their size, their prestige or their influence in the community, they have more power to negotiate prices, meaning they can charge insurers more for the care they give. “They are the only provider — or they are clearly the dominant provider — and the insurers in that community are relatively weaker, and there are a lot of them,” said Gerard Anderson, director of the Johns Hopkins University Center for Hospital Finance and Management, and one of the study’s authors. (Luthra, 5/2)

The hospitals with the highest price markups earned the largest profits. Anderson thinks they should lower their prices or plow more back into the communities. "Mostly, the hospitals are able to charge more because they can, and they do," he said. "There's no need for nonprofit hospitals to earn substantial profits." Hospitals are among the largest property owners and employers in many communities. Those designated as nonprofits receive state and federal tax breaks for providing “charity care and community benefit.” (Sun, 5/2)

Tenet Healthcare Corp, the third-largest U.S. for-profit hospital operator, expects other insurers to step in and absorb UnitedHealth Group Inc's share of the exchange market when the largest U.S. health insurance provider exits that business, company executives said on Monday. UnitedHealth, one of the biggest sellers of plans on the exchanges, last month said it would exit the Obamacare individual insurance market in most states next year, citing losses from the program. (Kelly, 5/2)

Tenet Healthcare Corp. swung to an unexpected first-quarter loss as the hospital operator increased a reserve for a potential resolution of a whistleblower lawsuit that alleges the company’s Georgia hospitals took part in a kickback scheme. However, shares rose 4.6% to $33.10 in recent after-hours trading as per-share earnings, excluding certain one-time items, were mostly above expectations and revenue topped estimates. (Stynes, 5/2)

Gov. John Bel Edwards debuted a new website and name for Louisiana's Medicaid program on Monday (May 2), saying "Healthy Louisiana" will replace Bayou Health as a program aimed at making people across Louisiana healthier. The new name is expected to be printed on all new materials being distributed as part of Medicaid expansion, Department of Health and Hospitals Secretary Rebekah Gee said Healthy Louisiana will only be printed on new materials. That means no cost to the state for the new moniker, though the managed care organizations that run Bayou Health have expressed concern about the costs on their side. (Litten, 5/2)

Gov. John Bel Edwards on Monday made back-to-back appearances in Baton Rouge to appeal to supporters and community leaders on two of the key issues he’s facing — the state budget shortfall and expansion of the Medicaid health care program. The effort to plug a $600 million gap in the state budget that begins July 1 and the looming launch of looser qualifications for Medicaid, which Edwards has hailed as a way to save the state millions of dollars while providing health care coverage to hundreds of thousands of residents, present two of the biggest tests for the Democratic governor’s administration in the next three months. (Crisp, 5/2)

Covered California’s Obamacare exchange has helped consumers get a better deal on health insurance in part because of its negotiating power — power that other Affordable Care Act marketplaces don’t have — according to a new analysis published Monday. (Aliferis, 5/2)

Lynn Kersey has some advice for pregnant women who bought health insurance policies from Covered California and want to keep them: Don’t report your pregnancy to the agency. “It’s not a requirement … and it’s actually worse to do so,” said Kersey, executive director of Maternal and Child Health Access, an advocacy group based in Los Angeles County. Why? Two of Kersey’s clients with Covered California health plans recently were thrown into Medi-Cal — the state’s health program for low-income residents — without their consent or prior notice after they reported their pregnancies to the state’s health insurance exchange. (Bazar, 5/3)

When patients in South Dakota seek help for serious but manageable disabilities such as severe diabetes, blindness or mental illness, the answer is often the same: With few alternatives available, they end up in nursing homes or long-term care facilities, whether they need such care or not. In a scathing rebuke of the state’s health care system, the Justice Department said on Monday that thousands of patients were being held unnecessarily in sterile, highly restrictive group homes. That is discrimination, it said, making South Dakota the latest target of a federal effort to protect the civil rights of people with disabilities and mental illnesses, outlined in a Supreme Court decision 17 years ago. (Apuzzo, 5/2)

Gov. Dennis Daugaard's administration is reviewing the results of the investigation. The head of the Justice Department's Civil Rights Division said people with disabilities deserve privacy, autonomy and dignity. South Dakota's long-term care system fails to give those individuals the choice to live in their own homes or communities, Principal Deputy Assistant Attorney General Vanita Gupta said in a statement. (5/2)

Foreign investors looking to land a coveted US green card have financed luxury apartments in the up-and-coming Fenway, hotels in Manhattan, ski resorts in Vermont, and Miami’s version of the Eiffel Tower. Now, they are increasingly pouring their money into a less glitzy but thriving industry: drug rehabilitation and psychiatric clinics. (Fernandes, 5/2)

An injection that can stop fatal overdoses of heroin or OxyContin could become more readily available in North Carolina. State health officials want a statewide standing order for physicians to prescribe naloxone (na-LOCK-sewn) for an opioid overdose in an emergency. The Senate Health Care Committee scheduled a hearing Tuesday on legislation for the state health director to set the order. (5/2)

Every day, headlines detail the casualties of the nation’s surge in heroin and prescription painkiller abuse: the funerals, the broken families and the patients cycling in and out of treatment. Now, a new study sheds light on another repercussion -- how this public health problem is adding to the nation’s ballooning health care costs and who’s shouldering that burden. The research comes as policymakers grapple with how to curb the increased abuse of these drugs, known as opioids. State legislators in New York, Connecticut, Alaska and Pennsylvania have tried to take action by adding new resources to boost prevention and treatment. In addition, President Barack Obama laid out strategies last month intended to improve how the health system deals with addiction. (Luthra, 5/2)

There is still no sign that Massachusetts’ opioid epidemic is slowing. New numbers released Monday show that 1,379 people died from unintentional opioid overdoses in the state in 2015. And that number is expected to top 1,500 once all death investigations are complete. (Becker, 5/2)

The biggest issues for Detroit’s health department are tied to poverty — 4 out of 10 residents live below the poverty line — or to decades of neglect that have hit the city’s African-American majority especially hard. Infant mortality is higher here than in any other major American city, and higher than in some foreign countries, including Mexico. Nearly 4 out of 10 Detroit adults are obese. The rate of asthma hospitalizations in the city is more than three times higher than the state average. (Nather, 5/3)

The number of American kids suffering from asthma and attention deficit hyperactivity disorder (ADHD) is on the increase, with poor children being hit the hardest, researchers report. Children living in extreme poverty who had asthma and ADHD were nearly twice as likely to have at least one other chronic medical condition. These conditions included developmental delays, autism, depression, anxiety, behavioral or conduct issues, speech and language problems, epilepsy and other seizure disorders, and learning disabilities. (Reinberg, 5/2)

The Food and Drug Administration's latest anti-smoking campaign takes aim at young adults in the LGBT community, who officials say are nearly twice as likely to use tobacco as their peers. The $35.7 million effort targets the estimated 40 percent of 2 million LGBT young adults in the U.S. who occasionally smoke. Dubbed "This Free Life," the campaign will begin running print, digital and outdoor advertising in 12 markets this week. The ads use the slogan "Freedom to be, Tobacco-Free," and are aimed at adults ages 18 to 24. (5/2)

My normal headache seemed to have matured into a migraine the way a baby crocodile grows into a human-snatching beast. From that day on I no longer had regular headaches. I now suffered from migraines. Migraines affect more than 29 million Americans and are more common among women than men. According to the Office of Women’s Health at the Department of Health and Human Services, most sufferers are between the ages of 15 and 55, have a family history of migraines or disabling headaches, and often have such symptoms as nausea, vomiting and sensitivity to light and sound. (Gokun Silver, 5/2)

States that spend more money on social services and public health programs relative to medical care have much healthier residents than states that don’t, a study out today by a prominent public health researcher found. The study comes as the Obama administration prepares to fund its own research to support the idea that higher social service spending can improve health and lower health care costs. (O'Donnell, 5/2)

Texas announced Monday that the federal government had approved its request for a temporary extension of a $3.1 billion annual Medicaid waiver — despite the Republican-controlled Legislature's refusal to embrace a key component of the White House's signature health care law. (Weissert, 5/2)

The Obama administration has agreed to temporarily keep some federal Medicaid money flowing into Texas to help hospitals treat uninsured patients, a relief to health care providers that feared losing the funds over state leaders' refusal to provide health insurance to low-income adults. (Walters, 5/2)

Texas will not feel the federal government's wrath for refusing to expand Medicaid, at least until 2018, thanks to a deal announced Monday that will allow health care providers to temporarily continue to receive billions of dollars in federal funding that many feared would be cut off. (Rosenthal, 5/2)

Texas health care providers that have relied on a $29 billion federal Medicaid program to help pay for care to the needy will see it extended 15 months, until the end of next year. The state announced the decision Monday as hospitals and others hailed the news, saying the five-year program has provided crucial support — $3.1 billion a year — for offsetting the cost of care to low-income Texans. It also has injected a similar amount into projects aimed at finding better ways to deliver care, potentially at a lower cost. (Roser, 5/2)

A pact between the Centers for Medicare & Medicaid Services and the Texas Health and Human Services Commission gives the state more time to study and show that the state’s decision not to expand Medicaid under the Affordable Care Act ​isn’t aided because it uses federally subsidized emergency room care to help patients who’d be eligible for coverage.​ Specifically, Texas has hired outside consultants to analyze the ways that poor state residents are getting health care. They’ll look at whether some are relying on emergency-room care that could’ve been paid for if the state offered the insurance program to certain low-income adults of working age. (Garrett, 5/2)

The Obama administration has raised the possibility of reducing this funding so that it does not cover care that would be covered if the state expanded Medicaid. That is, the administration says giving people insurance in the first place through Medicaid is a better system than reimbursing hospitals for caring for uninsured people. (Sullivan, 5/2)

The recent controversy and concerns about Iowa’s April 1 switch to hire private companies to manage the state’s Medicaid program has captured President Barack Obama’s attention. Deb McMahon, of Des Moines, recently wrote to the president about the matter through the White House website, explaining the situation with her disabled daughter, Annie. ... A letter dated April 18 with the presidential mark arrived in McMahon’s mailbox April 29. The letter was specific and not a form letter. It was signed by Obama. “You’re right that voices like yours and your daughter’s count – they help inform everything I do, and your message will remain on my mind,” Obama wrote in the letter. (Clayworth, 5/2)

Gov. Terry Branstad said he will carefully consider an agreement hammered out by Iowa legislators late last week that creates enhanced oversight of the state’s Medicaid program. The deal, which is included as part of a $1.8 billion budget bill, has been a priority for Democrats and is subject to the governor’s line item veto. (Pfannenstiel, 5/2)

An additional 15,000 children and pregnant women grappling with Flint's lead-contaminated water crisis should become eligible for government health insurance starting next week, once the funding receives final legislative approval, Gov. Rick Snyder said Monday. The expanded health coverage will apply to people under 21 who used Flint's water system from April 2014, when the city switched its water source, until the time it is deemed safe again. It also will cover women who were pregnant or become pregnant between early March and the safety declaration. They would remain eligible until age 21 or, if pregnant, until two months after their child is born. (Eggert, 5/2)

Alaska Senate Majority Leader John Coghill said Monday he has recommended that lawmakers drop their lawsuit challenging Gov. Bill Walker's authority to expand Medicaid on his own. Coghill, R-North Pole, said the issue has gotten wrapped up in the politics surrounding Medicaid expansion and adds to an already contentious situation as lawmakers try to reach agreements on the budget and other matters to end the extended legislative session. Coghill said he thinks pursuing the case is the right thing to do, but he also believes that support for doing so has dissipated. (Bohrer, 5/2)

A Miami federal judge agreed Friday to schedule a June 28 hearing to formally bless a settlement in a massive class-action lawsuit over children’s Medicaid services in Florida. (Ash, 5/1)

A “mega-bill” containing several provisions related to licensure of medical professionals survived a rules dispute to pass just before the Kansas Legislature adjourned early Monday morning. Unless Gov. Sam Brownback vetoes the bill, the conference committee report combined in House Bill 2615 will require acupuncturists to be licensed, enter Kansas into a compact that will license physicians to practice across state lines and expand the authority of nurse midwives. (Marso, 5/2)

The Legislature added several patient protection measures to a bill allowing “step therapy” for Medicaid drugs before passing the legislation early Monday morning. Advocates for Kansans with mental illness and other conditions were pleased with the changes but remain concerned about the possible effects of the underlying bill on vulnerable patients. (Marso, 5/2)

Gov. Dannel P. Malloy offered his third budget for the new fiscal year, pitching a compromise Monday that cuts his big transportation initiative, while asking legislators to reduce a sales-tax-sharing plan — but not by as much as he originally sought. Malloy would scale back his plans to reduce funding for hospitals, but also would impose deeper reductions on mental health and substance abuse treatment programs than legislators have proposed. (Phaneuf, Levin Becker and Rabe Thomas, 5/2)

U.S. Sen. Maria Cantwell wants Washington state to bring back the Basic Health Plan, which provided an inexpensive health insurance option for the working poor. The new federal program is modeled after a Washington plan that started in 1987 but suspended in 2014 with the start of provisions of federal health care reform. (Blankinship, 5/2)

Drinking water from private wells in northern New England may increase the risk of bladder cancer, according to a new study from the National Cancer Institute, Dartmouth and the state health departments in New Hampshire, Maine and Vermont. (Rodolico, 5/2)

Washington health officials will review the state’s screening for and response to potential lead poisoning in water supplies and other sources, following a directive issued Monday by Gov. Jay Inslee. (Aleccia, 5/2)

A doctor on the University of California’s Board of Regents has been allowed to keep his seat despite a secret investigation that concluded he violated ethics rules by trying to strike a financially beneficial deal between his eye clinics and UCLA, part of the university system the regents oversee. Dr. William De La Peña also engaged in discussions about a prominent eye center affiliation involving UCLA even after recusing himself, an investigation found. At the time, he was chairman of the regents’ health services committee. (Ornstein, 5/2)

Dr. Alejandro Badia started an orthopedic urgent-care center out of frustration. "Every patient that came to see me had already been somewhere, and that somewhere didn't do much for them," he said. "I said to myself, 'Why can't somebody reach me more directly?'" (Miller, 5/2)

Look around and there is more: special lighting, new anesthesia machines, new instruments — just a few of the upgrades totaling $60 million that have been made throughout the hospital over the last three years. (McGrory, 5/1)

A doctor who oversees the medical needs of over 200 jailed inmates in Hillsborough County has been barred from practicing at the facility for at least the next 120 days, after an emergency license suspension by the state’s Board of Medicine (Corwin, 5/2)

In many cases, a pill might be the answer. But doctors and researchers also are increasingly looking toward less invasive and more basic methods of treating mental illness and mood disorders, including exercise and vitamin supplements. (Kurtzman, 5/2)

Usually, just a handful of people show up to meetings of the Board of Health in Orange County, if they show up at all. But last week’s open meeting in Hillsborough on whether or not include electronic cigarettes in the county’s ban on tobacco in restaurants, bars and public buildings drew several dozen people and provided emotional testimony both for and against the proposal. (Hoban, 5/2)

By the time Sanctuary ATC opened its doors in Plymouth — around 11 a.m. Saturday morning — about a dozen people were already huddled around on the porch or hanging out in the parking lot outside, hoping to get in. (McDermott, 5/2)

The architects of the Affordable Care Act counted on competition in the health insurance market to keep costs down and quality high. While the law has accomplished many of its coverage and cost-containment goals, its vision of a more competitive insurance market seems to be fading. The nation’s second-largest health insurer, Anthem, is poised to acquire Cigna, the fourth- largest. Aetna, the third-largest insurer, is seeking to acquire Humana, the fifth-largest. If approved by the Justice Department, these mergers would produce companies controlling about 35 percent of the health insurance market. These mergers would likely leave that market with far fewer competitors — a disappointing result for those who hoped it would increase “choice and competition.” (Richard M. Scheffler and Sherry Glied, 5/2)

Over the past few years, when media outlets reached out to Theranos about whether its wunderkind founder, Elizabeth Holmes, would have time to sit for an interview, her P.R. team generally responded with two questions: What time and where? Holmes was a star. She bounced between TV networks like a politician giving a stump speech. She sat across from tech bloggers, reporters, and TV cameras who slurped up her delectable story—that she had come up with Theranos, her blood-testing company, as a Stanford freshman who was fearful of needles—and they largely regurgitated it, sometimes beat for beat. Yet in April of 2015, when John Carreyrou, an investigative reporter with The Wall Street Journal, reached out for an interview with Holmes, he said he got a very different response. (Nick Bilton, 5/3)

A few years ago, Luberta Whitfield suffered a stroke that left her right side paralyzed. The wheelchair-bound 87-year-old has emphysema and diet-controlled diabetes, is dependent on oxygen, and recently tore the right rotator cuff on her good arm. She also, amazingly, still lives in her own apartment. Ms. Whitfield is a participant in Independence at Home, a congressionally authorized pilot program. The program gives the sickest Medicare patients primary care right where they live. Since launching in 2012, it has been a tremendous success, delivering high-quality care at a lower cost than traditional Medicare. (Ezekiel J. Emanuel, 5/2)

Hospitals celebrate their safety records, but rarely discuss their mistakes. Yet it’s difficult, if not impossible, to improve safety without identifying and learning from errors. That’s why Brigham and Women’s Hospital has launched Safety Matters. This blog aims to describe mistakes made at the hospital along with steps the hospital is taking to prevent them in the future. (Karen Fiumara, 5/3)

If you were contracting for a kitchen remodeling, you’d probably solicit bids and select the lowest one that meets your quality standard. Many goods and services purchased by the government are bought in a similar way, including certain medical equipment like walkers and wheelchairs for Medicare patients. But a big part of Medicare isn’t: private coverage through Medicare Advantage. And that accounts for about a quarter of Medicare’s budget and a third of its enrollees. (Austin Frakt, 5/2)

In calling for "a new national effort to ... cure cancer" during his State of the Union speech in January and labeling it a "cancer moonshot," President Obama deliberately evoked John F. Kennedy's 1961 commitment to "achieving the goal, before this decade is out, of landing a man on the moon and returning him safely to the earth." But are the two efforts comparable? President Kennedy cited NASA's need for a $5.4-billion budget aimed at a very specific goal; Obama is hoping Congress will heed his call for a $1-billion launching fund for a much more nebulous and complicated goal. (Michael Hiltzik, 5/2)

But while it’s incredibly sad that a celebrity like Prince may have died of an opiate overdose, the even sadder news is that mothers, brothers, sons and daughters are dying every single day of prescription drug overdoses. Not just limited to the stereotype of “street junkies”, opiate abuse and death can affect anyone: Less than 3 weeks ago, my twin sons’ 28-year-old triathlon-winning, physically fit second grade teacher was found dead in what the local newspapers described as an opiate overdose. Indeed, most Americans know someone or know a family that’s been touched by this deadly plague. (Nicholas Kardaras, M.D., 5/2)

Suicide is not a minor social problem for Illinois communities; it's a health care crisis. Multiple factors have been linked to climbing suicide rates, including drug and alcohol abuse, mental illness and family history. Research also shows one of the greatest causes of suicide is lack of access to mental health services. In order to improve access, the proportion of Americans insured needs to rise and the number of doctors needs to expand. (Justin Haskins and Jacquelyn Corley, 5/2)

While soda drinking might be good for [Warren] Buffett's portfolio, it's unquestionably harmful for public health. Many studies show that drinking sugar-sweetened beverages every day leads children and adults alike to gain weight, mostly because few soda drinkers compensate by cutting other calories. This could help explain why obesity rates worldwide have risen along with increased consumption of sugar-sweetened beverages. (5/3)