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Hillary Clinton and Bernie Sanders have expressed their outrage at Republican threats to block President Barack Obama's choice to replace Supreme Court Justice Antonin Scalia. That's where the similarities end. For Clinton, the opening on the court has provided a chance to aggressively talk about abortion rights, immigration reform and voting rights — issues that rile up her base and closely align her with the sitting president. Clinton, with deep support from Hispanic voters and the full weight of abortion rights groups behind her, reminds those blocs of their uncertain futures by singling out individual cases that could directly affect them. (Debenedetti, 2/16)

On the first Monday in October 2003, a 32-year-old lawyer who then called himself R. Edward Cruz made his first appearance before the justices. It did not go well. Mr. Cruz had only recently taken a job as the Texas solicitor general. ... Speaking in South Carolina on Monday, he described his two-decade relationship with Justice Scalia with favorite tales of his judicial prowess and wit. At that first argument, though, the relationship looked rocky. Mr. Cruz was making a states’ rights argument. Texas had agreed to settle a federal lawsuit accusing it of denying medical treatment to children. But Mr. Cruz said the state had the constitutional authority to ignore the settlement, one that had taken the form of a consent decree. Justice Scalia was not convinced. “Why would the other side ever accept such a consent decree?” he asked. “It’s crazy.” Mr. Cruz lost, nine to nothing. (Liptak and Flegenheimer, 2/16)

In 2013, freshman Sen. Ted Cruz of Texas said he had a plan to do something that seemed impossible. He could force President Obama to strip the funding from the landmark health-care law that had come to bear his name — Obamacare — by threatening to shut down the government. To some other conservatives, there was a problem with Cruz’s plan. It still seemed impossible. (Fahrenthold and Zezima, 2/16)

Democratic regulars recoil at the potential labels Republicans could stick on [Vt. Sen. Bernie] Sanders. He’s proposing a $13.6 trillion, 10-year tax increase, and many proposals will hit the middle as well as wealthier classes. He wants universal health care for a nation still divided over the last massive overhaul, Obamacare. And there’s that socialist label. (Lightman, 2/17)

A law firm representing plaintiffs in an upcoming Supreme Court case on contraception is making a renewed push to outline its argument in the aftermath of Justice Antonin Scalia’s death, underscoring the potential uphill battle that lays ahead for the challengers in the case. The Becket Fund for Religious Liberty – a nonprofit representing the Little Sisters of the Poor in a challenge of the birth control mandate in the 2010 health care law – announced a new website on Tuesday to show “why a win for the Little Sisters is a win for all Americans.” (Zanona, 2/16)

There's not much more time to speculate about how the Supreme Court will handle healthcare-related cases without the late Justice Antonin Scalia. A number of them are fast approaching on the court's calendar, including one scheduled for arguments Tuesday. (Schencker, 2/16)

Democrats are urging the GOP-led House committee investigating Planned Parenthood to halt a round of subpoenas that they argue will endanger abortion doctors and patients. Rep. Marsha Blackburn (R-Tenn.), who leads the House’s select committee, plans to issue three subpoenas this week in an effort to collect information about fetal tissue research in the U.S. – something that Democrats say will turn into a national database used for political purposes. (Ferris, 2/16)

A House lawsuit against the Obama administration over the 2010 health care law shook loose new ammunition in the president’s fiscal 2017 budget request, according to a filing Tuesday: an updated dollar figure for Treasury payments that lawmakers consider unconstitutional. The filing is the latest development in a contentious battle for power in the appropriations process, where the House is demanding that the courts enforce the separation of powers by curbing what they see as an overreach of the executive branch. (Mejdrich, 2/16)

For the first time, the Medicare program and the health insurance industry have agreed on a set of ratings to gauge how well doctors do their jobs. Leaders of the federal Centers for Medicare and Medicaid Services and the trade group America’s Health Insurance Plans announced Tuesday that they have reached a consensus on how to measure physician quality in seven medical areas, from primary care to treatment of patients with cancer or AIDS. (Goldstein, 2/16)

The Obama administration and health insurers took a step Tuesday toward standardizing and improving the measures that are intended to gauge the quality of healthcare but are widely criticized as too burdensome for providers and too numerous or irrelevant to be much help to consumers. (Evans, 2/16)

The government, doctors' groups, insurers and patient advocates say they're coming together on a common set of measurements for what constitutes quality health care. A collaborative representing the various players Tuesday released quality measures for seven broad areas: primary care, cardiology, digestive system, HIV and hepatitis C, medical oncology, orthopedics, and obstetrics and gynecology. (2/16)

Public and private health insurance providers on Tuesday announced a new set of quality measurements meant to make reporting requirements for doctors and care providers more consistent and efficient. By easing the reporting complexity for clinicians, insurers are also hoping to bring down costs for themselves and consumers. While individual payers currently utilize their own measurements, insurers have come together to agree on core measures in seven areas. The effort was led by the Centers for Medicare and Medicaid Services and America’s Health Insurance Plans, an industry trade group. (Siddons, 2/16)

The federal government and the insurance industry released on Tuesday an initial set of measures of physician performance that they hope will reduce the glut of conflicting metrics doctors now must report. The measures are intended to make it easier for Medicare, patients, insurers and employers to assess quality and determine pay. (Rau, 2/16)

New Jersey Gov. Chris Christie’s seventh budget proposal, released on Tuesday, sticks to his pledge against raising taxes, but it assumes that public-sector unions agree to benefit cuts. The $34.8 billion plan also includes steep cuts to state hospitals to fund so-called charity-care cases, which involve treating uninsured or underinsured patients. (Haddon, 2/16)

Community Health Systems Inc.’s share price plummeted Tuesday after a weak earnings report, the latest threat to U.S. hospital investors who have seen big gains of recent years from an improving economy and the 2010 federal health law largely erased in recent months. Community announced Monday that revenues in the last quarter of 2015 fell 2.4% compared with the final three months of 2014. The company added it was setting aside $169 million to cover unanticipated losses on unpaid bills. (Weaver, 2/16)

Shares of hospital operator Community Health Systems fell more than 25 percent after the company reported an unexpected quarterly loss due partly to lower hospital visits from a year ago and slower-than-expected benefits from an acquisition. (2/16)

Medicare appears on track to start in April a test program that will make about 800 hospitals financially responsible for how well people fare after knee and hip replacements, despite pleas from industry groups for more time to prepare for the major reimbursement change. The Centers for Medicare and Medicaid Services seems unlikely to offer further concessions on its Comprehensive Care for Joint Replacement program after having last year shifted away from the original January 2016 start date. The draft proposal for the CJR program was first unveiled in July 2015. (Young, 2/16)

This season, Downton Abbey has a new plot line that has health wonks on the edge of their seats: a heated debate about hospital consolidation that closely parallels what’s going on in the U.S. health care system today. It’s 1925 for the lords and ladies at Downton Abbey. A big hospital in the nearby city of York is making a play to take over the Downton Cottage Hospital next to the posh estate. Or as Maggie Smith’s character sees it, “The royal Yorkshire county hospital wants to take over our little hospital, which is outrageous!” (Gold, 2/17)

The earlier a child with autism can be identified and get treatment the better, child development specialists say. So there's been a push to have pediatricians give all toddlers screening tests for autism during well child visits. But the influential U.S. Preventive Services Task Force said Tuesday that there's not yet enough evidence to show that screening all children delivers measurable benefits, a decision sure to frustrate or anger many in the autism community. (Shute, 2/16)

Sparking strong reaction from doctors and child development experts, an influential task force says there’s “insufficient evidence” to argue definitely that the benefits of screening all young children for autism outweigh the harms. “There’s not enough evidence for us to recommend for or against screening in children for autism under 30 months,” said David Grossman, vice chair of the U.S. Preventive Services Task Force and a Seattle pediatrician. (Luthra, 2/16)

An influential government panel has concluded that evidence is insufficient to recommend autism screening for all toddlers, a position contrary to guidelines from other health associations and advocacy groups. (Price, 2/16)

The Food and Drug Administration on Tuesday issued new guidelines for blood banks intended to help prevent the contamination of the nation’s blood supply with the Zika virus. Among other measures, the agency called for blood banks in areas where the virus is transmitted locally — like Puerto Rico and the United States Virgin Islands — to import whole blood and red blood cells from regions without an outbreak instead of using local donations. (Saint Louis, 2/16)

The Food and Drug Administration is recommending delays for blood donations from people deemed at risk of having the Zika virus. (Sullivan, 2/16)

Federal and international health officials confessed Tuesday to an encyclopedic list of unanswered questions about the fast-spreading Zika virus, which in a matter of months has become an international public health crisis. In a bleak assessment of their ability to confront the disease, epidemiologists, public health experts, scientists and researchers – one by one –told a conference on Zika of their concerns that too little was known about diagnosing the disease and about how it might be spread. (Ordonez, 2/16)

The World Health Organization says it will take $56 million to kickstart a coordinated international response to the Zika virus outbreak racing through much of the Americas, and the WHO plans to tap a newly created emergency contingency fund to pay for the initial efforts. In a lengthy action plan published Tuesday, the organization said a hefty chunk of the money will go toward disease surveillance, which will include tracking new Zika cases and the suspected birth defects and rare autoimmune syndrome that scientists suspect are linked to the mosquito-borne virus. (Dennis, 2/16)

The U.S. Centers for Disease Control and Prevention has begun working with medical researchers in northeast Brazil to investigate the suspected link between the Zika virus and a rare condition that causes brain and skull deformities in newborns. About 15 epidemiologists and experts in birth defects will be working in coming weeks in João Pessoa, the capital of Paraíba state, one of the states that has recorded surging numbers of cases of the condition called microcephaly. The first several members of the CDC’s team arrived Sunday, the organization said. (Johnson, McKay and Jelmayer, 2/16)

Experts say there's no evidence that an increase in birth defects in Brazil, which has coincided with an outbreak of Zika virus, is due to pesticides used to kill mosquito larvae. ... The Argentine environmentalists' claims have stoked conspiracy theories online and in social media, causing some to proclaim the Zika virus a hoax. On its web site, the group claims that spraying mosquitoes using planes is "criminal, useless and a political maneuver" to make it appear that governments are taking action. The root of Zika, the group claims, "lies in inequality and poverty." (Szabo, 2/16)

Employee wellness firms and insurers are working with companies to mine data about the prescription drugs workers use, how they shop and even whether they vote, to predict their individual health needs and recommend treatments. Trying to stem rising health-care costs, some companies, including retailer Wal-Mart Stores Inc., are paying firms like Castlight Healthcare Inc. to collect and crunch employee data to identify, for example, which workers are at risk for diabetes, and target them with personalized messages nudging them toward a doctor or services such as weight-loss programs. Companies say the goal is to get employees to improve their own health as a way to cut corporate health-care bills. (Silverman, 2/16)

It's no secret that stimulant medications such as Adderall that are prescribed to treat symptoms of ADHD are sometimes used as "study drugs" aimed at boosting cognitive performance. And emergency room visits linked to misuse of the drug are on the rise, according to a study published Tuesday in the Journal of Clinical Psychiatry. ... Overall, the study found that nonmedical use of Adderall and generic versions of the drug increased by 67 percent among adults between 2006 and 2011. The findings are based on data from the National Survey on Drug Use and Health. The number of emergency room visits involving Adderall misuse increased from 862 visits in 2006 to 1,489 in 2011 according to data from the Drug Abuse Warning Network. (Aubrey, 2/16)

After a skiing accident in January left him with a smashed knee, Beck Bailey, a transgender man in Greenfield, Mass., spent 15 days in a Vermont hospital undergoing a handful of surgeries. As part of his normal routine, Mr. Bailey gives himself regular shots of testosterone. But the endocrinologist on duty in Vermont told him that patients should not take testosterone post surgery. Mr. Bailey explained that he couldn’t just stop his hormone treatment. But the doctors were so resistant that he finally had them call his primary care physician, who explained he should resume his usual protocol. Mr. Bailey’s experience is echoed by many transgender patients, both those who have fully transitioned and those in the process. (Ellin, 2/16)

Needle exchanges could receive a financial boost this year following a decision by Congress to lift a ban on federal funding. As abuse of prescription drugs and opiates continues to spread across the nation, more states are considering exchanges as a way to save lives. The change in federal policy, part of a spending bill approved earlier this month, allows funding only in areas where drug-related cases of hepatitis and HIV are rising or are likely to. State and city health departments will make that determination along with the federal Centers for Disease Control and Prevention, according to the legislation. (Gorman, 2/17)

Iowa Medicaid leaders told skeptical lawmakers Tuesday that they’re confident they will be able to shift the program to private management on March 1. Federal officials blocked Iowa from implementing the controversial plan Jan. 1, saying managed care companies weren't prepared to handle the 560,000 Iowans who use the program. The feds ordered Iowa to wait until at least March 1 to make the change. They have yet to say if they’ll allow the shift to proceed in two weeks. (Leys, 2/16)

The state of Iowa is ready to offer its Medicaid program under private management on March 1, a state official insisted on Tuesday despite remaining issues and multiple criticisms from a legislative panel. (Rodriguez, 2/16)

A company stripped of its contract to manage Iowa’s Medicaid program following allegations of unfair bidding practices has dropped legal actions to overturn that decision, a company executive said Tuesday. (Clayworth, 2/16)

Despite having one of the strictest eligibility requirements in the country, Alabama has struggled to control the rising costs of Medicaid, which provides health coverage to more than 1 million residents. Alabama Gov. Robert Bentley, a popular two-term Republican governor, and a dermatologist, is offering an unusual cure. The state last week won federal approval to shift most of its Medicaid recipients into managed care organizations, which are paid a fixed monthly fee from the state for each person in the plan. (Galewitz, 2/17)

California's state auditor on Tuesday questioned the use of no-bid contracts at the Covered California health insurance exchange, which spent nearly $200 million during a three-year period without seeking competitive bids on 64 contracts. The total represented about one-fifth of the nearly $1 billion in contracts issued during the period. (Cooper, 2/16)

A new audit slams Covered California, the agency tasked with enrolling state residents in Obamacare, for not following rules when awarding lucrative contracts without a competitive-bidding process. The report discovered nine out of 40 justifications given for the sole-source contracts were insufficient based on the agency’s own standards. Covered California’s policy at the time allowed sole-source contracts, but generally only when timeliness or unique expertise were required for the job. (Cadelago, 2/16)

California's attorney general says as many as three in five Californians may have had electronic records stolen last year. Attorney General Kamala Harris said Tuesday that there were 178 data breaches in California endangering 24 million records. Her report blames a few large breaches for most of the thefts. That includes records exposed by health insurer Anthem Inc. affecting more than 10 million Californians. (2/16)

Florida regulators have approved Aetna’s bid to buy Humana’s health insurance companies in Florida – with conditions. According to a statement from the Florida Office of Insurance Regulation, Aetna and its companies must maintain “fair treatment of Floridians with HIV.” Aetna and other Florida insurers had previously been accused of raising the costs of HIV drugs to discourage enrollment. Regulators want stricter financial requirements for the company as well. (Aboraya, 2/16)

The Medicare-heavy state of Florida has given its blessing to Aetna's $37 billion acquisition of Humana, on the condition that Aetna expands its health plan offerings in the state's insurance exchanges. (Herman, 2/16)

Health insurer UnitedHealthcare will partner with a local doctor’s group in a move they say will lower health care costs. The move could affect more than 20,000 people in central Florida. Accountable Care Organizations, or ACOs, were created by the Affordable Care Act, and the idea was simple: If doctors can prove they can save money without sacrificing the quality of the care, the government will give them a cut of the savings. (Aboraya, 2/16)

The Florida Supreme Court will hear arguments May 4 in a dispute between State Farm Mutual Automobile Insurance and a major Jacksonville hospital about information related to the hospital's reimbursement rates. State Farm took the case to the Supreme Court last year after the 1st District Court of Appeal sided with Shands Jacksonville Medical Center, now known as UF Health Jacksonville. The case involves personal-injury protection auto-insurance claims and the hospital's contracts with health insurers for other types of care. (2/16)

After two testy committee hearings, a Georgia House health panel passed a bill Tuesday that would allow dental hygienists to practice in safety-net settings without a dentist present. The House Health and Human Services Committee vote came after agreement between the hygienists and the Georgia Dental Association on provisions in the bill. (Miller, 2/16)

Minnesota House Democrats are proposing a package of health care measures aimed at reducing drug costs, stopping fraud and adding greater transparency to medical bills. (Pugmire, 2/16)

In the run-up to Tuesday’s meeting, some questioned surrounded whether Florida Surgeon General John Armstrong would be confirmed. Armstrong’s been under fire for decreasing enrollment in the Children's Medical Services program, rising HIV infections and staff cuts in local health departments. (Hatter, 2/16)

Governor Wolf’s proposed budget for fiscal year 2016-2017 makes strategic investments that Pennsylvania’s seniors, children and families need to succeed. Pennsylvania faces a nearly $2-billion-dollar deficit. We can either raise revenue to address our budget crisis and make smart investments that will result in long term savings or we can cut vital services for our Commonwealth’s seniors, children and people with disabilities. (Kraus, 2/17)

U.S. Sen. Claire McCaskill is renewing her call for Missouri legislators to pass a bill monitoring the sales of prescription drugs. Missouri is the only state that has no such database in place. McCaskill, a Democrat, contends that failure to pass such a law has contributed to Missouri’s epidemic of people abusing opioid prescription drugs and heroin. She blamed Missouri’s lack of monitoring on “a few legislators who believe this system would violate people’s privacy.” (Mannies and Leahy, 2/16)

A state lawmaker says Missouri's abortion laws need stronger steps to ensure the person giving parental consent for a teenage girl is actually her legal guardian. A House panel heard testimony Tuesday on legislation from Rep. Sonya Anderson that would require parents or legal guardians to provide written proof of their relationship to the minor seeking an abortion. Her bill would also change the process for a minor seeking a judge's permission to bypass parental consent requirements. (Aton, 2/16)

Marijuana Policy Project has unveiled more details about the medical marijuana amendment planned for Ohio this year. And it has named three Ohioans who will co-chair the campaign. (Borchardt, 2/16)

Seeking to secure justice for thousands of rape victims, about 20 states are moving to test a backlog of unexamined rape kits found in storage rooms in police departments across the country — and change the rules for how rape cases are handled in the future. ... The goal of all the legislation is to ensure that forensic evidence in the kits, such as DNA that is collected from victims in an invasive process that can last four to six hours, is promptly and properly tested to help identify and prosecute suspected rapists. The DNA evidence is placed in an FBI database so that it can be compared to that of criminals and suspects who’ve had theirs taken. (Beitsch, 2/17)

When Kentucky officials launched a multimillion-dollar advertising campaign to promote its new health care options, including an expanded Medicaid program, they assumed they might find a few thousand people who qualified under the old program. (Beam 2/16)

Oklahoma Gov. Mary Fallin is rejecting proposed state mental health rules that would have prohibited payments to independent counselors and therapists to treat Medicaid-eligible Oklahoma children. Fallin said Tuesday she's rejecting the proposal by the Oklahoma Department of Mental Health and Substance Abuse Services that was enacted as a result of budget cuts to state agencies. (2/16)

Hit by recent cuts in state mental health programs, Wyandot Inc., an umbrella organization for four nonprofit agencies in Kansas City, Kan., has eliminated 26 positions. Six of the positions were vacant and won’t be filled and six other employees accepted transfers to other positions in the organization, leaving a total of 14 who lost their jobs. (Margolies and Sherry, 2/16)

An ex-medical technician has been indicted on charges of tampering with narcotics at a Colorado hospital, leading authorities to urge nearly 3,000 people who had surgery there to be tested for blood-borne diseases, federal prosecutors said on Tuesday. The case was brought after the defendant was caught swapping a syringe containing fentanyl citrate, a powerful synthetic opiate, for a dose of an unspecified substance during a patient’s surgery last month, U.S. Attorney John Walsh said in a statement. (Gorman, 2/16)

Senate Bill 277, which goes into effect July 1, eliminates personal belief exemptions and requires children to be vaccinated in order to attend public or private school or day care. Parents will have to show vaccination records to enroll their child in a new school, kindergarten or seventh grade. The only way out is to get a release from doctors for medical reasons (such as having an allergic reaction to shots) or to home school. (Renner, 2/16)

The phone call in September gave Carol Albert some hope: After years on a waiting list, her daughter Casey seemed poised to get a spot in a state program for people with brain injuries. (Levin Becker, 2/16)

The company said 2015 was particularly strong because of a 37 percent growth in business contracts worth more than $5 million and a 62 percent growth in contracts worth more than $10 million. It was the best year in Cerner’s history for new bookings, with both large hospitals and smaller ambulatory facilities contributing. Part of Cerner’s continuing workload is its collaboration with Leidos on a $16.3 billion contract with the U.S. Department of Defense to digitize and improve the military’s health records system. Last year also completed Cerner’s acquisition of Siemens Health Services. (Stafford, 2/16)

A Baltimore-based startup offering privacy tools for electronic medical records announced Tuesday it had raised $4 million in a fundraising round. Protenus received funding from a group of investors led by Arthur Ventures, an early stage venture capital firm with offices in Fargo, N.D., and Minneapolis. Other investors in the Series A financing round included LionBird Venture Capital, DreamIt Ventures, Cognosante, TEDCO and the Baltimore Angels. Founded by a pair of former Johns Hopkins medical students, Protenus offers tools to protect electronic medical records from employee snooping, and identifies when the records are accessed inappropriately. (Wells, 2/16)

“Hillbilly heroin,” they called it – OxyContin, and other opioid prescription painkillers. Police Chief Bill Hollingsed of Waynesville, in Western North Carolina’s Haywood County, recalls about four years ago when the county medical examiner shared with him a shocking statistic: Twenty-five percent of recent deaths investigated by that office were attributable to overdose of these drugs. (Sisk, 2/17)

[Guissela Mariluz is] one of at least 3,600 men and women in Massachusetts who help patients pay bills, arrange pet or child care so the patient can have surgery, or sit with them at an AA meeting. It’s a job that’s been taking shape for decades but is just now becoming a more formal profession. Massachusetts is finalizing rules that are expected to establish the first voluntary community health certification. (Bebinger, 2/17)

Michigan, seeking to prevent another oversight fiasco after lead poisoning in Flint and a deadly Legionnaires' disease outbreak in the area, is considering new water testing rules for hospitals and possible changes to how large facilities manage their water systems that could include new monitoring requirements. (Williams, 2/16)

A South Florida teen has been arrested after authorities say he was posing as a doctor at an illegal medical office he ran. The Palm Beach County Sheriff’s Office says in a news release that 18-year-old Malachi Love-Robinson was arrested Tuesday and charged with practicing medicine without a license. At the West Palm Beach clinic he opened, officials say Love-Robinson performed a physical exam on an undercover agent and offered medical advice Tuesday. (2/16)

For months now, headlines about the Affordable Care Act have focused on complaints from big insurers that they haven't been making money from individual insurance plans mandated by the act. Here's what they haven't been saying so loudly: They're making scads of money from Obamacare — so much that almost universally, they're expanding their participation. What's the catch? The big profits have come not from the insurance exchanges, but via the ACA's Medicaid expansion, in which the largest insurers have been playing a major role. (Michael Hiltzik, 2/16)

How will the death of Justice Antonin Scalia affect the major cases before the U.S. Supreme Court this term, all of which are expected to be decided by the end of June? The answer doesn’t depend entirely on how Scalia would’ve voted. It also depends on a necessary rule of procedure: When the Supreme Court is divided equally, it upholds the decision below. ... The Texas abortion case to be argued March 2, Whole Woman’s Health v. Hellerstedt, is an anomaly. The 5th Circuit upheld the law despite its effect of closing down most of the abortion clinics in the state. Kennedy was expected to be the deciding vote, and he still will be. If he votes to uphold the decision below, the tally will almost certainly be 4-4. If he votes to strike it down, it’ll be 5-3. Either way, he makes the call. (Noah Feldman, 2/16)

Beginning last August, student journalists from the University of Maryland's Philip Merrill College of Journalism in partnership with the non-profit Kaiser Health News were dispatched to West Baltimore to answer this simple question: In a city with some of the finest health institutions in the world, how could there be such enormous disparities in health outcomes? (2/16)

Provider taxes demonstrate the worst aspect of our nation’s health care entitlement programs (Medicare, Medicaid, and the Affordable Care Act)—complicated rules and subsidies that profit special interest groups and empower government bureaucracies with too little benefit for patients most in need and taxpayers. (Brian Blase, 2/16)

In this issue of JAMA, the US Preventive Services Task Force (USPSTF) presents final recommendations for screening children aged 18 to 30 months for autism spectrum disorder (ASD). Autism spectrum disorder can be responsible for significant, long-term impairment in social interaction, communication, and functional capacity. Emerging evidence suggests that early intensive behavioral therapy has the potential to improve outcomes. The prevalence of ASD has increased in recent years and is estimated to be as high as 1 in 68 children, suggesting that improving long-term outcomes could have substantial societal impact. (Michael Silverstein and Jenny Radesky, 2/16)

Every year in the United States there are more than 136 million total visits to emergency departments (EDs). Approximately 20% of adult patients who seek ED care will be hospitalized, and the rest will be treated and discharged, usually to home. However, a proportion of patients who are discharged from the ED will soon return for additional ED care, usually related to the problem treated at the previous visit or on occasion for new symptoms. Depending on location, payer mix, and acuity of illness, rates of return visits to the ED range from 7.5% to 22.4% between 3 days and 30 days. (James G. Adams, 2/16)

Deaths from drug overdoses have exploded around the country, fueled in part by addiction to prescription painkillers. Earlier this month, a Los Angeles doctor was sentenced to 30 years to life in prison after being convicted of murder in the overdose deaths of patients for whom she overprescribed such drugs. It was apparently the first such conviction in the United States. Some say the prosecution will make the medical community hesitant to prescribe opioids to patients who need them. (2/17)

The opioid abuse epidemic has become a major issue on the campaign trail because the number of people who die each year from opioid overdoses is approaching 30,000. But it's important to note that nearly two-thirds of those deaths are due to overdoses of prescription opioids, not heroin. (Merrill Goozner, 2/13)

With no end to Flint’s water emergency in sight, a lot of Michiganders — most genuinely furious, some sensing political opportunity — are demanding Gov. Rick Snyder’s recall or resignation for his role in the crisis. And I suspect there have been mornings when either prospect looked attractive to Snyder, who has seen himself demoted from everyone’s favorite vice presidential prospect to poisoner-in-chief in little more than an eye-blink. But I wish some of those howling for Snyder’s scalp would explain how his abrupt departure would accelerate relief to Flint's beleaguered residents or hasten the reversal of the regulatory neglect that precipitated the city’s ongoing public health emergency. (Brian Dickerson, 1/15)

As the $1 trillion shift from volume to value is rapidly becoming reality, health systems are responding. The first reality that hits health systems is that the old model of the hospitals as the center of the healthcare universe has led to a catastrophic misalignment of population health resources. Even patients who are heavy utilizers (aka Hot Spotters) spend 99+% of their lives outside the hospital. The handwriting on the wall couldn’t be clearer for forward-looking health executives: They must develop a sound strategy for addressing that other 99+% of the patient’s life. (Dave Chase, 2/16)