Mary K. Caffrey

Iowa's unique brand of Medicaid expansion and its efforts to improve mental health delivery gained notice in 2014. The announcement this week had few details except that it seeks to save $51.3 million in first half of 2016.

A major technical partner is announced for the long-awaited HIT initiative that will give oncologists a data-derived "second opinion" right from their desktops, with the earliest versions scheduled to come online this year.

The meta-analysis published today and an accompanying editorial should serve as a wake-up call for healthcare organizations about the costs of caring for aging populations that have spent much of their lives behind desks and watching TV.

The tentative agreement, which must be ratified by 18,000 RNs, calls for a 14% raise over 3 years and retirement protections, as well as safety steps including training to prevent nurses from being harmed by infectious diseases such as Ebola.

Covered California's leader says its decision is only fair to those insurers who took on the risk of a brand new marketplace in 2014. But the state's insurance commissioner says limiting choices is unfair to consumers.

The aging US population means that Medicare is taking care of more older, sicker people for longer periods of time. Population trends suggest this phenomenon will only increase, unless drastic management and healthcare delivery solutions are found.

Hospitals have endorsed the movement toward Regional Care Organizations (RCOs), which would guide the transition away from fee-for-service. But a looming budget gap is an immediate concern, while Alabama's Medicaid costs keep climbing.

The increasing popularity of retail clinics to provide basic care is bring driven by many factors, including consumer interest in transparency, cost, and convenience. Malls are beneficiaries of the shift.

Advocacy groups have gone to federal court to force states to make higher payments to Medicaid providers to improve access. But a spokesman for state Medicaid officials said the courts are an inappropriate place for such disputes.

The Consumer Financial Protection Bureau and the Kaiser Family Foundation have both examined how rising cost-sharing and the complexity of medical billing put patients at a disadvantage when they are most vulnerable. Patients tell the CFPB that bill collectors are calling even when they can't get complete information about the medical bill in question.

ASCO and AACR called on the FDA to regulate e-cigarettes and other electronic nicotine delivery systems and for more research to occur to find out how long-term use affects health. Leaders of these groups said that e-cigarettes could cause nicotine addiction among teens, and CDC data show rising use of the products among middle- and high-schoolers.

North Carolina is the latest state to express interest in a possible waiver to expand Medicaid. But CMS and President Obama will have to rethink a position taken when Pennsylvania's request for a job training requirement was rejected last year.

Illinois passed a law in 2011 that called for moving 50% of its Medicaid population into managed care by January 1, 2015. The state came very close to meeting that goal, with the expressed mission of achieving the "triple aim" called for in the Affordable Care Act.

Congress eased school nutrition standards championed by Michelle Obama in the final days of the last session, and some nutrition advocates believe it's just the beginning of a rollback of the 2010 law that put healthier foods on lunchroom plates. What happens if Congress' efforts to water down school lunch standards run counter to the ongoing work of the committee setting the nation's nutrition policy, whose work will be released in the next few weeks?

Advocacy groups led by the JDRF gained strong bipartisan support for a bill in the last session of Congress, even though it was introduced late in the session. Those who support gaining Medicare coverage for devices that allow persons with type 1 diabetes to better monitor their blood sugar believe that bodes well for passage in the session that begins next week.

A report from HHS notes that through December 15, 2014, 52% of enrollees were new consumers, which could indicate that the Obama Administration is on track to meeting its goal of signing up 9 million Americans for health coverage on the exchanges in 2015.

The plaintiff, John Doe, alleges that not having access to a community pharmacist will limit his ability to gain counseling on potential drug interactions. United Healthcare settled a similar action earlier in 2014. Consumer groups have also alleged discrimination against HIV patients by insurers over drug access in Florida.

Republican Governor Bobby Jindal moved quickly to privatize 6 public hospitals with advanced lease payments, and he set up a prescription reimbursement schedule without prior approval from CMS. The agency signed off on privatization but rejected both financial pieces this week, which could leave Louisiana's next governor with a budget shortfall.

CMS' Sean Cavanaugh announces in a blog post that 89 newcomers will participate in 2015. But ACOs remain a work in progress, with rule changes on the way and some discussion about whether these entities are assuming enough risk or dampening competition in certain markets.

The most important case since the Supreme Court upheld the constitutionality of the Affordable Care Act will determine the law's ability to function in states without their own exchanges.