HHS has indicated support for state initiatives linking Medicaid benefits to work requirements, but almost 60% of beneficiaries are already employed at least part-time. Many of those who are unemployed report that illness, school or the need to care for a family member prevents them from working, according to the Kaiser Family Foundation.
Negotiations on health care continue, but Congress' priority will be voting for a spending bill before Friday's deadline to avoid a government shutdown, House Speaker Paul Ryan, R-Wis., said. Freedom Caucus member Rep Dave Brat, R-Va., predicted a health care vote early next month.
Some health care providers say they believe concern over possible deportation is leading immigrant patients to avoid making medical appointments or skip follow-up care. Providers express concern that patient health and quality of life could suffer, particularly for those with high-risk pregnancies or chronic conditions. Under Immigration and Customs Enforcement policy, agents "avoid conducting enforcement activities at sensitive locations unless they have prior approval from an appropriate supervisory official or in the event of exigent circumstances," said spokeswoman Dani Bennett.
An amendment to the American Health Care Act proposed by Rep. Tom MacArthur, R-N.J., would retain the Affordable Care Act's essential health benefits at the federal level but allow states to request approval to replace the EHBs with their own list. States could also let insurers charge higher premiums to people with preexisting conditions if they create high-risk pools for those patients, according to the amendment, which has been billed as a tool for resurrecting the legislation for a vote the White House would like to see happen next week.
A study in the Journal of the American Geriatrics Society found that bringing informal, unpaid caregivers into the discharge process for elderly patients helped reduce 90-day readmissions by 25% and 180-day readmissions by 24%. Most of the studies included in the paper also found that inclusion of informal caregivers in discharge processes was linked to lower post-discharge care costs, shorter time-to-readmission and shorter rehospitalization periods.
Danish researchers found type 2 diabetes patients who achieved A1C levels of less than 6.5% after six months of metformin initiation had the lowest risk for cardiovascular events or death, while those who had an A1C of at least 8% had the highest risk. The findings in Diabetes Care, based on 24,752 adults with a mean age of 62.5, showed that large A1C reductions among those with a baseline A1C of more than 9% were associated with the greatest outcome risk reductions.
Type 1 diabetes patients who had an average glycated hemoglobin level of 6% and mild retinopathy should be screened once every three years, while those with severe or moderate retinopathy should be screened every three to six months, respectively, according to a study in The New England Journal of Medicine. Researchers used a cohort of 1,441 patients ages 13 to 39 and found those who had an average glycated hemoglobin level of 6% and no signs of retinopathy could undergo one eye exam every four years, while those with glycated hemoglobin levels of up to 10% should undergo screening more often.
The use of apomorphine subcutaneous infusion may reduce periods of unpredictable fluctuations in motor function or "Off" time in Parkinson's disease patients, according to a placebo-controlled study to be presented at the American Academy of Neurology's annual meeting. APO infusion is not approved for this patient group in the US but is used in Europe.
Boston University School of Medicine researchers found that adults who drank one artificially sweetened soda daily were nearly three times as likely to develop dementia and ischemic stroke over 10 years, compared with those who didn't drink diet soda. The findings in the journal Stroke, based on data involving 4,372 adults ages 45 and older, also showed a 2.6 times increased odds of stroke but not dementia among those who drank six or fewer diet sodas a week.
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