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Although approximately one in five Medicare beneficiaries are discharged from hospital acute care to postacute care at skilled nursing facilities (SNFs), little is known about access to timely medical care for these patients after they are admitted to a SNF. Our analysis of 2,392,753 such discharges from hospitals under fee-for-service Medicare in the period January 2012–October 2014 indicated that first visits by a physician or advanced practitioner (a nurse practitioner or physician assistant) for initial medical assessment occurred within four days of SNF admission in 71.5 percent of the stays. (Ryskina et al, 4/1)

Most clinician-family conferences about prognosis and goals of care for critically ill patients appear to lack important elements of communication about values and preferences, with robust deliberation being particularly deficient. Interventions may be needed to better prepare surrogates for these conversations and improve clinicians’ communication skills for eliciting and incorporating patients’ values and preferences into treatment decisions. (Scheunemann et al, 4/1)

Visits to the emergency department (ED) for psychiatric purposes are an indicator of chronic and acute unmet mental health needs. In the current study, we examined if psychiatric ED visits among individuals 6 to 24 years of age are increasing nationwide. (Kalb, 4/1)

West Virginia is at the epicenter of a national opioid crisis, with a 2016 fatal opioid overdose rate of 43.4 per 100,000 population—more than triple the US average. We used claims data for 2014–16 to examine trends in treatment for opioid use disorder (OUD) among people enrolled in the West Virginia Medicaid expansion program under the Affordable Care Act. (Saloner et al, 4/1)

The rising cost of prescription drugs is currently a major focus for policymakers. One medication that has come under increasing scrutiny over its price increases is insulin, used by people with both Type 1 and Type 2 diabetes to control blood glucose levels. Among people with Medicare, one third (33%) had diabetes in 2016, up from 18% in 2000. The rate of diabetes is higher among certain groups, including more than 40% of black and Hispanic beneficiaries. Although not all people with diabetes take insulin, for many it is a life-saving medication and essential to maintaining good health. (Cubanski et al, 4/1)

The Trump administration is considering a proposed rule that would change long-standing policy in the Supplemental Nutrition Assistance Program (SNAP). The rule would tighten the criteria states use to obtain waivers of work-related time limits from the federal government for SNAP participants known as “able-bodied adults without dependents.” Able-bodied adults without dependents are required to meet stricter work requirements than other adults participating in SNAP. In order to receive SNAP benefits for longer than three months out of a three-year period, they must work 80 hours per month. (Joo and Waxman, 4/1)