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A federal appeals court has decided a case involving Arkansas’ efforts to exclude Planned Parenthood from its Medicaid program, ruling that courts cannot intervene to halt injuries to beneficiaries before they occur. If the decision stands, other states may follow suit.

Courts are political animals; as a result, they strive not only to carry out their assigned role in national governance but also to balance that role within the political and social system in which they operate. Sperling and Cohen offer an elegant, in-depth analysis of how these institutional interests have helped shape decision-making by the Israeli Supreme Court in a health policy context. In doing so, the authors tell a universal story, one with enormous resonance in the U.S.

Updated with new chapters and topics, this book provides a comprehensive description of all essential topics in contemporary pharmacokinetics and pharmacodynamics. It also features interactive computer simulations for students to experiment and observe PK/PD models in action. •    Presents the essentials of pharmacokinetics and pharmacodynamics in a clear and progressive manner •    Helps students better appreciate important concepts and gain a greater understanding of the mechanism of action of drugs by reinforcing practical applications in both the book and the computer modules •    Features interactive computer simulations, available online through a companion website at: https://web.uri.edu/pharmacy/research/rosenbaum/sims/ •    Adds new chapters on physiologically based pharmacokinetic models, predicting drug-drug interactions,  and pharmacogenetics while also strengthening original chapters to better prepare students for more advanced applications •    Reviews of the 1st edition: \"This is an ideal textbook for those starting out … and also for use as a reference book ….\" (International Society for the Study of Xenobiotics) and \"I could recommend Rosenbaum's book for pharmacology students because it is written from  a perspective of drug action . . . Overall, this is a well-written introduction to PK/PD …. \"  (British Toxicology Society Newsletter)

In National Federation of Independent Business v. Sebelius, the US Supreme Court upheld the constitutionality of the requirement that all Americans have affordable health insurance coverage. But in an unprecedented move, seven justices first declared the mandatory Medicaid eligibility expansion unconstitutional. Then five justices, led by Chief Justice John Roberts, prevented the outright elimination of the expansion by fashioning a remedy that simply limited the federal government's enforcement powers over its provisions and allowed states not to proceed with expanding Medicaid without losing all of their federal Medicaid funding. The Court's approach raises two fundamental issues: First, does the Court's holding also affect the existing Medicaid program or numerous other Affordable Care Act Medicaid amendments establishing minimum Medicaid program requirements? And second, does the health and human services secretary have the flexibility to modify the pace or scope of the expansion as a negotiating strategy with the states? The answers to these questions are key because of the foundational role played by Medicaid in health reform.In National Federation of Independent Business v. Sebelius, the US Supreme Court upheld the constitutionality of the requirement that all Americans have affordable health insurance coverage. But in an unprecedented move, seven justices first declared the mandatory Medicaid eligibility expansion unconstitutional. Then five justices, led by Chief Justice John Roberts, prevented the outright elimination of the expansion by fashioning a remedy that simply limited the federal government's enforcement powers over its provisions and allowed states not to proceed with expanding Medicaid without losing all of their federal Medicaid funding. The Court's approach raises two fundamental issues: First, does the Court's holding also affect the existing Medicaid program or numerous other Affordable Care Act Medicaid amendments establishing minimum Medicaid program requirements? And second, does the health and human services secretary have the flexibility to modify the pace or scope of the expansion as a negotiating strategy with the states? The answers to these questions are key because of the foundational role played by Medicaid in health reform.

This national survey showed that less than 2% of U.S. hospitals have a comprehensive system of electronic health records across all clinical units. No more than 12% of U.S. hospitals have even a basic electronic-records system in at least one clinical unit. Computerized provider-order entry has been implemented in 16% of hospitals. The primary barriers to the adoption of electronic health records were reported to be the initial capital required and the high cost of maintenance. This national survey showed that less than 2% of U.S. hospitals have a comprehensive system of electronic health records across all clinical units. No more than 12% of U.S. hospitals have even a basic electronic-records system in at least one clinical unit. The U.S. health care system faces challenges on multiple fronts, including rising costs and inconsistent quality. 1 – 3 Health information technology, especially electronic health records, has the potential to improve the efficiency and effectiveness of health care providers. 4 , 5 Methods to speed the adoption of health information technology have received bipartisan support among U.S. policymakers, and the American Recovery and Reinvestment Act of 2009 has made the promotion of a national, interoperable health information system a priority. Despite broad consensus on the potential benefits of electronic health records and other forms of health information technology, U.S. health care providers have been . . .

Medicaid's coverage guarantee for poor Americans often fails to translate into access to care. The U.S. Supreme Court is now poised to hear a case about the effects on access of California's payment reductions for health care providers who treat Medicaid patients. Since Medicaid was enacted in 1965, its coverage guarantee for millions of the poorest Americans has faced a substantial vacuum in actual access to health care. Multiple factors contribute to this problem: severe shortages of physicians and hospitals in many low-income inner-city and rural communities; low rates of participation in Medicaid among available providers, owing to low payment rates; state administrative practices that drive providers away; and the economic, clinical, educational, and cultural characteristics of Medicaid beneficiaries. 1 Where they are operating, federal programs such as community health centers, federally funded family planning agencies, the National Health Service Corps, local public . . .

This national survey finds that only 4% of physicians use an extensive, fully functional system for electronic health records, and 13% use some form of basic electronic records. Those who use electronic records are generally satisfied with the systems and believe that they improve the quality of care that patients receive. Only 4% of physicians use an extensive, fully functional system for electronic health records, and 13% use some form of basic electronic records. Those who use electronic records believe that they improve the quality of care that patients receive. Health-information technology, such as sophisticated electronic health records, has the potential to improve health care. 1 – 3 Nevertheless, electronic-records systems have been slow to become part of the practices of physicians in the United States. 4 , 5 To date, there have been no definitive national studies that provide reliable estimates of the adoption of electronic health records by U.S. physicians. Recent estimates of such adoption by physicians range from 9 to 29%. 4 , 5 These percentages were derived from studies that either had a small number of respondents or incompletely specified definitions of an electronic health record. 5 , 6 To provide clearer estimates of . . .

Rosenbaum discusses the implications of the Patient Protection and Affordable Care Act. The legislation will take years to implement, and its full meaning can only be conceptualized at this point. But January 2014 will arrive in the blink of an eye. In sum, the Affordable Care Act is transformational, and enormous implementation challenges lie ahead. But the opportunities for major advances in public health policy and practice are simply unparalleled. The Act represents a singular opportunity not only to transform coverage and care, but also to rethink the basic mission of public health in a nation with universal coverage.

President Biden has made reforms intended to “protect and strengthen Medicaid” a centerpiece of his health policy agenda. Given Medicaid’s size and complexity, the administration faces myriad policy and operational challenges.

Mild traumatic brain injury (mTBI) manifests a wide array of clinical features, indicating great heterogeneity of its underlying pathologic features. mTBI diversity is related to pre-injury inter-individual differences and differences in the characteristics of each injury. This review summarizes key features of mTBI patients, their injuries and outcomes to give context to the scope of complexity inherent in this disorder. These differences are underscored by heterogeneity in postmortem pathology and in vivo imaging studies. Recognition, understanding and accounting for disease heterogeneity in mTBI are needed to enhance diagnosis and patient management, as approaches that do not account for inter-individual variation in pathology and patient characteristics relevant to real-life clinical trial participants, may entirely miss therapeutic targets. Refining our approach to TBI diagnosis, in light of inter-individual differences, can facilitate the development of effective prognostic tools and algorithms. New paradigms, which embrace heterogeneity of mTBI, in both preclinical and clinical investigation as well the appreciation of this variability in clinical care, offer much promise for enhancing outcomes and mitigating the burden of mTBI on its victims.