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In this cross-sectional study, hospitals in the lowest quintile of dual enrollment saw an increase of $12.3 million in penalties, while those in the highest quintile of dual enrollment saw a decrease of $22.4 million. Large hospitals, teaching hospitals, hospitals in the most disadvantaged neighborhoods, and those with the highest proportion of beneficiaries with disabilities were markedly more likely to see a reduction in penalties, as were hospitals in states with higher Medicaid eligibility cutoffs. (Maddox et al, 4/15)

Nutrition assistance programs are the subject of ongoing policy debates. Two proposals remain uninformed by existing evidence: whether restricting benefits to allow only fruit and vegetable purchases improves overall dietary intake, and whether more frequent distribution of benefits (weekly versus monthly) induces more fruit and vegetable consumption and less purchasing of calorie-dense foods. In a community-based trial, we randomly assigned participants to receive food vouchers that differed in what foods could be purchased (fruit and vegetables only or any foods) and in distribution schedule (in weekly or monthly installments, holding total monthly value constant). (Basu et al, 4/1)

The affordability of health insurance and health care continue to be key public concerns.  While recent policy discussions have largely focused on the adequacy of financial assistance for those covered in the Affordable Care Act marketplaces and the nongroup market, millions of people with low incomes get their coverage through a workplace, where there are fewer protections from high costs. This analysis uses information from the Current Population Survey to look at the average amounts and the shares of family income people in working families with employer-based coverage pay out-of-pocket toward their premiums and direct payments for medical care. (4/15)

In this cohort study of 11 patients with focal epilepsy, seizure reduction was not associated with the direct effects of acute responsive stimulation events. Indirect effects on seizure electrophysiology, which occurred remotely to individual stimulation events, were associated with improved seizure control. (Kokkinos et al, 4/15)