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Persistent opioid use after surgery is a concern among adolescents and young adults and may represent an important pathway to prescription opioid misuse. Identifying safe, evidence-based practices for pain management is a top priority, particularly among at-risk patients. (Harbaugh et al., 1/1)

In a study comparing 12 695 280 commercial insurance beneficiaries with a household member who started a new prescription of opioids, to 6 359 639 beneficiaries with a household member who started a new prescription of nonopioid pain relievers, the 1-year risk of subsequent opioid use was 0.71% higher among individuals exposed to opioids through a household member’s prescription. (Seamans, Carey and Westreich, 1/1)

This report presents information on the work requirements currently in use in TANF, SNAP, and federal housing assistance programs and discusses the available evidence on implementation experiences and impacts. It also describes Medicaid waiver requests currently under consideration at CMS that would include work requirements and closes by highlighting key questions for consideration when assessing the use of work requirements in safety net programs. For example, given the evidence that employment among families who are subject to current work requirements rarely pays high enough wages to move a family off assistance and out of poverty, what are the expected benefits of implementing new work requirements? (Hahn et al., 12/22)

Concerns about the stability of the individual insurance market under the Affordable Care Act (ACA) have been raised in the past year following exits of several insurers from the exchange markets, and again with renewed intensity in recent months during the debate over repeal of the health law. Our earlier analysis of first quarter financial data from 2011-2017 found that insurer financial performance indeed worsened in 2014 and 2015 with the opening of the exchange markets, but showed signs of improving in 2016 and stabilizing in 2017 as insurers began to regain profitability. (Cox, Semanskee and Levitt, 1/4)

Exemption rates for mandated immunizations are associated with ease of the administrative procedures to obtain exemptions. Several states, in recent years, have implemented the addition of health care provider counseling/signature as a requirement to obtain a nonmedical exemption. ... States in the United States and jurisdictions in other countries should consider adding parental counseling by health care provider as a requirement for obtaining exemptions to vaccination requirements. (Omer et al., 1/1)