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Urban hospital markets are getting more top-heavy, drawing concern from economists and researchers who warn that less competition can inflate healthcare costs. Nearly three-quarters of 112 metropolitan areas across 43 states had "highly concentrated" hospital markets in 2016, according to a new report by the Health Care Cost Institute. The share of highly concentrated markets, as defined by the Herfindahl–Hirschman Index, increased to 72% in 2016, up from 67% in 2012. (Kacik, 9/17)

Weekend fights at six Oklahoma prisons that left one inmate dead and more than a dozen others injured were apparently coordinated and the result of race-based gang tension inside the facilities, the head of a prison workers association said Monday. The first fight erupted Saturday at the Northeast Oklahoma Correctional Center in Vinita, in the northeast of the state. (Murphy, 9/16)

Former CVS (CVS) chief executive Thomas M. Ryan and his wife are giving $35 million to the University of Rhode Island to bolster a neuroscience institute, scholarships, and URI basketball — the largest private donation in the state university’s history. Ryan told the Boston Globe that his father, George Ryan, died of Alzheimer’s disease eight years ago, and his mother, Anne Ryan, “died taking care of him.” (Fitzpatrick, 9/16)

Unions representing more than 80,000 Kaiser Permanente workers said their members will participate in a weeklong strike starting Oct. 14 to protest the company’s labor practices. The healthcare giant’s workers will strike in California and five other states as well as the District of Columbia, the unions said. The strike will affect employees with jobs as optometrists, a variety of technicians, clinical laboratory scientists, housekeepers and hundreds of other positions — largely those who are not doctors, registered nurses or mental health workers. (Hussain, 9/16)

The Coalition of Kaiser Permanente Unions announced late Monday their roughly 80,000 workers will walk off their jobs as part of a seven-day strike beginning Oct. 14 in California, five other states and the District of Columbia. (Anderson, 9/16)

A new policy designed to eliminate unused beds in nursing homes has put Gov. Ned Lamont at odds with a key part of his base, Connecticut’s largest healthcare workers’ union. SEIU Healthcare 1199NE announced Monday a new online ad campaign to press the Democratic governor to reverse the policy, which it says has put nine nursing homes — with large vacancy rates — at risk of closing. (Phaneuf, 9/16)

For Jonathan Bush, there is life after athenahealth. The outspoken former chief executive of the Watertown company has landed a new gig as executive chairman of the Boston startup Firefly Health, which aims to provide primary care for patients through an app as well as clinic and employer visits. (Chesto, 9/16)

Zandra Bartell transferred here in June after the General Motors plant in Lordstown, Ohio, ceased production. “It was either come here or be without a job,” said Bartell, 49. On Monday, she found herself, along with thousands of other local United Auto Workers members, seeking a better deal from the company. (Merrilees, 9/16)

For every dollar state agencies are proposing to cut to meet Gov. Brian Kemp’s order to slow spending, they’re requesting nearly two more to pay for programs, from education and health care to law clerks and fighting gangs. That’s because not all agencies are equal when it comes to cutting, or adding spending. (Salzer, 9/16)

A defense attorney says a former Wisconsin nurse is prepared to plead guilty to hurting infants in a Madison hospital's intensive care unit. Forty-three-year-old Christopher Kaphaem faces 19 felony child abuse counts involving nine infants. WKOW-TV reports Kaphaem's attorney, Jonas Bednarek, notified the court of the plea in a letter Monday. (9/16)

As San Francisco reels from a recent string of traffic fatalities, new city data points to another vexing trend: a surge in the number of pedestrians gravely injured by cars. Fifty-five pedestrians were critically hurt in crashes last year, according to the Department of Public Health. (Swan, 9/16)

When Los Angeles City Councilman Mitch O’Farrell laid out a proposal that would bar people from sleeping on streets and sidewalks near schools, parks and other targeted facilities, local activists lined up at a City Hall hearing to denounce the idea and showed up at O’Farrell’s home in Glassell Park to protest. Now they have taken to the streets again — this time with pens and maps. (Reyes, 9/16)

Prices for CalPERS’ most popular health insurance plans are going up more in Sacramento County than in most of the state, partly as a result of a change the retirement fund’s board made to how it groups insurance markets last year. Employees of schools and local agencies who are enrolled in CalPERS’ most popular plan, a Kaiser Permanente HMO, face a 12 percent premium increase in the Sacramento area, according to published rates. (Venteicher, 9/16)

Arizona is one of eight states that had "statistically significant" increases in the number of people without health insurance between 2017 and 2018, the U.S. Census Bureau says. In Arizona, 750,000 people didn't have any health insurance last year. That's about 1 in 10 people or 10.6% of the population. The number of Arizonans without coverage jumped by 55,000 people over 2017, after several years of drops in the rate of uninsured. (Innes, 9/16)

Flanked by police chiefs in Claremont City Hall, Sullivan County Attorney Marc Hathaway said the state has finally given law enforcement the legal resources to end the scourge of “bath salt” use in the county. “It’s the most disruptive drug in the county,” Hathaway said. Hathaway and the police chiefs from Claremont, Newport, Sunapee, Grantham, Plainfield and several other communities announced a change in the drug schedule in New Hampshire that now makes the most common variant of “bath salts” illegal. (Fisher, 9/16)

Initial testing of the air near a medical supply sterilizing facility in Smyrna found little to no ethylene oxide in the large majority of samples taken earlier this month. The September tests occurred days after Sterigenics shut down the plant, which uses ethylene oxide (also known as EtO), a cancer-causing chemical. (Goodman and Miller, 9/16)

Fewer Massachusetts high school students used marijuana over the decade before the state’s first cannabis stores opened last year, according to a new report.In 2017, about 24 percent of the state’s public high school students said they used cannabis in the previous month, down from 28 percent in 2011. Meanwhile, the share of the students reporting heavy cannabis use — at least 20 times per month — also dropped, from 9 percent to 5.6 percent. (Martin, 9/16)