Amid a wave of state restrictions on gender-affirming care for minors, some red states are also limiting treatment for adults, Maya writes.

Why it matters: Many states that enacted limits on transition-related care for minors in recent years said they were focused on protecting children.

• But three states have broadly limited or sought to broadly limit transition care for adults. Transgender rights advocates expect state lawmakers to pursue more restrictions on adults this year.
• Mainstream medical societies endorse gender-affirming care, as research shows that the care is safe and can be life-saving.

Driving the news: Ohio Gov. Mike DeWine last week announced new draft regulations that civil rights advocates say would be the strictest limits on adult transition care in the country if they take effect.

• The rules would require minors and adults to get approval from an endocrinologist, psychiatrist and bioethicist before receiving gender-affirming care. There are also stringent reporting requirements.
• Ohio's restrictions would amount to a "de facto ban" on trans care in the state, said the American Civil Liberties Union of Ohio.

Zoom out: Florida last year began requiring that adults seeking transition care sign an informed consent form, undergo psychological evaluations to continue hormone therapy, and receive all related care from a physician in person.

• Missouri's attorney general also issued a rule last year that would have sharply curtailed care for adults, but it was withdrawn after a lawsuit.
• The state last year also barred Medicaid from covering gender-affirming care for adults, and at least eight other states have a similar restriction.
• Lawmakers in at least four states last year introduced bills that would prohibit people as old as 26 from receiving hormone therapies or gender-affirming surgeries.

The other side: Conservative advocacy groups pushing states to adopt anti-trans policies said they are prioritizing measures that would restrict care for minors.

Keep reading

Congress is once again being urged to reverse a cut to physicians' Medicare payments, prompting calls for a broader overhaul of how the program reimburses doctors, Axios' Peter Sullivan writes.

Why it matters: Congress is still stuck in an annual dance of being pressured to increase physician payments, even after Washington nearly a decade ago put an end to the despised "doc fix" that forced lawmakers to regularly forestall deep cuts.

Driving the news: With the Jan. 19 government funding deadline approaching, doctors are ramping up pressure on Congress to use the next spending package to reverse cuts that took effect Jan. 1.

• American Medical Association president Jesse Ehrenfeld told Axios the cuts are "placing enormous pressure on physicians."

Yes, but: Josh Gordon, director of health policy for the Committee for a Responsible Federal Budget, argues that doctors' complaints are overblown, and that the cuts won't undermine care for seniors and people with disabilities enrolled in Medicare.

• The bigger issue, he said, is that Washington appears to be back in the annual cycle of Medicare cutting physician pay, only for Congress to step in again, making a long-term fix reasonable if it is paid for.
• At the end of 2022, Congress also partially reversed Medicare cuts to doctors, though the industry at the time argued it was not enough.
• "It's probably time for Congress to do a more long-term reform," Gordon said.

Zoom in: It took lawmakers years to agree on how to eliminate the flawed Medicare payment formula behind the doc fix.

• Any bigger reform to the current Medicare payment formula likely wouldn't be nearly as pricey, but the politics of reforming physician pay are tricky.

Go deeper

A version of this story was published first on Axios Pro. Unlock more news like this by talking to our sales team.

First things first: If there's an emergency, call 911.

• But then, maybe check YouTube for quick advice on how to help, the tech giant says.

Driving the news: YouTube is launching a new feature directing users to short, step-by-step first-aid tutorials on how to deliver potentially life-saving care before first responders arrive, Tina writes.

• This includes directions on performing CPR, recognizing a heart attack or administering overdose reversal drug Narcan.

The big picture: It's the company's latest move to combat health misinformation — a problem supercharged by the pandemic — by providing high-quality, vetted information.

• It also comes as policymakers are pushing for expanded access to emergency measures like Narcan and defibrillators that the general public can use but aren't familiar with.

YouTube partnered with Mass General Brigham and the Mexican Red Cross to produce content that will be pinned on the website to appear first when searched.

• Previously when viewers searched for these sorts of videos, YouTube would have prioritized information from authoritative health sources, but they weren't necessarily the most helpful videos in an emergency.

More here

Hospitals continued to shake off the pandemic's long-term financial effects as the holidays approached, with key metrics like inpatient and outpatient revenue rising year-over-year, Axios' Adriel Bettelheim writes on the latest Kaufman Hall report.

The big picture: The severity of illness at more than 1,300 facilities in Kaufman's analysis returned to more normal levels in November, with the average length of patient stay down 6% year-over-year.

• Margins kept trending positive and facilities were able to reduce their reliance on costly contract labor where possible.

Yes, but: The numbers don't reflect the surge of seasonal respiratory illness that has since swamped many medical systems and taxed resources.

• More uninsured people from Medicaid redeterminations and continued congressional interest in overhauling Medicare payment policies could also complicate the outlook.

By the numbers: Inpatient and outpatient revenue increased year-over-year by 5% and 9%, respectively.

• Bad debt and charity care measured as a percentage of gross revenue was down 4%.
• Labor expense per adjusted patient discharge also was down 4% year-over-year, while drug spending per discharge was up 4%.

What we're watching: Some hospitals could seize the moment and launch expansions or embark on other growth strategies. But Kaufman Hall noted there's still a wide gap between the industry's high and low performers.

Share this

🩺 The Biden administration rescinded much of the Trump-era conscience protections for health providers. (Modern Healthcare)

🔎 VA hospitals have fallen short on treating people with mental illness, according to a review of over 300 inspector general reports. (ProPublica)

❓Medicare now pays for a common Alzheimer's test, but there are questions about its reliability. (Forbes)