TASK DEFINITION: Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.
PROBLEM: The “Asbestos in Talc Symposium,” sponsored by the Food and Drug Administration, was dominated by industry hands: Most of the 21 non-government participants had done work for talc companies, such as testing and serving as expert witnesses and consultants, symposium documents and other records show. Key sessions were led by witnesses for Johnson & Johnson in lawsuits alleging the company failed to warn customers that its Baby Powder was tainted with cancer-causing asbestos, the records show. Others who sought invitations were turned away, including a physician who had testified against J&J in trials that resulted in billions of dollars in damage awards against the company. History was repeating itself. Over the past 50 years, the FDA has relied upon - and often deferred to - industry even as outside experts and consumers repeatedly raised serious health concerns about talc powders and cosmetics, a Reuters investigation found. Again and again since at least the 1970s, the agency has downplayed the risk of asbestos contamination and declined to issue warnings or impose safety standards, according to documents produced in court proceedings and in response to public records requests. The agency said it lacks the authority to require manufacturers to test for asbestos in talc or report any results. And it seldom has ordered its own tests - until recently. Amid heightened scrutiny in Congress, a criminal investigation of J&J and costly jury verdicts against the company, the regulator commissioned tests that found asbestos in 11 talc-based cosmetics, including Johnson’s Baby Powder. J&J recalled 33,000 bottles. Raja Krishnamoorthi, an Illinois congressman who chairs a U.S. House subcommittee investigating talc safety, told Reuters it was time for regulators to stop relying on manufacturers’ safety assurances. “When something as serious as cancer or carcinogens are at issue,” Krishnamoorthi said, “self-regulation doesn’t make a lot of sense.”  In written responses to questions from Reuters, the FDA said its resources and authority to regulate the cosmetic industry are limited. The agency said it has no power to ensure the safety of cosmetics before they are put on store shelves, nor to force companies to pull them off when potential hazards are discovered. “We are dependent on manufacturers to take steps to ensure the safety of their products,” the FDA said after announcing a voluntary recall of tainted cosmetics in March. FDA officials declined to comment on the decisions of former employees over the years, saying only that the agency relies on the best information available and that studies “have improved our understanding of how and why asbestos fibers are hazardous.”  The agency said it now recognizes, as the World Health Organization and other public health agencies did years ago, that there is no known safe level of asbestos. FDA officials said their current policy is to act swiftly - and if necessary encourage recalls - even when small amounts are discovered. The regulator has stood by its recent tests of Johnson’s Baby Powder, despite pushback from the company. J&J, the world’s largest producer of talc powders, said in a statement that it recalled the 33,000 bottles of Baby Powder out of an “abundance of caution.” Eleven days later, the company announced that tests by labs it hired had determined that there was no asbestos - other than some contamination it said came from an air conditioner - in samples from the one bottle tested by the FDA and the batch it came from. In written responses to Reuters, J&J said it systematically tests its talc and has always found its powders to be safe and pure. “Throughout the 1970s and ‘80s, the FDA and other regulatory bodies defended talc,” J&J’s Chief Executive Alex Gorsky testified in an Oct. 3 deposition. “FDA agreed overall with the position that we had taken with the safety of our talc.”  The company told Reuters that it “has long cooperated (with) and supported the FDA in its mission to protect the public health,” and that any suggestion it has unduly influenced the agency to reduce regulation or standards is “just false.”  The FDA now is under increasing pressure to ensure talc powders and cosmetics are free from asbestos. The agency’s testing of talc-based cosmetics this year followed jury verdicts totaling more than $5 billion against J&J in cancer lawsuits, as well as a Dec. 14 Reuters report showing that J&J knew its raw talc and powders sometimes tested positive for asbestos from the 1970s into the early 2000s and did not report those findings to the agency. J&J has disputed the Reuters report as “one-sided, false and inflammatory.”  In the wake of the Reuters report, the company announced it was under investigation by the U.S. Department of Justice and the Securities and Exchange Commission. According to people familiar with the matter, these include a criminal grand jury probe into how forthright J&J has been about the safety of its powders. The FDA began looking into talc safety in 1971 after researchers at Mount Sinai Medical Center in New York found what appeared to be asbestos in unnamed brands of talc powder. Two years later, FDA records show, the agency found asbestos in a sample of Shower to Shower, a J&J powder at the time that was made with the same talc as Johnson’s Baby Powder. The FDA never publicly announced the finding. J&J told Reuters the result was not final, citing findings in an FDA table issued in 1976. But that table, reviewed by Reuters, is ambiguous, listing no result for the type of asbestos found in 1973. J&J told Reuters the gap means no asbestos was found. Assured by J&J and other manufacturers that their talc was safe, the FDA eventually ended its inquiry without taking action because “the potential hazard did not warrant a recall,” Heinz J. Eiermann, a former J&J researcher who at the time ran the agency’s cosmetics division, wrote in a March 1976 memo. That same year, J&J, other talc companies and their trade group, the Cosmetic Toiletry and Fragrance Association, persuaded FDA officials that manufacturers could monitor the safety of their own products, according to records J&J and the group produced in litigation. The FDA dropped plans to impose testing and purity standards for talc powders and cosmetics. The trade group published its own test, which was voluntary for companies to use. The written standard for that test acknowledges that it cannot detect most types of asbestos at low levels, nor one common type - chrysotile - at all. In a statement to Reuters, the trade group said it believed that chrysotile was not commonly linked to talc used in cosmetics. Chrysotile is the type of asbestos the FDA-commissioned test found in Baby Powder this year. It also was found in several tests conducted by labs for J&J on its talc from 1972 through 2003, according to records produced in litigation. J&J has said that some of the tests were on industrial talc and that others, on Baby Powder talc, reflected background contamination. Asbestos is a loose term for a group of six minerals that readily separate into needles or fibers. Easily inhaled, they are known to cause lung, ovarian and other types of cancer. While most people exposed never get cancer, for some even small amounts are enough to trigger the disease. Just how small has not been established. Talc safety concerns resurfaced in 1983 when a graduate  student scouring geology journals for a toxicology class came across information he considered disturbing: Talc deposits are commonly laced with asbestos, a similar mineral. Philippe Douillet immediately thought of the talc powder his sister used on her baby, he recalled in an interview with Reuters. He urged her to stop using it. Then he petitioned the FDA to require an asbestos warning on talc powders. “It was really obvious to me there was a big issue there,” said Douillet, who now runs a biotechnology company in Miami. When the FDA began evaluating Douillet’s petition, it looked to J&J for key information, agency records show. The FDA’s June 1985 risk assessment relied upon a decade-old letter from the company for the agency’s estimate of the amount of dust babies were exposed to during diapering. That 1974 letter from J&J to the FDA said that, hypothetically, even if babies were exposed to talc powder with as much as 1% asbestos, it would be a far lower concentration than allowed at the time for industrial workers. J&J told Reuters in a statement that “at no point has Johnson & Johnson taken the position that it would consider talc containing 1% asbestos appropriate for sale to consumers.”   In the end, the FDA decided there was no need for an asbestos warning on talc powders. In a July 1986 letter to Douillet, acting associate FDA commissioner J.W. Swanson wrote that the quality of cosmetic talc had improved “and that even when asbestos was present, the levels were so low that no health hazard existed.”  What’s more, Swanson wrote, agency officials had come to question earlier reported findings of asbestos in talc powders. Those doubts, he wrote, were based in part on a paper published in the proceedings of a 1977 scientific conference. Both of the paper’s authors had worked for J&J, one as an asbestos testing contractor and the other as its longtime talc supply manager. The authors argued that some testing methods were apt to misidentify microscopic lookalike rock splinters as asbestos. The industry’s test, the paper said, was designed to avoid this confusion. Other U.S. and European public health authorities have come to regard such splinters as presumptive toxins because of their similarity to asbestos. The FDA defended its 1986 decision to reject Douillet’s petition. In a statement, it said the graduate student “did not provide persuasive evidence that the cosmetic talc produced at the time contained significant amounts of asbestos minerals.”  Eight years later, the regulator received a new request for a warning label on talc powders. This one came from Dr. Samuel Epstein, a University of Illinois environmental medicine professor who chaired the Cancer Prevention Coalition, an advocacy group. Epstein’s 1994 petition didn’t concern asbestos. It raised the possibility that talc, by itself, was a hazard worthy of a warning label. His petition was based on research showing that talc, when used as an antiperspirant and deodorant in underwear, was associated with ovarian cancer. In a brief July 1995 letter, FDA acting cosmetics chief John Bailey told Epstein’s coalition that the agency had taken no action because it had other priorities. Bailey told Reuters in a statement that he issued this “interim” response because the petition lacked scientific support. In 2002, having taken no action on the petition, Bailey moved to the cosmetic trade group, now known as Personal Care Products Council. The council considered him a “key employee” because of his “former employment with the FDA,” according to a tax filing by the group. Now a consultant, Bailey serves as a litigation expert witness to J&J and other talc companies. In his statement to Reuters, Bailey said he had been hired at the council “as a scientist responsible for applying sound science to decision making.” He disputed Reuters’ finding that the FDA deferred to industry, saying the agency takes potential health concerns seriously and does its own evaluations. In 2006, the World Health Organization’s International Agency for Research on Cancer classified use of talc powder in the perineum area - the pelvic region between the legs - as “possibly carcinogenic.” Two years later, Illinois medical scientist Epstein filed a second petition to the FDA seeking a cancer warning label on talc products. J&J went to work to defeat it. In a May 2008 email to colleagues, J&J executive Kathleen K. Wille wrote: “Our response could be a potential source of data and information on which the FDA can base their response.”  Together, J&J, its talc supplier and the Personal Care Products Council arranged for a pair of scientists to assess the published studies that linked talc and ovarian cancer, according to emails and other records produced in litigation. The scientists concluded that the evidence was too weak to consider talc as a cause. At a May 2009 meeting, Bailey, Wille and other industry representatives briefed FDA officials on the assessment, according to a meeting memo produced in litigation by J&J’s talc supplier. Three days later, Wille told colleagues in an email, “We have every confidence that the FDA will dismiss this petition once they have reviewed our submission.”  J&J told Reuters in a statement that the company had been confident because it believed the agency would be swayed by science, which it said supported J&J’s position that talc does not cause ovarian cancer. Before the FDA ruled on the warning requests, however, concerns about asbestos contamination flared again. This time, the FDA’s South Korean counterpart reported finding asbestos in talc powders. Acting on that 2009 report, the FDA commissioned talc tests for the first time in 40 years, hiring Maryland-based AMA Analytical Services Inc, which analyzed 34 samples of talc powders and cosmetics, including Johnson’s Baby Powder. It found no asbestos in any of them. The lab had no experience testing for asbestos in talc. Its prior work focused on building materials such as vinyl flooring, according to the deposition testimony of AMA lab director Andreas Saldivar. The FDA has said Saldivar’s lab used “the most sensitive techniques available” but cautioned that the results were limited to the 34 talc powders and cosmetics tested. The testing had other limitations as well. Saldivar’s lab looked at less talc per sample than other labs that have found asbestos in talc powders. And it did its work in a fraction of the time typical for such analyses, according to a Reuters review of the lab report and interviews with experts who test talc for asbestos. Saldivar’s lab was recently rehired by the FDA. This time, it found the asbestos that led to the first recall of J&J’s iconic Baby Powder. Saldivar declined to comment. In the first verdict of its kind, a South Dakota jury found in October 2013 that J&J had a duty to warn women that research had linked its talc powder to ovarian cancer. No damages were awarded. Then the FDA weighed in on the issue. In April 2014, 20 years after Epstein first contacted the agency, the FDA rejected both of his petitions for warning labels. Its announcement said the science wasn’t strong enough to support a cancer warning, echoing the assessment J&J and its industry partners had presented to the agency in 2009. In court, such arguments have not always proved convincing. In early 2016, a Missouri jury concluded J&J’s powders caused a woman’s ovarian cancer death and awarded her survivors $72 million. An appellate court later set that verdict aside, ruling that the woman had filed her suit in the wrong state. In the aftermath, the FDA asked J&J for “safety literature and data regarding talc,” correspondence shows. The company submitted a report saying no asbestos had “ever been found during any testing” of its talc. Since then, lawsuits have compelled J&J to produce internal documents that show the company knew its talc and powders had tested positive for asbestos on occasion for decades. The company now faces more than 16,000 lawsuits alleging that its powders caused ovarian cancer and mesothelioma, an incurable cancer. The vast majority are awaiting trial. In court, there have been mixed verdicts, mistrials and some appellate rulings in J&J’s favor. Last year, in response to renewed asbestos concerns, FDA cosmetics chief Dr Linda Katz began organizing the November 2018 symposium and a public hearing on talc testing, now planned for next year. She reached out to J&J for help. J&J vice president Jethro Ekuta responded by sending Katz a letter in June 2018 recommending a list of three talc testing experts. All three had served as defense witnesses or consultants for J&J. Two of the experts Ekuta recommended, as well as a third J&J defense witness, led sessions at the closed-door “Asbestos in Talc Symposium” on Nov. 28, 2018. None of the sessions were led by medical experts who had questioned the safety of talc powders and cosmetics. J&J said that apart from recommending experts, it did not advise the FDA on the symposium. Ekuta, who has left J&J, declined to comment. In a statement to Reuters, the FDA downplayed its role in the symposium, saying the event was “hosted” by the Joint Institute for Food Safety and Applied Nutrition (JIFSAN), a research group co-founded by the FDA. “No formal or regulatory recommendations were expected or made,” the agency said. In fact, records show, the FDA initiated and paid for the meeting, set the agenda and chose the participants. The meeting set the stage for formal recommendations on how to test products used every day by millions of people. The FDA said a government committee tasked with proposing a standard test for asbestos in talc powders and cosmetics is “continuing to work through issues discussed at the JIFSAN symposium.”  Many FDA meetings are held in public and invite comment. Details on the talc symposium were hard to come by, however, even after it was over. The FDA declined Reuters’ requests to provide a list of participants or any information on what transpired. After Reuters filed a public records request with JIFSAN, the research group posted meeting information online and released planning emails. The guest list showed that more than half of the 54 participants were employed by or recently retired from FDA and other agencies. Of the 21 non-government participants, 17 had either worked for talc companies, done lab testing or served as expert witnesses for the industry, Reuters found. Five of the participants affiliated with talc companies also have served as expert witnesses for plaintiffs. Most of the non-government participants were experts in geology or minerals testing. In a statement, the FDA said it would ordinarily avoid having sessions led by defense or plaintiff witnesses. However, the agency said there are a “limited number of experts worldwide with scientific knowledge” on asbestos testing, standards and results analysis. Not everyone was welcome. Among those turned away was Dr. David Egilman, a clinical professor of family medicine at Brown University. He testified last year in a trial that ended in a $4.69 billion verdict for women alleging J&J’s talc powders caused their ovarian cancers. Egilman told Reuters he was concerned that if the FDA was guided by geologists and industry consultants, it might overlook fundamental questions about which mineral fibers cause cancer. He wanted to offer his expertise, as a physician and researcher, on what technicians should look for under the microscope. Testing hinges “on the determination of what particles or elements should be tested for,” he wrote in a November 2018 email to organizers asking to be included in the symposium. “This is a medical question and not a technical question.”  Katz took a different view. In an email forwarded to Egilman, she said: “This meeting is not intended to discuss health-related issues or concerns.”  She met with Egilman later. Katz also told Egilman that the symposium was not intended to reach any consensus. At its conclusion, however, session leaders, including three who have served as defense witnesses for J&J, drafted what they called “consensus” or “concurrence” reports. Two of the reports reviewed by Reuters embraced industry positions on what fibers should be counted as hazardous, an issue of fierce contention in courtrooms across the country. The reports discouraged counting fibers that may or may not be asbestos, saying that doing so might exaggerate the hazard. That view runs contrary to the positions of other U.S. and European public health officials, who presume mineral fibers that even look like asbestos are toxic. As Arnold Brody, a professor emeritus at Tulane University Medical School, told jurors in a talc powder trial last year, “The lung doesn’t care” what it’s called. These issues are likely to be aired at the public hearing the FDA said it is planning for next year. The gathering could signal how the agency intends to navigate between industry and consumer interests in coming years. Krishnamoorthi, the congressman heading the House investigation into talc safety, said the agency needs to bring consumers and their advocates into the discussion. “In light of the public interest around this particular issue,” he said, “we need to find out what’s going on.”

SOLUTION: Special Report: Powder Keg - FDA bowed to industry for decades as alarms were sounded over talc.

PROBLEM: Today’s fit-focused travelers want to pair exercise with escapades and fitness with fun, whether it’s yoga among the sea turtles, bootcamp on the beach or a zumba cruise. “Fitness retreat used to mean go away and lose weight,” said Melisse Gelula, co-founder of the wellness media company Well+Good. “Now it’s just working fitness into a schedule that might also include lavish dinners, beach time, cocktail hours, nights out dancing.”  Wellness tourism, which includes travel paired with activities such as yoga retreats, fitness centers, boot camps, cycling, gyms and other activities, is about a $500 billion global market, according to The Global Wellness Tourism Economy report of 2013. The report said wellness tourism represents 14 percent of total global tourism revenues overall and is projected to rise to 16 percent by 2017. In January, Royal Caribbean Cruises Ltd will launch its first ever Zumba Cruise, offering all-day classes in the popular Latin American dance-based aerobic program during a  cruise that will leave from Fort Lauderdale in Florida and make stops in Jamaica and Haiti. Daily classes will be led by 130 zumba instructors. “Our focus is more fun,” said Allison Robins of the global lifestyle brand Zumba Fitness, which is working with the cruise line. “You’ll never see us talking about weight loss, although that just happens.”  Maria Walker, founder of Getaway Fitness in Florida which offers workout vacations in Florida and California, refers to the growing industry as fitness adventure. “When I started, there were spa resorts and fat camps but not much in  the middle,” said Walker, whose clients are mostly  people in their 30s, 40s and 50s. Now activities range from boot camp and rock climbing to kayaking, and discussions focus more on exercise and nutrition than weight loss. YogaWorks, the national chain of yoga studios, offers 10 to 15 retreats a year and plans to scale up offerings in 2016. “It’s definitely a growing part of the business,” said spokesperson Kim Allardyce, adding it is not just about perfecting one’s yoga postures. Although the emphasis is on yoga, depending on where the tour is, local sites are also included. In Costa Rica vacationers might help release sea turtles and in Italy go on wine-tasting excursions. The goal, she said, is to marry fitness with an experience specific to the location.

SOLUTION: Fitness vacations favor fun, adventure over weight loss.

PROBLEM: “You name it, I’ve had it,” Wright says. “I’m a very hard case.”  Now, patients like Wright are at the forefront of an experiment, under way in Peoria, Illinois, and hundreds of other U.S. cities, that could transform the way doctors, nurses and hospitals deliver care to patients. Amid the barrage of criticism over the rollout of Obamacare, groups known as Accountable Care Organizations (ACOs) are quietly going about the business of testing the potential for healthcare reform. The efforts, born of President Barack Obama’s Affordable Care Act, are part of the biggest experiment yet to fix the costly and error-plagued U.S. healthcare system. The new models of care, which encourage providers to form networks to coordinate care and cut costs, involve close monitoring of the sickest patients to address budding health problems before they cause a costly trip to the emergency room or an extended hospital stay. Providers that succeed in keeping patients healthy and cutting costs are rewarded with a portion of the savings. In Peoria, a city of 116,000 that is often seen as the archetypal middle American community, two hospital systems - OSF Healthcare and UnityPoint Health - are taking on the challenge. Progress so far is largely anecdotal, but early data showing declines in readmissions and emergency room visits offers a tantalizing glimpse into the potential for reform. Still, there are no guarantees that the savings will exceed the costs. OSF is in its second year of participating in the federal Pioneer Accountable Care Organization, a pilot program involving 32 hospital systems across the country that aims to improve quality while cutting costs in the government’s Medicare insurance program for the elderly. The program rewards doctors and medical centers that show gains on 33 measures of quality, including routine cancer and depression screenings, while still managing to cut overall costs. In its first year, 13 hospitals reported savings. OSF was not one of them, but it came close. The Centers for Medicare and Medicaid Services has not allowed providers to disclose their full first-year results, but Tara Canty, chief operations officer of OSF’s Accountable Care Organization, said the hospital system saw a 30 percent drop in emergency room admissions and a 20 percent drop in inpatient stays among Medicare participants. Canty sees the first two years as a learning process but says she will be “upset personally” if OSF is not achieving savings by year three. Dr. Keith Knepp, chief information officer at UnityPoint Health-Methodist, says reforms are needed, but he sometimes finds it hard to stay optimistic. “Will there be reimbursement to reward the improved quality, or will we spend more money to take in less?”  Success may depend on controlling costs among high-use patients like Wright. She is among the 5 percent of OSF patients who consumes more than 50 percent of the care delivered by the system. Wright spends most of her days in her tidy home in Mackinaw, outside Peoria, tooling around in a motorized wheelchair. Her legs swell up, making her prone to blood clots. Two years ago in November, she had a major complication from her blood thinner drug, Coumadin. “My brain started bleeding. They had to drill holes in my head,” Wright recalls of the ordeal, which kept her in the hospital for nearly a month. “I nearly died twice.”  Wright was among the first of OSF’s Pioneer patients to be assigned a care manager, a nurse charged with keeping her healthy and out of the hospital. “The theory here is if you focus on the people with chronic disease who are your highest utilizers of care … and make a better outcome for those patients, you are able to invest that savings into some of the care for the larger population of patients,” said Michelle Conger, OSF’s chief strategy officer. Like most providers across the country, Peoria’s hospitals have been hit by federal budget cuts and burdened by an outdated reimbursement system focused on how many services they perform rather that quality. OSF, a system of eight acute-care hospitals with $6 billion in annual patient revenue, needs to cut $200 million over the next five years in response to reimbursement cuts from Medicare and other payers. It has adopted the ACO model to help it get there. An actuarial firm is combing through claims data for the 34,000 Medicare patients in OSF’s ACO to help identify patients like Wright, whose high-risk conditions are likely to require more emergency room visits or admissions. The system assigned 35 care managers to work with these patients and come up with ways to prevent more acute health crises. Sometimes that means simply helping patients keep track of their medications or arranging transportation to a pharmacy, said Priscilla Romans, a nurse who works in OSF’s call center. It also means routine checks on high-risk patients. During a call last month, a heart failure patient complained of shortness of breath and a headache. Romans asked whether she could put her shoes on that day. She was only able to get one on, a sign of fluid buildup, and she couldn’t wear her rings. Romans had the woman take her blood pressure, which was too high, and reported the findings to her doctor. The physician doubled the patient’s dose of Lasix to cut the swelling in her hands and feet, and started her on a blood pressure medication. When Romans called the next day, a Friday, the woman felt much better. Romans believes the time she spent on the phone with this patient helped avert a much more costly ER visit. Often, the issues driving health costs are social. In one case, OSF discovered that a patient who kept getting readmitted to the hospital for emphysema had not been taking her medication. “She was squirreling away her money to fix her roof,” said Dr. Stephen Hippler, OSF’s senior vice president for clinical excellence. The Catholic hospital system tapped into a charity program and made the repairs. UnityPoint Health-Methodist, Peoria’s second-biggest provider, has been taking part in Medicare’s Shared Savings ACO, a transitional program in which hospitals assume less risk than in the Pioneer ACO but have fewer potential rewards. The hospital has cared for about 10,000 Medicare ACO patients since July 2012. In November, UnityPoint acquired the 220-bed Procter Hospital, Peoria’s third-largest provider, giving it access to new addiction recovery services and skilled nursing care. The Procter deal follows Methodist’s decision in 2011 to join Iowa-based UnityPoint Health, the 13th-largest non-profit health system in the United States with annual revenue of $2.7 billion. The moves are part of a national consolidation trend among hospitals trying to fill out their menu of services and bring costs under centralized control. “There is a need for size and scale in the new environment,” said Terry Waters, vice president for strategy and development at UnityPoint Health. “You have to be able to diversify your financial risk over a larger patient population.”  According to the Henry J. Kaiser Family Foundation, an estimated 14 percent of the U.S. population is covered by some form of accountable care organization, including 4 million Medicare beneficiaries. OSF could not say whether it has saved money on Wright’s care in the two years since she has been in care management because the system does not release financial information about individual patients. But Canty said the system “has seen significant and sustained declines in the cost of care for patients in care management.”  As for Wright, she appreciates the quick access she now has to her doctors, but she still needs a lot of care. In May, a hip implant had become infected and had to be replaced. While recovering, Wright developed a bothersome cough that turned out to be pulmonary fibrosis, a dangerous scarring of the lungs. “Between May 21 and July 19, I had been released and admitted five times. Five times! It was dreadful.”  Romans, who has helped coordinate some of Wright’s care, said her job is to try to keep patients out of the hospital, but that’s not always possible. “Here we are trying to be financially prudent with our dollars, but the patient needed the care.”  Now, the goal is to stretch out the period between visits. Wright went from July to September with only one hospitalization. “It was quick. She went back home, and she hasn’t been back to the hospital since,” Romans said.

SOLUTION:
Health reform's grand experiment: Will it play in Peoria?.