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Patients often welcome palliative care once it is explained that it can be more than hospice care. Many doctors, on the other hand, are still slow to embrace the approach.

When the severity of patient sickness and special local expenses are taken into account, some areas marked by big Medicare outlays flip from profligate to average or even frugal, according to the calculations from the federal Centers for Medicare & Medicaid Services.

Half a dozen states are considering changes in laws that would allow psychologists to prescribe medicines to treat mental illness. Shortages of psychiatrists in some areas and psychologists' success in New Mexico have given the approach traction, despite the objections of medical doctors.

A Maryland program to prevent hospital complications goes further than most, including those already under way in Medicare and new ones slated to begin next year under the health care overhaul law.

To boost the odds you'll stick with your medicines, try taking your pills when you do something else on a regular schedule, such as brushing your teeth. Signing up for automatic refills may also help.

To reduce the odds a patient will have to return to the hospital, some health systems are trying to do a better job coordinating care. Starting in 2012, the federal health law will penalize hospitals for excess readmissions for some conditions.

The federal health overhaul law imposed a variety of restrictions on flexible spending accounts as a way to boost government revenue. Now a backlash is brewing in Congress and bills to roll back some of the changes are getting traction.

Amid last year's debate over the federal health overhaul, the American Medical Association was the biggest spender for lobbying operations among health care groups. Overall, though, the top 10 health care players spent 9 percent less than they did the year before.

The TennCare cuts, which followed the resolution of a long-running court battle, affected mostly elderly or disabled residents, including approximately 37,000 who had relied on the state program for all their health care needs.

A much-publicized provision of the new health law would give parents the option of keeping children on their insurance plans until age 26, but coverage won't kick in for months.