Chelsea Conaboy

Neurologists are fighting a decision by the Centers for Medicare & Medicaid Services to pay less, starting next year, for diagnostic tests used to assess muscle and nerve pain or weakness.  The change comes under a provision of the Affordable Care Act aimed at cutting Medicare costs. It will also help to redirect money to primary care physicians, who are widely seen as underpaid and are being asked to take on more responsibilities under the federal law.

Neurologists say the change could injure patient access to care. But this is likely an early example of what could become a common debate:

The tests effectively subsidize other kinds of neurology care that provide less lucrative payments, and specialists said the change could prompt some neurologists and hospitals to see fewer Medicare patients.

But Jonathan Gruber, an MIT economist who was a consultant to the Obama administration during drafting of the Affordable Care Act, said there is little doubt that more money must be directed to primary care services.

“We have a system that everyone agrees is out of whack,” Gruber said. “Everyone agrees we spend too much on health care. The problem is, once we get to fixing it, that’s where the disagreements arise.”

I managed BostonGlobe.com’s liveblog on election night, pulling in feeds from Globe reporters at the polls and at the campaign headquarters, news from the wires, color from social media, and election decisions called by network race-watchers and the Associated Press. This is curation in its purest form. I’ve done it a few times for the Globe now, when police cleared Occupy protesters from Boston’s Dewey Square in December and when the Supreme Court upheld most of the Affordable Care Act in June. Each time, I’ve started the task wondering if it was worthwhile. Particularly last night, I was simply gathering together tidbits that were already publicly available on Twitter, TV, and elsewhere on the Globe’s website. But looking back at the blog in the wee hours of the morning, I realized there is value in being able to see the full narrative of the night, from the collective anxiety felt here and across the country as the polls began to close through the moments of clarity in state and national races as votes were tallied and President Obama took the stage:

11:46 p.m.: President Barack Obama has been re-elected, the Associated Press reports. Read more on Obama’s win from Globe staff in Chicago and Boston.

11:44 p.m.: The Associated Press is reporting that Democrats will retain control of the US Senate.

11:32 p.m.: Obama takes Oregon. Matt Viser reports the crowd at the convention center is chanting, “Mitt! Mitt! Mitt!”

11:23 p.m.: The Associated Press calls Ohio for Obama. From Matt Viser in Boston: “Absolute silence at the Romney party as Fox News tells them they’ve called the entire election for Obama.”

11:21 p.m.: Analysis from Scott Helman: “Four years ago, we made much of Obama redrawing the electoral map by winning states like Virginia, Colorado, and Indiana. This year, if things hold – and indeed, it remains an if at this moment – Obama will cede North Carolina and Indiana but still preside over an expanded map. Republicans have to start thinking about appealing more broadly.”

11:18 p.m.: CNN and NBC are projecting Obama will carry the state of Ohio and win re-election. No word from the Associated Press and that’s the standard the Globe is using to call the race.

Starting Oct. 1, the federal government began docking Medicare pay for those hospitals where patients are most likely to return to the hospital soon after being treated for certain common conditions, including pneumonia and heart failure. Kaiser Health News analyzed readmission rates to determine which hospitals would be penalized this year and how much. Ten Massachusetts hospitals will lose the maximum amount, 1 percent of Medicare revenue. I talked with experts in the state about whether the readmissions penalties are effective and how hospitals here are dealing with them:

Days after she was discharged to her Saugus home from Beth Israel Deaconess Medical Center after being treated for pneumonia, Carol Sewell got a call. A nurse working for both the hospital and her primary care doctor began checking in on her regularly, sometimes three times a week: Did she know about her follow-up appointments? Could she get a ride to the doctor’s office? And had she filled her prescriptions?

“It kept me doing things that I should be doing that I might not have,” Sewell said. “She’d ask questions. I’d have to have the answer.”

The calls made the 69-year-old with a history of cancer and chronic obstructive pulmonary disease feel that someone was watching out for her. Beth Israel Deaconess hopes that such intensive follow-up will help patients like Sewell maintain their health and avoid being readmitted.