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In one of the largest tests of a novel way to deliver and pay for healthcare, insurer CareFirst BlueCross BlueShield announced on Thursday that 1.1 million people receiving care through its "patient-centered medical homes" last year were hospitalized less often and stayed for fewer days compared to patients in traditional fee-for-service care. Medical homes, a centerpiece of President Barack Obama's healthcare reform, have been heralded as one of the best hopes for reducing the cost of U.S. healthcare, the highest in the world, and improving its quality, which lags that of many other wealthy countries. Medical homes are basically groups of primary-care providers who pledge to coordinate care, adhere to guidelines meant to improve patients' health, and avoid unnecessary tests, among other steps. According to CareFirst, its medical home program, in its fourth year, also delivered high-quality care, measured by yardsticks such as whether doctors gave recommended can

One man died, more than 500,000 people were urged to evacuate and hundreds of flights were canceled in Japan as a strong typhoon brought torrential rain and high winds to its southwestern islands and could bring heavy rain to Tokyo later this week. Typhoon Neoguri weakened from its original status as a super typhoon but remained intense, with gusts of more than 250 km per hour (155 mph). It was powering through the Okinawa island chain where emergency rain and high-seas warnings were in effect. The storm was at its most powerful when passing Okinawa, some 1,600 km (1,000 miles) southwest of Tokyo on Tuesday, but the Japan Meteorological Agency (JMA) warned of heavy rains and potential flooding in Kyushu, the westernmost of Japan's main islands, as well as heavy rain in the rest of the nation as the storm turns east later in the week. "People must take the utmost caution," Keiji Furuya, state minister in charge of disaster management, told a news conference. One man

Swathes of the Amazon may have been grassland until a natural shift to a wetter climate about 2,000 years ago let the rainforests form, according to a study that challenges common belief that the world’s biggest tropical forest is far older. The arrival of European diseases after Columbus crossed the Atlantic in 1492 may also have hastened the growth of forests by killing indigenous people farming the region, the scientists wrote in the U.S. journal Proceedings of the National Academy of Sciences (PNAS). "The dominant ecosystem was more like a savannah than the rainforest we see today," John Carson, lead author at the University of Reading in England, said of the findings about the southern Amazon. The scientists said that a shift toward wetter conditions, perhaps caused by natural shifts in the Earth’s orbit around the sun, led to growth of more trees starting about 2,000 years ago. The scientists studied man-made earthworks, uncovered by recent logging in B

Booming demand for food in China's southern and eastern cities is worsening water shortages in arid northern provinces, adding to the country's environmental problems, new research shows. "Consumption in highly developed coastal provinces is largely relying on water resources in the water-scarce northern provinces, such as Xinjiang, Hebei and Inner Mongolia, thus significantly contributing to the water scarcity in these regions," an international group of researchers wrote in the latest edition of the journal Environmental Science and Technology. "Rich coastal provinces gain economic profits from international exports at the expense of ecosystem quality in the less developed regions," the researchers from the University of Maryland and the International Institute for Applied Systems Analysis concluded ("Virtual Scarce Water in China" June 2014). Rain and snowfall is concentrated in south and south-western China, as well as along the east coast

U.N. climate negotiations have made greater progress towards agreeing a 2015 deal to bind all nations to cut greenhouse gas emissions than the lead-up to the previous attempt in 2009, former U.N. climate chief Yvo de Boer told Reuters. Envoys from almost 200 nations are aiming to agree this year on the main elements of a text to be signed by their leaders in Paris in late 2015 to tackle the emissions from 2020 that U.N.-backed scientists say are causing more severe droughts, flooding and a rise in sea levels. "The process is definitely further advanced a year before Paris than it was a year before Copenhagen (in 2009)," de Boer said in an interview in London on Tuesday. The Dutch diplomat was the public face of the negotiations from 2006 but stepped down shortly after the Copenhagen talks almost broke down despite the attendance of more than 130 world leaders late into the final night. Late on Monday, the U.N. published several documents on its website meant to help gui

California regulators violated the law by approving expanded use of pesticides that have been shown to hurt honeybees needed for pollinating key American crops, according to a lawsuit filed against the state by environmental groups on Tuesday. The lawsuit seeks an injunction prohibiting the state Department of Pesticide Regulation from approving any new neonicotinoid products or new uses of those products unless it completes a required re-evaulations of the pesticides. The environmental and food safety non-profit groups also seek to overturn the department's recent approval of expanded use of Venom Insecticide, manufactured by Valent USA, a unit of Sumitomo Chemical Co Ltd, and Dinotefuran 20SG, made by Mitsui Chemicals Agro. The Center for Food Safety, Beyond Pesticides and the Pesticide Action Network North America, filed the lawsuit in Alameda County Superior Court. The Department of Pesticide Regulation, Valent USA and Mitsui Chemicals Agro did not respond to requests f

Thunderstorms and high winds swept through the U.S. Northeast on Tuesday following tornado warnings, killing three people in New York state and a boy who was crushed to death by a fallen tree in Maryland, weather and emergency officials said. One of the hardest-hit spots was a community outside the hamlet of Peterboro in Madison County, New York, 25 miles (40 km) southeast of Syracuse, where a severe storm with high winds struck at about 7 p.m. The full extent of damage there was not immediately clear. But the National Weather Service office in Binghamton, New York, said local emergency management authorities had confirmed three deaths "from three collapsed homes." The storm uprooted trees and tore down power lines across several counties in central New York, part of a broader expanse of extreme weather that stretched from the Ohio Valley and parts of New England through the mid-Atlantic region, police and weather officials said. CNN reported nearly 500,000 homes and