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Medicare, Medicaid, Health Reform

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Monthly Archives: July 2013

Geographic Variation in Health Care Spending and Medicare Payment Reform

In the ongoing struggle over wasteful health care spending, geographic cost variation is a veteran hot topic. The fact that public programs and private health plans spend more for providers in some regions, even after accounting for normal differences in costs by location, has irked policymakers and researchers who see the discrepancy as evidence of health care misuse and...

Military Health Care: Health Professional Contracting and Coordination

The Department of Defense contracts with more than 11,000 health care professionals, at an annual cost of about $1 billion. A recent Government Accountability Office report says the military could do more to coordinate its contracting duties to save money and avoid duplication. Military Health Spending: The Military Health System provides health care to almost 10 million active-duty service men and...

Medicaid Accountable Care Organizations: Provider Capabilities and State Supports

Though most commonly associated with Medicare, Accountable Care Organizations are now making their way into state Medicaid programs. Providers, of course, are an essential part of the ACO model. But many providers don’t yet have the resources to coordinate care, analyze cost and usage data, and adapt to value-based payments - all necessary to make ACOs successful. A helpful brief...

Shared Savings: Most Popular Model, Best Practices for Accountable Care Organizations

Even as Accountable Care Organizations and other payment reform models become more common, there is still not much comprehensive information about which models providers participate in most often, and what exactly to do to make those arrangements work well. It is also important for providers to understand the best practices - in care delivery reform, culture change, health information technology,...

Former Texas Medicaid Director’s Insights into Payment Reform

Billy Millwee, former Texas Medicaid director, recently published an excellent piece with insight into that state’s experience with quality-based payment reform. Health care payors, both private and public, are looking more and more to tie payment with outcomes. Millwee’s article is a thoughtful and thorough assessment of Texas Medicaid's payment reform challenges and opportunities. Payment Reforms on the Rise: Increasingly, health...

Health Insurance Exchanges: Progress Report on State-Based Exchanges

States and the federal government are doing all they can to make sure the Health Insurance Exchanges - also called Health Insurance Marketplaces - open on time, on October 1 this year. The rush to make sure everything is ready explains some of the recent news to delay certain requirements for employers and small businesses under Obamacare. Those delays...

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