Controlling statewide costs in prisons was the rationale for privatizing the correctional healthcare delivery system across the nation, but there have been consequences. The increased incarceration levels and shift from governmental to private criminal justice system medical care has resulted in an additional burden of care placed on hospitals...
The causes of autoimmune disorders such as lupus, diabetes (type 1), rheumatoid arthritis, and Sjogren’s syndrome have not been determined, but an abnormal immune response is the common feature. While symptoms are mild in some patients, these can be highly debilitating (and even life-threatening) in other individuals. Due to...
Hospital Readmissions: Conditions, Cost, and Utilization Differences in Medicare, Medicaid, and Private InsuranceKip Piper -
Hospital readmissions are costly but largely preventable. Reducing inpatient readmissions are a top priority for Medicare, state Medicaid programs, and private health plans. The opportunities to lower costs and improve patient outcomes are considerable. Therefore, healthcare purchasers are realigning hospital payment methods to reward hospitals for fewer readmissions and...
Kip Piper -
The basis for medical treatment of heart disease is the belief that interventions like coronary angioplasty and bypass surgery are effective, and that their benefits outweigh the risks. Does this conviction stem from a solid scientific foundation, or might it be an illusion? Is it conceivable that both physicians and...
To control rising health care costs and improve outcomes, health care purchasers - Medicare, state Medicaid programs, and large employers - and health plans are eager to entirely replace traditional, inefficient, volume-based fee-for-service (FFS) physician and hospital reimbursement with value-based payment models. Value-based payment comes in various flavors but...
State Innovations in Health Payment and Delivery Reform: $730 Million in New Federal Grants AvailableKip Piper -
States across the US are engaged in ambitious and critically important initiatives to reform health care payment and care delivery. Partnering with other major health care purchasers and payors, including employers and commercial health plans, State Medicaid agencies seek to improve health outcomes and decrease per capita health spending. This...
Kip Piper -
Price transparency - or making price information publicly available - is an idea that has gained steam recently as one more way to reduce health costs and improve quality. So far, that has taken the form of online tools to help private health plan enrollees choose providers. But states...
Kip Piper -
Medicare-Medicaid dual eligibles are often talked about as a single type of patient. They have significant levels of disability and chronic disease, and account for a disproportionately large spending in both Medicare and Medicaid budgets. But dual eligibles are a diverse group. A few recent studies into health spending on dual...
Various economists and health care policy experts have tried to explain the recent slowdown in health spending growth. Some say it’s because of the Affordable Care Act, whose major provisions have yet to take effect. Others say it’s because of the economic slowdown, suggesting that the decrease in spending...
Multi-payor medical home initiatives have many benefits. They can bring Medicare, Medicaid, and private health plans together to promote care coordination, better health outcomes, and lower costs. But they have one potential flaw: Allowing payors to coordinate payment policies could trip federal (or state) anti-trust protections to prevent price-fixing and...
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