Kip Piper's Health Care Blog
Medicare, Medicaid, Health Reform

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...
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...
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...
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...
Special Needs Plans (SNP) are part of the Medicare Advantage program and were created by the Medicare Modernization Act of 2003 (MMA). There are three types of SNPs, each intended to provide coordinated care for Medicare beneficiaries that meet specific criteria. Institutional SNPs (I-SNP) serve beneficiaries who, for 90 days...
The Government Accountability Office (GAO) says it has found a more fair way to set federal matching rates for state spending on social programs such as Medicaid and the Children's Health Insurance Program (CHIP). Match rates that take into account differences among states in health costs, demand for services,...
The prices of generic drugs vs. brand-name drugs has gathered a lot of attention lately. But buying in bulk and purchasing practices can have as much of an effect on prices as drug patents do.  That’s what the Government Accountability Office (GAO) found when it compared Rx prices paid in prescription...
Hypertension, or high blood pressure, is related to several major chronic diseases. Obesity and diabetes raise your chance of developing high blood pressure, which in turn makes you more likely to suffer from heart disease and stroke. High blood pressure also becomes more prevalent with age. Those factors make high...
Hospitals face another year of tight Medicare reimbursement, with rates for FY 2014 falling farther behind cost increases and margins declining as a result.  Most hospitals already lose money on caring for Medicare and Medicaid patients.  Hospitals are entering a far more challenging new business environment under the Affordable...
Growth in health care spending has slowed recently.  Why?  Supporters of the Affordable Care Act (ACA) - aka Obamacare - says its due to the controversial law, although most of the ACA's provisions are yet to take effect.  However, new evidence shows that the economy is the cause of...

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