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

The term “post-acute care” (PAC) covers a range of services patients receive after a hospital stay. Skilled nursing facilities, home health care agencies, long-term care hospitals, and inpatient rehabilitation hospitals all provide post-acute care. PAC providers are an important part of efforts to reduce hospital readmissions, which are a...
Many new care models in both the public and private sector focus on people with chronic diseases, particularly conditions like diabetes, congestive heart failure, and hypertension. The Veterans Health Administration (VHA) Care Coordination/Home Telehealth (CCHT) pilot program serves veterans at risk of needing long term care for chronic conditions. Physician...
It’s not uncommon for a patient to be confused or overwhelmed by a diagnosis or treatment plan.  Complicated medical procedures or decisions can overwhelm patients to the point that they feel that they cannot, or should not, ask questions of their providers.   However, this lack of patient involvement in...
Primary care is shifting to payment based on providing higher quality, lower cost health care. New payment models - such as patient-centered medical homes (PCMH) - replace or supplement traditional fee-for-service payments with per-member per-month payments, and emphasize coordinated care, quality measurement, and accountability. Some models offer cost-sharing, as...
For the past several years, major payers in U.S. health care have experimented with new payment models that create incentives to control unnecessary health care spending. The traditional fee-for-service model for health insurance does not give providers a reason to control health costs: The more services they provide, the...
Health information technology, care coordination, and cost containment have increasingly become entwined in health care policy. Medicare and Medicaid both have electronic health record (EHR) incentive programs to encourage physicians, hospitals, and other providers to use them. Electronic patient communication also is part of care coordination models, such as...
Poor quality of care and preventable medical errors are a major cause of high costs and patient suffering.  The opportunities for improvement are considerable. In addition, as states and health plans gear up for Health Insurance Exchanges (HIX), they will count quality and patient safety among their key considerations.  For...
The Department of Defense (DOD) and the Department of Veterans Affairs (VA) in recent months have delivered grim statistics on military and veteran suicides. In a report earlier this year, the VA announced veterans committed suicide at a rate of 22 per day in 2010. Active-duty military suicides reached...
A painful fact about the U.S. health system is that roughly one third of health costs and spending are wasted. A study in the Journal of the American Medical Association (JAMA) found that wasted health spending could reach from about $500 billion to almost $1 trillion each year. And...
Much of the health information technology (HIT) today promotes patient communication to improve care and potentially lower costs. Some examples are interactive preventive health records (IPHR), e-prescribing, and electronic health records (EHR). Emerging telehealth technologies, however, take it a step further. Telehealth allows physicians and other providers not only to...

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