State insurance commissioners typically bear most of the responsibility for enforcing health insurance consumer protections. In theory, that will remain the case after broad new consumer protections included in the Affordable Care Act (ACA) go into effect. States are expected to be the first-line of enforcement, and the federal...
Prevention and wellness care are widely recognized as means to reduce health costs and spending, while also improving outcomes for patients. Preventive services typically include screenings for diseases, such as cancer, or harmful conditions, such as obesity. They also include immunizations. For example: someone gets a flu shot costing...
Electronic Patient Communication: Recommendations to Promote Patient-Centered Tools that Improve CareKip Piper -
Communication with patients is at the heart of new primary care tools and models that improve outcomes and lower costs, such as patient-centered medical homes (PCMH) and interactive preventive health records (IPHR). Often, communication means electronic communication, and is part of efforts by Medicare, Medicaid, and private health plans to...
Hospital Quality Reporting and EHRs: Inpatient Quality Data Reporting Using Electronic Health RecordsKip Piper -
By making hospital quality of care information public, the Hospital Inpatient Quality Reporting (IQR) program is designed to help patients make informed decisions and encourage hospitals and physicians to improve the quality of inpatient care. Under the Hospital IQR program, hospitals submit clinical quality data to the Centers for Medicare...
Medicare and Medicaid spending will exceed $1 trillion in FY 2013. Together, the two programs now serve about 113 million Americans - over a third of the population. Policymakers in Washington and the states face a daunting challenge to containing costs in Medicare and Medicaid – both health programs are...
Hospitalization of Seniors from Nursing Homes: High Cost of Avoidable Hospital Admissions of ElderlyKip Piper -
The cost of hospitalizations, particularly hospital readmissions, is increasingly a concern for Medicare, Medicaid, and private health plans. The Centers for Medicare and Medicaid Services (CMS) in particular has emphasized reducing hospitalizations and readmissions. Results from the CMS Medicare Coordinated Care Demonstration pilot project show coordinated care for Medicare...
Kip Piper -
Enrollees in both Medicare and Medicaid, called dual eligibles, are the most expensive and vulnerable group of beneficiaries. More than 40 percent of dual eligibles have severe cognitive disabilities, are likely to have severe physical disabilities, and have higher rates of chronic disease, such as diabetes and Alzheimer’s. All...
Kip Piper -
Healthcare-associated infections (HAI) contribute significantly to U.S. health costs and spending. They can be a major problem in hospitals, with one in every 20 hospitalized patients contracting a healthcare-associated infection, according to the Centers for Disease Control and Prevention (CDC). Each year, HAIs kill more than 1.7 million people...
Kip Piper -
Businesses have a big incentive to keep their employees healthy and to curb their health costs and spending. Premiums for employer-sponsored insurance for families almost doubled in the past decade, with the employer’s share of premiums increasing from $5,866 in 2002 to $11,429 in 2012. Data from the Health...
Privacy and Security of Health Information: Federal Guide on Privacy, Security, and Confidentiality of Electronic Health RecordsKip Piper -
Health information technology (HIT) and electronic health records (EHR) increasingly play an important role in the U.S. health care system. Many providers and health plans are using technology to improve care coordination, engage patients in primary care, raise transparency, and lower costs. Health insurance exchanges (HIX), part of the...
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