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

Improving care integration for Medicare-Medicaid dual eligible beneficiaries is one of the many initiatives embedded in the Affordable Care Act (ACA). The health reform law created the Medicare-Medicaid Coordination Office at the Centers for Medicare and Medicaid Services (CMS), and provided funds for state demonstrations to integrate care for...
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...
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...
Debate about whether consumers will pay more for insurance under health reform has become political, with conservative organizations saying Obamacare will increase premiums and liberals saying it won't, at least not when you take into account taxpayer-funded subsidies for health coverage. In a new study, RAND Corporation joins the latter group....
Risk adjustment is a key mechanism to ensuring appropriate payments for Medicare Advantage plans, Medicare Part D drug plans, and Medicaid health plans.  Since health plans vary in their mix of healthy and sick enrollees, risk adjustment modifies premium payments to better reflect the projected costs of members served and...
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...
The Affordable Care Act (ACA) coverage expansions to childless adults, through Medicaid and Health Insurance Exchanges, could have broad effects on public health. A recent study gives us one good example of that by showing that pregnant women in Medicaid with tobacco cessation coverage were less likely to smoke...
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...
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...
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...

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