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

In the ongoing struggle over wasteful health care spending, geographic cost variation is a veteran hot topic. The fact that public programs and private health plans spend more for providers in some regions, even after accounting for normal differences in costs by location, has irked policymakers and researchers who...
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...
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...
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...
For over a decade, the sustainable growth rate (SGR) has been a source of financial worry for physicians who serve Medicare patients. Medicare’s physician payment rate is based on a composite measure of the cost of care, multiplied by a factor derived from the SGR formula. Every year since...
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...
Medicare-Medicaid dual eligibles are often held up as a prime case for the need for better care management to reduce health costs and spending while improving quality.  But doing so can be challenging.  Most dual eligibles have multiple health conditions, whether a chronic disease, severe cognitive or physical disabilities,...
Medicare Part D, the Medicare drug benefit, served roughly 31 million seniors last year. Medicare Part D is more similar to Medicare Advantage than to traditional Medicare in that enrollees can choose among several private health plans for drug coverage. The lists of which drugs Part D plans cover -...
Primary care delivery through patient-centered medical homes (PCMHs) and other coordinated-care models have improved care and reduced costs. Health plans have a strategic opportunity to promote better care at a lower cost by embracing medical homes and encouraging their development as a core component of provider networks. PCMHs will also...
The Health Coverage Tax Credit (HCTC) program is tiny compared to better-known public health coverage programs, such as Medicare, Medicaid, and CHIP. Only about 500,000 Americans in 2010 were eligible for the HCTC program, which pays 72.5 percent of private health plan premiums for workers whose jobs were cut...

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