Opportunity for Health Plans to Improve Quality and Reduce Costs by Embracing Primary Care Medical HomesKip Piper -
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...
Policy circles are abuzz with news about Arkansas Governor Mike Beebe’s creative plan to expand Medicaid under the Affordable Care Act. While details are sketchy and there's no official federal approval yet, the basic idea is to use the federal funding for Medicaid expansion (100% in 2014-2016, no less...
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...
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...
Medicaid Disproportionate Share Hospital Payments: Understanding DSH and Funding Cuts Under Affordable Care ActKip Piper -
A common story during the health reform debate was that of an uninsured person who went to the hospital for treatment and left behind a mountain of unpaid medical bills. Uninsured and under-insured patients account for billions of dollars in uncompensated health care each year, which reached a total $57.4...
Kip Piper -
A year from now, in January 2014, new health insurance exchanges (HIX) will offer coverage to individuals and small-business employees. Part of the Affordable Care Act (ACA), the exchanges present vast and complex challenges for states, the federal government, and health insurers weighing whether to participate by becoming qualified...
State Partnership Exchanges are a hybrid model for operation of a Health Insurance Exchange (HIX) under the Affordable Care Act. In this model, responsibility for Exchange functions is shared between the state and Centers for Medicare and Medicaid Services (CMS). The other two models are a Federally Facilitated Exchange...
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...
Employer Mandate Under Affordable Care Act: IRS Answers Questions on ACA Employer Shared ResponsibilityKip Piper -
The Employer Mandate is one of the many complex new requirements of the Affordable Care Act (ACA) health reform law. Under the Employer Mandate - decorously called Employer Shared Responsibility in the law - most employers must provide health insurance coverage to all full-time employees or pay a penalty...
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