Today, Medicaid spends nearly $500 billion a year on health care for about 71 million Americans. Responsible for a quarter of state budgets, the highly complex program is poised to grow dramatically under the Affordable Care Act (ACA). The extraordinary fiscal, clinical, and administrative demands of Medicaid have left state...
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...
Patents form the basis of the pharma and biotech industry, also called the life sciences industry. They give companies an incentive to make large investments in risky drug development and innovations, which have the potential to be ineffective or to fail Food and Drug Administration (FDA) approval. More than 6,000 U.S. businesses spent...
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...
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...
Medicaid directors have been pushed to find cost savings in their programs in the midst of recent budget shortfalls, often using blunt instruments such as cuts in benefits, provider rates, and eligibility. But Medicaid directors are also evaluating and implementing more sustainable reforms to ensure Medicaid continues to provide...
Kip Piper -
Based on data from Germany’s experience with wellness programs, a recent report cautions that wellness incentives under the Affordable Care Act (ACA) could lead to higher insurance premiums for low-income and chronically ill people. The Commonwealth Fund’s brief found that one quarter of the publicly insured population participated in...
Healthcare Quality and Cost: Engaging Employers as Change Agents in Lowering Costs and Improving QualityKip Piper -
As the second-largest health care service purchaser, employers have an opportunity to use their substantial market leverage as a means to augment quality. If mobilized and motivated, employers could act as a key change agent by influencing other stakeholder groups, exercising a leadership role, and pushing community health plans...
Kip Piper -
As part of the Affordable Care Act (ACA), Medicaid coverage could be expanded to cover nearly 400,000 currently uninsured American Indians and Alaska Natives (AI/AN). This population, particularly sensitive to health disparities, suffers from elevated disease burdens and poorer overall health than that of the general population. The AI/AN...
National Advisory Council Subcommittee Identifies Core Set of Health Quality Measures for Medicaid-eligible AdultsKip Piper -
The AHRQ released its background report, National Advisory Council Subcommittee: Identifying Health Care Quality Measures for Medicaid-Eligible Adults. Required by the Affordable Care Act, this report identified a recommended core set of quality measures for Medicaid-eligible adults. Also aimed at providing states with insight into health care quality for...
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