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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...
Much about the Health Insurance Exchanges is uncertain, even as the October 1 deadline to make them operational approaches. Many states running their own or partnership exchanges have yet to decide on key elements of plan management, consumer outreach, and other important functions. Exchanges are a genuine game changer...
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...
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...
It’s not uncommon for a patient to be confused or overwhelmed by a diagnosis or treatment plan.  Complicated medical procedures or decisions can overwhelm patients to the point that they feel that they cannot, or should not, ask questions of their providers.   However, this lack of patient involvement in...
The nation's largest health care buyers - Medicare, state Medicaid programs, large employers, and health plans - are eager for ways to improve the quality and efficiency of chronic health conditions, which drive the bulk of health spending.  Payment reform and care delivery reforms are critically important.  Providers -...
Primary care is shifting to payment based on providing higher quality, lower cost health care. New payment models - such as patient-centered medical homes (PCMH) - replace or supplement traditional fee-for-service payments with per-member per-month payments, and emphasize coordinated care, quality measurement, and accountability. Some models offer cost-sharing, as...
Health information technology, care coordination, and cost containment have increasingly become entwined in health care policy. Medicare and Medicaid both have electronic health record (EHR) incentive programs to encourage physicians, hospitals, and other providers to use them. Electronic patient communication also is part of care coordination models, such as...
In recent testimony to the Senate Finance Committee, Gary Cohen of the Centers for Medicare and Medicaid Services (CMS) gave an update of progress on Health Insurance Exchanges (HIX) implementation, now called Health Insurance Marketplaces. There is plenty to do, as shown in the timeline CMS presented that day,...

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