Hospital Readmissions: Conditions, Cost, and Utilization Differences in Medicare, Medicaid, and Private InsuranceKip Piper -
Hospital readmissions are costly but largely preventable. Reducing inpatient readmissions are a top priority for Medicare, state Medicaid programs, and private health plans. The opportunities to lower costs and improve patient outcomes are considerable. Therefore, healthcare purchasers are realigning hospital payment methods to reward hospitals for fewer readmissions and...
Kip Piper -
The basis for medical treatment of heart disease is the belief that interventions like coronary angioplasty and bypass surgery are effective, and that their benefits outweigh the risks. Does this conviction stem from a solid scientific foundation, or might it be an illusion? Is it conceivable that both physicians and...
To control rising health care costs and improve outcomes, health care purchasers - Medicare, state Medicaid programs, and large employers - and health plans are eager to entirely replace traditional, inefficient, volume-based fee-for-service (FFS) physician and hospital reimbursement with value-based payment models. Value-based payment comes in various flavors but...
The practice of medicine in the age of generic pharmaceuticals is built upon the premise that these chemically identical medications have the same therapeutic effect as the brand-name ones. But do they? Generic: The Unbranding of Modern Medicine by Jeremy A. Greene, MD, PhD, of John Hopkins University is...
State Innovations in Health Payment and Delivery Reform: $730 Million in New Federal Grants AvailableKip Piper -
States across the US are engaged in ambitious and critically important initiatives to reform health care payment and care delivery. Partnering with other major health care purchasers and payors, including employers and commercial health plans, State Medicaid agencies seek to improve health outcomes and decrease per capita health spending. This...
Kip Piper -
In the U.S., we usually hear about health care in Europe as an example of what the American health system is not. Universal health coverage, state-run provider networks, and rationing are the two differences that come up most often. But the U.S. and Europe share many health care policy challenges:...
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...
Kip Piper -
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...
Kip Piper -
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...
Various economists and health care policy experts have tried to explain the recent slowdown in health spending growth. Some say it’s because of the Affordable Care Act, whose major provisions have yet to take effect. Others say it’s because of the economic slowdown, suggesting that the decrease in spending...
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