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

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...
Hospital admissions and readmissions are a hot topic in the healthcare community.  Reducing hospital utilization can result in a leaner, more efficient system with lower costs and greater health outcomes.  The opportunities to save money and improve care are extraordinary. Accordingly, Medicare, state Medicaid agencies, health plans, and patient organizations...
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...
While the Affordable Care Act is expected to shift more of health coverage from the private employers to taxpayers, the most common source of health insurance for Americans is still though an employer or the employer of a spouse or parent.  According to the most recent census data, over...
Coordinated primary care models have shown great potential to reduce health care costs while improving care, a goal that will become even more important after the Affordable Care Act (ACA) coverage expansion provisions take full effect next year. The models typically involve communication among providers, a focus on patients...
For the past several years, major payers in U.S. health care have experimented with new payment models that create incentives to control unnecessary health care spending. The traditional fee-for-service model for health insurance does not give providers a reason to control health costs: The more services they provide, the...
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...
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...
Medicare Advantage plans provide many benefits to Medicare beneficiaries, including lower costs, added services, higher quality than traditional fee-for-service (FFS), and less paperwork.  However, the way Medicare paid Medicare Advantage health plans led to a situation where Medicare was paying health plans more than the average cost of Medicare FFS...

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