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...
Shared Decision Making by Physicians and Patients: Actions for Employers to Improve Health and Reduce CostsKip Piper -
Employers should encourage shared decision-making - which involves patients in health care decisions - as a way to reduce medical costs and improve health outcomes among employees, argues a recent brief from the National Business Coalition on Health (NBCH). Patients who have a better understanding of and are more...
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...
Kip Piper -
Care coordination is a process that ensures a patient’s health services and information sharing preferences and needs are met. Care coordination, a critical component during the nation’s current shift from a fragmented system toward one that stresses accountability and continuity, is primarily accomplished by people as opposed to technology....
Health Plans and Quality Improvement Reporting Under the Affordable Care Act: Recommendations for Implementing Reporting of Quality Improvement StrategiesKip Piper -
The Affordable Care Act (ACA) requires the Centers for Medicare and Medicaid Services (CMS) issue employer group health plan quality improvement reporting requirements. Reports shall cover specified quality improvement activities regarding plan or coverage benefit and provider reimbursement structures. Those requirements shall include efforts to improve health outcomes, ensure...
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...
More than 75 percent of total health care costs cover preventable chronic conditions like diabetes, heart disease, and cancer. The Affordable Care Act (ACA) mandates that self-insured employers and health plans provide common, evidence-based wellness screenings designed to reduce such conditions without charging a copayment, deductible, or co-insurance. Because health...
Medicare Advantage and Preventative Services: GAO Finds Preventative Care Services and Clinical Recommendations Could Be Better AlignedKip Piper -
Because preventative care can reduce expenditures and improve health outcomes, the GAO conducted a study examining actual preventative service use in relation to the U.S. Preventative Services Task Force (USPSTF) and Advisory Committee on Immunization Practices (ACIP) by Medicare fee-for-service (FFS) beneficiaries. This study also examined whether or not the...
44.6 ° F