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

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...
By making hospital quality of care information public, the Hospital Inpatient Quality Reporting (IQR) program is designed to help patients make informed decisions and encourage hospitals and physicians to improve the quality of inpatient care.  Under the Hospital IQR program, hospitals submit clinical quality data to the Centers for Medicare...
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...
Healthcare-associated infections (HAI) contribute significantly to U.S. health costs and spending. They can be a major problem in hospitals, with one in every 20 hospitalized patients contracting a healthcare-associated infection, according to the Centers for Disease Control and Prevention (CDC). Each year, HAIs kill more than 1.7 million people...
Health care quality and patient safety have become increasingly important in recent years, particularly as part of efforts to prevent wasteful spending, hospital readmissions, and medical errors. Accountable Care Organizations (ACO), health information technology (HIT), electronic health records (EHR), and new health plan reporting requirements are among the many...
To help determine the value of health care provided by qualified health plans (QHPs) that will contract with Health Insurance Exchanges, the Centers for Medicare and Medicaid Services (CMS) is seeking information on best practices in health plan quality management and reporting. Through a Request for Information (RFI), CMS seeks information...
Opaque prices – the norm in U.S. health care – in a key driver of inefficient, ineffective medical care and rapid cost increases.  Transparency of health care prices - public reporting of prices - is an essential ingredient for a high-value, cost effective health care system. In recent years, rising...
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...
The number of people choosing consumer-directed health plans continued to grow in 2011, reaching 7 percent of people with private insurance. Consumer-directed or consumer-driven health plans (CDHPs) are high-deductible plans paired with health savings accounts (HSAs). Individuals pay into HSAs with pre-tax income, reducing their tax burdens. The plans...
States might find it useful to have a database replete with health care service claims data to identify Medicaid fraud, evaluate disease trends, establish cost and utilization rates, and share price information with consumers. Typically such comprehensive data is difficult to gather because it comes from various public and...

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