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

The Centers for Medicare and Medicaid Services (CMS) has answered some questions about how Arkansas’s creative plan to expand Medicaid under the Affordable Care Act (ACA). The plan, which Gov. Mike Beebe put forward, would use federal Medicaid expansion money to give premium subsidies for Medicaid beneficiaries to enroll...
Love it or hate it, the Affordable Care Act is unprecedented in size, scope, complexity, and uncertainty.  To project its impact, numerous policy, economic, competitive, and behavioral factors must be considered and assumptions made.  From an analytical perspective, the ACA is a simultaneous, non-linear equation from hell. A number of...
The Affordable Care Act (ACA) created a trade-off for providers, particularly hospitals: On the one hand, Medicare fee-for-service hospital payments will be cut by $260 billion over 10 years. Some people newly eligible for Medicaid will switch from private insurance, which pays much higher provider rates than Medicaid does....
Some states have expressed interest in using premium assistance to expand Medicaid eligibility under the Affordable Care Act (ACA).  Instead of serving the new ACA Medicaid expansion population through the Medicaid delivery system (through Medicaid health plans or Medicaid fee-for-service, depending on the state), the new enrollees would be...
Medicare-Medicaid dual eligibles are often held up as a prime case for the need for better care management to reduce health costs and spending while improving quality.  But doing so can be challenging.  Most dual eligibles have multiple health conditions, whether a chronic disease, severe cognitive or physical disabilities,...
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...
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...
Policy circles are abuzz with news about Arkansas Governor Mike Beebe’s creative plan to expand Medicaid under the Affordable Care Act.  While details are sketchy and there's no official federal approval yet, the basic idea is to use the federal funding for Medicaid expansion (100% in 2014-2016, no less...
The Health Coverage Tax Credit (HCTC) program is tiny compared to better-known public health coverage programs, such as Medicare, Medicaid, and CHIP. Only about 500,000 Americans in 2010 were eligible for the HCTC program, which pays 72.5 percent of private health plan premiums for workers whose jobs were cut...
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...

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