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

Pharmaceutical manufacturers face an economic transformation as payors look more toward value-based – as opposed to transactional, unit-based – models for drug reimbursement.  This value-based revenue model presents enormous implications for the future of pharma and biotech, impacting everything from innovation, clinical trials, pricing, and marketing. The Health Research Institute at PwC surveyed...
Prescription drug spending rose by $135 billion between 2001 and 2010 to comprise approximately 12 percent of the nation’s overall healthcare outlay. While drug expenditure was one of the fastest growing components of U.S. healthcare spending prior to the early 2000s, generic drugs helped reduce the rate of annual...
The latest issue of the journal American Health & Drug Benefits includes a valuable mix of studies and articles of interest to decision makers. Topics include health reform, bundled payment, drug pricing, benefit design, Medicaid, medication therapy, and specific clinical conditions. The Health Reform Law: Key Changes to Be Implemented...
MedPAC released its Medicare Data Book for 2010, with a wide range of useful information on Medicare spending, utilization, beneficiaries, providers, health plans, drug plans, access, and quality. The format is reader-friendly charts and tables with bulleted summaries. Specifically, the latest MedPAC Data Book includes information on: Medicare spending, including Medicare...
Medicare Advantage plans and Medicare Part D prescription drug plans face an extraordinary array of changes as a result of the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act (HCERA). These include: New payment benchmarks for Medicare Advantage (MA) plans, phased in and...
The Medicare Payment Advisory Commission (MedPAC) has released its Medicare payment recommendations to Congress for 2011. In addition to specific recommendations for payment updates for fee-for-service providers and Medicare Advantage plans, MedPAC's report includes interesting information and analysis on spending trends, consequences of rapid spending on Medicare and the...
Here are articles from the latest issue of American Health & Drug Benefits. AHDB is a peer-reviewed journal for 30,000 decision makers in health plans, PBMs, Medicare, Medicaid, and the pharma and biotech industries: Predictive and Prognostic Models: Implications for Healthcare Decision-Making in a Modern Recession: F. Randy Vogenberg, RPh, PhD...
The Medicare Payment Advisory Commission (MedPAC) has updated its excellent series of reader-friendly primers on Medicare payment methodologies for hospitals, physicians, Medicare Advantage plans, prescription drug plans, and other health care providers. MedPAC is an advisory agency to Congress and is highly influential, particlarly on payment methods, delivery systems,...
At the last annual meeting of the Academy of Managed Care Pharmacy, several of us spoke on pharmaceutical research and development in the quickly emerging value-driven healthcare system. Topics focused on the impact of value-based benefit designs, comparative effectiveness research, and government policies on the development of new drugs...
Here are articles from the latest issue of American Health & Drug Benefits. AHDB is a peer-reviewed journal for 30,000 decision makers in health plans, PBMs, Medicare, Medicaid, and the pharma and biotech industries: June - July 2009 Issue: Applying Evidence for Medical Technologies: Closing the Gap between R&D and Decision...

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