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...
Care Management and Hospitalizations: Care Management Reduces Inpatient Admissions for High-Risk Medicare PatientsKip Piper -
Care management for Medicare beneficiaries at high risk of hospitalization can significantly reduce hospital admissions without increasing costs, according to two studies in Health Affairs and sponsored by the Robert Wood Johnson Foundation. The studies found decreases in Medicare inpatient admissions of 17 percent and 8 to 33 percent, respectively. Care management...
The Congressional Budget Office’s issue brief, Lessons from Medicare’s Demonstration Projects on Disease Management, Care Coordination, and Value-Based Payment, provides details on the outcome of 10 major Medicare demonstrations following independent researcher evaluation. Demonstrations were conducted during a 20-year span within two categories. Demonstrations were aimed at improving health care...
Medicare-Medicaid Dual Eligibles Market for Health Plans: Briefing by Kip Piper for Wall Street Analysts at Citi Global Healthcare ConferenceKip Piper -
The $350 billion Medicare-Medicaid dual eligible market is an extraordinary new business opportunity for health insurers, as well as a way for state Medicaid programs to generate significant budget savings and improve access and quality of care for frail seniors and persons with severe disabilities. A dozen states are now looking...
The budgetary impact of proposed health reform initiatives - whether through legislation, rules, or waivers - significantly affects the likelihood of success. The following provides a concise briefing on some key players and processes affecting cost estimates of federal health care initiatives. Congressional Budget Office (CBO): The Congressional Budget Office (CBO),...
The next President and Congress will face many fiscal and policy challenges from the $436 billion Medicare program. Following my earlier quick primers on Medicaid policy making and Medicare and Medicaid waivers, here is a similar briefing on the primary vehicles of Medicare policy making. As a federal health program...
Federal waivers are powerful tools to demonstrate Medicare or Medicaid reforms, including new payment methods, benefit packages, and delivery systems. The business and policy opportunities are considerable. Here's a quick primer. Demonstration Waivers: Historically, federal policymakers have understood the need to test new ideas in the complex Medicare and Medicaid programs....
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