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

Health care expenditures are three times greater for patients who have both functional limitations and multiple chronic conditions than for patients without functional limitations. This was the impetus for a recent report, entitled High-Need, High-Cost Patients: Who are They and How Do They Use Health Care?1 The following is...
Health care payment reform efforts focus on substituting cost-effective value for volume and ultimately aligning the financial incentives of provider reimbursement with expectations for patient outcomes, care management, and efficiency.  The complex dynamics and trade-offs of different payment reform models are discussed in a helpful new report from the Urban Institute...
The massive reforms to Medicare physician reimbursement mandated under Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) present many issues and opportunities for accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP).  While moving Medicare Part B to a new merit-based system of physician and clinic payment, MACRA also...
Childhood Diseases in Adulthood
Increased immunizations have reduced the rates of specific diseases associated with childhood. However, adults who are infected with the same viruses can experience dire consequences—and a vaccination in childhood may not guarantee immunity in middle age.  While the evidence supporting childhood vaccination and booster immunizations for adults is overwhelming, ignorance...
How have alternative health care payment models, aimed at lowering costs while improving patient outcomes, affected physicians and physician practices in the United States? A recent RAND Corporation study, sponsored by the American Medical Association, looks at the effects payment reform models have on physicians' finances, practice management, and...
Healthcare is undergoing a revolution in the transformation of data into credible, actionable information for decision making at all levels, including financing, coverage, reimbursement, product development, diagnoses and treatment, clinical care delivery, and consumer choices. In a fascinating new interview, one of the world’s top experts on health informatics discusses...
The Affordable Care Act (ACA) is changing the health care landscape for everyone, including safety net hospitals. Just how this change will affect these key providers and what they must do to stay open are subjects of much debate.  In a multitude of ways, the ACA, new marketplace dynamics,...
As policymakers in Washington argue over the best way to reform America's health care system, a compelling new book by Eric Topol, MD, suggests that the advance of technology is going to change how health care services are delivered in more profound and unpredictable ways than most people can...
The practice of behavioral healthcare is being transformed by technological innovations in mobile health and a growing understanding of the role patient behavior, behavioral health conditions, and dual physical/behavioral health diagnoses play in health outcomes and costs.  This transformation has in turn given rise to a profusion of fascinating and...
While mountains of raw health care data continue to grow, the challenge of turning that data into usable, actionable information is largely being unmet. There are certainly tremendous new opportunities to use information to improve health care decisions at the purchaser, plan, provider, and patient levels and thereby improve...

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