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

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...
Hospital readmissions are costly but largely preventable. Reducing inpatient readmissions are a top priority for Medicare, state Medicaid programs, and private health plans.  The opportunities to lower costs and improve patient outcomes are considerable.  Therefore, healthcare purchasers are realigning hospital payment methods to reward hospitals for fewer readmissions and...
The basis for medical treatment of heart disease is the belief that interventions like coronary angioplasty and bypass surgery are effective, and that their benefits outweigh the risks. Does this conviction stem from a solid scientific foundation, or might it be an illusion? Is it conceivable that both physicians and...
To control rising health care costs and improve outcomes, health care purchasers - Medicare, state Medicaid programs, and large employers - and health plans are eager to entirely replace traditional, inefficient, volume-based fee-for-service (FFS) physician and hospital reimbursement with value-based payment models.  Value-based payment comes in various flavors but...
High hospital emergency room use by Medicaid enrollees is a perennial concern. What do we know about Medicaid emergency department visits? Are they medically necessary? What drives Medicaid emergency department visits? Is Medicaid ER utilization increasing under the Affordable Care Act? The Medicaid and CHIP Payment and Access Commission (MACPAC)...
Overuse and abuse of opioid drugs, particularly prescription pain killers, is a serious, costly problem, with a host of challenges for purchasers, payors, patients, physicians, pharmacists, regulators, public health, and drug manufacturers.  For 20 years, overuse of opioid drugs has steadily increased, as have inpatient hospitalizations for opioid overdoses.  Together, Medicaid and...
In the U.S., we usually hear about health care in Europe as an example of what the American health system is not. Universal health coverage, state-run provider networks, and rationing are the two differences that come up most often. But the U.S. and Europe share many health care policy challenges:...
Medicare-Medicaid dual eligibles are often talked about as a single type of patient. They have significant levels of disability and chronic disease, and account for a disproportionately large spending in both Medicare and Medicaid budgets. But dual eligibles are a diverse group. A few recent studies into health spending on dual...
Debate about whether consumers will pay more for insurance under health reform has become political, with conservative organizations saying Obamacare will increase premiums and liberals saying it won't, at least not when you take into account taxpayer-funded subsidies for health coverage. In a new study, RAND Corporation joins the latter group....
Various economists and health care policy experts have tried to explain the recent slowdown in health spending growth. Some say it’s because of the Affordable Care Act, whose major provisions have yet to take effect. Others say it’s because of the economic slowdown, suggesting that the decrease in spending...

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