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

Much of the story about rising health costs and spending has to do with relatively small groups of people with expensive health needs. For example, the Centers for Medicare and Medicaid Services (CMS) estimates Medicare beneficiaries with two or more chronic conditions accounted for 93 percent of Medicare spending...
For over a decade, the sustainable growth rate (SGR) has been a source of financial worry for physicians who serve Medicare patients. Medicare’s physician payment rate is based on a composite measure of the cost of care, multiplied by a factor derived from the SGR formula. Every year since...
The term “post-acute care” (PAC) covers a range of services patients receive after a hospital stay. Skilled nursing facilities, home health care agencies, long-term care hospitals, and inpatient rehabilitation hospitals all provide post-acute care. PAC providers are an important part of efforts to reduce hospital readmissions, which are a...
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...
State Medicaid programs will spend about $175 billion this year on health care for dual eligibles - low-income seniors and persons with disabilities who receive benefits from both Medicare and Medicaid.  State spending on dual eligibles falls primarily in three areas:  long term services and supports (nursing home, home...
Employer-sponsored insurance (ESI) has been central to the U.S. health care system. The Affordable Care Act (ACA) adds many requirements and imposes many costs on employers that could change how - and if - they offer employee health care coverage.  But estimating the effect of changes to ESI is...
Many new care models in both the public and private sector focus on people with chronic diseases, particularly conditions like diabetes, congestive heart failure, and hypertension. The Veterans Health Administration (VHA) Care Coordination/Home Telehealth (CCHT) pilot program serves veterans at risk of needing long term care for chronic conditions. Physician...
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...
One of the most talked-about aspects of the Affordable Care Act (ACA) is how it will affect women’s health care. The biggest After 2014, health plans will no longer be allowed to charge different premiums based on gender, regardless of whether or not they are Qualified Health Plans (QHP)...
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....

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