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

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...
Hospitals ought to invest in processes that keep discharged patients from returning, and should do so for two main reasons, a new report argues: (1) readmissions are costly and are increasingly a concern for Medicare, Medicaid, and private payers, and (2) steps to reduce readmissions will prepare hospitals for...
States that expand Medicaid and establish Health Insurance Exchanges - both part of the Affordable Care Act (ACA) - should start planning early, should take advantage of time-limited federal funding to improve enrollment systems, and should emphasize online enrollment methods, says a brief from the Robert Wood Johnson Foundation’s Maximizing...
So far, federal guidance has fallen short of what states need to implement the Affordable Care Act’s Medicaid expansion, according to a recent report by the Government Accountability Office (GAO). State officials questioned for the report said delays of meaningful direction from the Centers for Medicare and Medicaid Services (CMS),...
States deciding whether to create a Basic Health Program (BHP) are worried it could undercut their health insurance exchanges, create a new entitlement program, and could carry financial risks if federal funds don’t cover the costs, according to a series of briefings on state progress in implementing the Affordable...
Under the Affordable Care Act, Health Insurance Exchanges, whether state or federally operated, must manage several core functions starting in 2014.  The functions include pre-screening for Medicaid or CHIP coverage, federal subsidy eligibility determination, consumer assistance, management and oversight of qualified health plans (QHPs), financial management, and enrollment of individuals or small...
New federal guidance outlines what States must do to demonstrate they are ready to operate a Health Insurance Exchange (HIX) or share HIX functions with the Centers for Medicare and Medicaid Services (CMS).  While CMS guidance on HIX implementation and operation remains very general and many questions remain, the new guidance...

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