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

In the King v. Burwell case on federal premium subsidies in the federally-run health insurance exchanges, Congress, the White House, and States have a simple option should the Supreme Court rule in favor of King. This option is a simple legislative fix likely to be scored at no cost...
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...
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...
Delivery of physical medical care and behavioral health services is too often uncoordinated, operating in silos with little or no communication between physicians and other providers providing a patient with primary, specialty, acute, and pharmacy services and behavioral health professionals proving that same patient with mental health care or...
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...
Managed Long Term Services and Supports (MLTSS) programs provide long-term care primarily to aging adults and people with disabilities. This care is provided not via the fee-for-service model but through managed care organizations. These contractors deliver benefits, which include community, home, and institution-based services, and receive payment through Medicaid....
Undocumented immigrants may be able to receive federally subsidized health insurance coverage under waiver authority built into the Affordable Care Act (ACA).  The ACA allows States to request waivers of certain major provisions of Obamacare, including a waiver of the ACA requirement limiting federal premium and cost sharing subsidies...
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...
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...

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