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

Rick Wagoner, chairman and CEO of General Motors, is calling on both political parties to work together to solve the nation
Health insurers, whether commercial health plans or public programs like Medicaid and Medicare, only wish to pay for care that is necessary. Every day they make decisions on what is and is not "medically necessary." Gov. Phil Bredesen has proposed a new definition of medical necessity for TennCare, Tennessee's long-troubled...
If President Clinton had to wait weeks or months for urgent bypass surgery like patients in Canada or the UK, he would be dead. Mr. Clinton's physicians said he was at serious risk of a major, life-threatening heart attack. He needed the bypass quickly and got it. In Canada, patients...
In the typical hospital, nurses spend only about 30 percent of their time on patient care. The remaining 70 percent of their long days are spent largely on paperwork. This lopsided situation is seen as a major cause of poor quality, patient dissatisfaction, nurse turnover, and operating inefficiency. Thanks to...
Escape Fire is collection of compelling speeches by one of America's leading crusaders for health care quality and patient safety - Don Berwick, MD, founder and president of the Boston-based Institute for Healthcare Improvement. Each year, IHI hosts the National Forum on Quality Improvement in Health Care. The influential annual...
There is ample evidence America has a serious problem with poor quality health care and high rates of preventable medical mistakes. Thankfully, there is no shortage of caring professionals motivated to improve care and the problems are solvable. As with any effort to improve performance, measurement is the first step...
Under the Medicare Modernization Act (MMA), the new Medicare prescription drug benefit (aka, Medicare Part D) includes a retiree subsidy to encourage the continuation of employer-sponsored drug plans for retired Americans. Here are some excellent resources to help employers understand the Medicare retiree subsidy: - White Paper on Retiree Drug Coverage...
State Medicaid programs are the nation's largest buyers of prescription drugs, serving over 50 million Americans, including the most vulnerable and costly patients. However, Medicaid drug benefits are complex and vary from state to state and among the diverse populations served. We now have an wealth of new information on...
In 2002, Medicaid became the world's largest health program, with expenditures exceeding the better-known Medicare program. With over a third of trillion dollars in spending and over 50 million beneficiaries, America's most complex and fastest growing health program is also its largest. Not surprisingly, Medicaid is now the largest part...
Medicaid health plans are the Ginger Rogers of managed care. They have to do everything commercial and Medicare health plans do but have to do it backwards and in high heels. Despite dealing with more complex requirements and the toughest, most vulnerable patient populations, Medicaid health plans often provide...

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