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

As promised, here's my list of likely losers under the new Medicare prescription drug benefit: ● Dual Eligibles: These 6.5 million highly vulnerable beneficiaries will lose their Medicaid drug benefit and be enrolled in the less generous, slightly more expensive, far more complex Medicare drug benefit. They also face the...
Sophisticated health care purchasers and health plans know the value of prescription drug data. When analyzed with paid claims data from physicians and hospitals, data from pharmacy claims can be used to identify, understand, and track a wide range of issues. Starting January 2006, when the 6.5 million dual eligibles...
Medicare Advantage is the new name for voluntary managed care options in Medicare (also know as Medicare Part C and formerly "Medicare+Choice"). Medicare Advantage plans are now available in nearly every area of the country. Beneficiaries who select a MA plan elect to receive all Medicare benefits through the...
Under the Medicare Modernization Act, employers will receive about $124 billion in tax-free subsidies to encourage them to continue prescription drug coverage for retirees. Because of a long history of taxpayer-funded health benefits "crowding out" employer-sponsored coverage, Congress wanted to reduce the incentive for employers to drop retirees into...
It looks increasingly likely that several states will challenge the constitutionality of a key element of Congress' financing of the new Medicare prescription drug benefit (also known as Medicare Part D). To help fund the massive new Medicare drug benefit, Congress mandated that state governments send monthly checks to the...
As part of the HHS appropriations bill for FY 2006, Congress is moving fast to drop federal funding for erectile dysfunction (ED) drugs in Medicaid, Medicare, and other federal health programs. This makes sense but there is a catch, albeit an unintentional one. Federal law will still require state...
For cash-strapped state governments, the "clawback" is the most controversial and costly provisions of the Medicare Modernization Act (MMA) and the new Medicare prescription drug benefit. Now, as state begin new fiscal years and grapple with the latest Medicaid spending projections, some state leaders are balking at paying the federal...
By Michael H. Bailit, MBA President of Bailit Health Purchasing, LLC Introduction The serious problems in our health care system have been more than adequately documented in this journal and many others over the two past decades. Rates of uninsurance rise with a steadiness fueled by costs that seemingly know no bound....
Medicaid has become a fiscal disaster for states. With spiraling costs, bulging enrollment, and a degree of complex only a quantum physicist could love, Medicaid is in desperate need of large-scale reform. The National Governors Association (NGA) has adopted an interim policy on comprehensive Medicaid reform. The policy, which all...
States continue to serve as laboratories for health care reform. In recent years, many of these state-based efforts have focused on: 1. Leveraging Employer-Based Coverage: With the goal of making health insurance coverage more affordable to small businesses and their employees, state tools include (a) premium assistance, (b) reinsurance to...

Stay Connected

4,688FansLike
6,936FollowersFollow
21,503FollowersFollow

Latest Articles