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

While the Affordable Care Act is expected to shift more of health coverage from the private employers to taxpayers, the most common source of health insurance for Americans is still though an employer or the employer of a spouse or parent.  According to the most recent census data, over...
Coordinated primary care models have shown great potential to reduce health care costs while improving care, a goal that will become even more important after the Affordable Care Act (ACA) coverage expansion provisions take full effect next year. The models typically involve communication among providers, a focus on patients...
For the past several years, major payers in U.S. health care have experimented with new payment models that create incentives to control unnecessary health care spending. The traditional fee-for-service model for health insurance does not give providers a reason to control health costs: The more services they provide, the...
In recent testimony to the Senate Finance Committee, Gary Cohen of the Centers for Medicare and Medicaid Services (CMS) gave an update of progress on Health Insurance Exchanges (HIX) implementation, now called Health Insurance Marketplaces. There is plenty to do, as shown in the timeline CMS presented that day,...
Primary care delivery through patient-centered medical homes (PCMHs) and other coordinated-care models have improved care and reduced costs. Health plans have a strategic opportunity to promote better care at a lower cost by embracing medical homes and encouraging their development as a core component of provider networks. PCMHs will also...
State insurance commissioners typically bear most of the responsibility for enforcing health insurance consumer protections. In theory, that will remain the case after broad new consumer protections included in the Affordable Care Act (ACA) go into effect. States are expected to be the first-line of enforcement, and the federal...
A year from now, in January 2014, new health insurance exchanges (HIX) will offer coverage to individuals and small-business employees. Part of the Affordable Care Act (ACA), the exchanges present vast and complex challenges for states, the federal government, and health insurers weighing whether to participate by becoming qualified...
The Employer Mandate is one of the many complex new requirements of the Affordable Care Act (ACA) health reform law.  Under the Employer Mandate - decorously called Employer Shared Responsibility in the law - most employers must provide health insurance coverage to all full-time employees or pay a penalty...
Essential health benefits (EHB) will play a fundamental role in shaping health plans after 2014. Part of the Affordable Care Act (ACA), EHBs define a baseline of 10 types of services those plans must cover, including prescription drugs, hospital services, preventive or wellness services, and chronic disease management. Qualified...
Businesses have a big incentive to keep their employees healthy and to curb their health costs and spending. Premiums for employer-sponsored insurance for families almost doubled in the past decade, with the employer’s share of premiums increasing from $5,866 in 2002 to $11,429 in 2012. Data from the Health...

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