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

The Centers for Medicare and Medicaid Services (CMS), charged with protecting Medicare’s fiscal integrity, works to recover payments made by Medicare that are the responsibility of non-group health plans. While CMS has not always been aware of all such situations in the past, 2007 legislation introduced mandatory non-group health...
The Agency for Healthcare Research and Quality (AHRQ) has released interesting new data on increases in premiums and employee contributions for employer-sponsored health insurance coverage (ESI) from 2001 to 2009. Types of Employer-Sponsored Health Insurance Coverage: There are three types of employer-sponsored health insurance offered by employers in the U.S.: 1. ...
Under the Affordable Care Act (ACA), most health plans are now required to provide preventive services to their enrollees without any co-payments or other cost sharing.  Over time, this is expected to significantly improve prevention and wellness, reducing costs and reducing incidence of preventable condtions.  However, the preventive services...
While most of the major health reforms start in 2014, the Affordable Care Act (ACA) imposes several new requirements in 2011 on health plans and self-insured employers. To prevent either a large increase in premiums or a significant decrease in access to health coverage, the Centers for Medicare and Medicaid...
Creating a wellness-based healthcare system is the focus on a new series of articles published by American Health and Drug Benefits, a peer reviewed journal. They cover a wide spectrum of topics on how to build and support prevention and wellness, particularly for chronic conditions. The ideas and information...
Here are articles from the latest issue of American Health & Drug Benefits. AHDB is a peer-reviewed journal for 30,000 decision makers in health plans, PBMs, Medicare, Medicaid, and the pharma and biotech industries: Predictive and Prognostic Models: Implications for Healthcare Decision-Making in a Modern Recession: F. Randy Vogenberg, RPh, PhD...
At the last annual meeting of the Academy of Managed Care Pharmacy, several of us spoke on pharmaceutical research and development in the quickly emerging value-driven healthcare system. Topics focused on the impact of value-based benefit designs, comparative effectiveness research, and government policies on the development of new drugs...
Here are articles from the latest issue of American Health & Drug Benefits. AHDB is a peer-reviewed journal for 30,000 decision makers in health plans, PBMs, Medicare, Medicaid, and the pharma and biotech industries: June - July 2009 Issue: Applying Evidence for Medical Technologies: Closing the Gap between R&D and Decision...
To aid the incoming 111th Congress and Obama Administration, the Congressional Budget Office (CBO) released a 235-page report outlining 115 budget options for health care reform. The report catalogs most of the hottest legislative ideas on Capitol Hill, with useful background information and scores of costs and savings. Here's...

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