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

Fears abound that health insurance premium increases because of the Affordable Care Act (ACA) will discourage young, healthy people from participating in the Health Insurance Exchanges. But most young people are likely to be eligible for exchange subsidies, softening the sting of so-called premium shock and attracting healthier people to...
Even as Accountable Care Organizations and other payment reform models become more common, there is still not much comprehensive information about which models providers participate in most often, and what exactly to do to make those arrangements work well. It is also important for providers to understand the best practices...
States and the federal government are doing all they can to make sure the Health Insurance Exchanges - also called Health Insurance Marketplaces - open on time, on October 1 this year. The rush to make sure everything is ready explains some of the recent news to delay certain...
Risk adjustment is a key mechanism to ensuring appropriate payments for Medicare Advantage plans, Medicare Part D drug plans, and Medicaid health plans.  Since health plans vary in their mix of healthy and sick enrollees, risk adjustment modifies premium payments to better reflect the projected costs of members served and...
Debate about whether consumers will pay more for insurance under health reform has become political, with conservative organizations saying Obamacare will increase premiums and liberals saying it won't, at least not when you take into account taxpayer-funded subsidies for health coverage. In a new study, RAND Corporation joins the latter group....
Health insurance in America has changed dramatically in the past few years, changes that will speed up once the Affordable Care Act (ACA) major provisions take effect in 2014. It’s easy to be sucked into the details of policy change, from payment reforms, to Accountable Care Organizations (ACO), to...
Employers face a multitude of challenges under the Affordable Care Act (ACA).  The ACA fundamentally changes the landscape for employer sponsored health insurance, forcing businesses to understand, navigate, and adapt to a quickly changing, highly complex, and still uncertain marketplace for health benefits.  To illustrate this, here are 10...
For health plans, the Affordable Care Act dramatically increases complexity and uncertainty in the health insurance market.  One thing is clear - Obamacare turns traditional risk management practices of health plans upside down. Predicting and adapting to the financial and operational dynamics of ACA is a daunting challenge for health plans,...
The medical goal for children diagnosed with pediatric cancers is remission or cure, but consistency and speediness of health insurance coverage is critical to access to preferred treatment. The therapeutic intervention differs based on the cancer type, stage, tolerance of the child to radiation and pharmaceutical agents, and numerous...

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