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

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...
Policy circles are abuzz with news about Arkansas Governor Mike Beebe’s creative plan to expand Medicaid under the Affordable Care Act.  While details are sketchy and there's no official federal approval yet, the basic idea is to use the federal funding for Medicaid expansion (100% in 2014-2016, no less...
The Health Coverage Tax Credit (HCTC) program is tiny compared to better-known public health coverage programs, such as Medicare, Medicaid, and CHIP. Only about 500,000 Americans in 2010 were eligible for the HCTC program, which pays 72.5 percent of private health plan premiums for workers whose jobs were cut...
A painful fact about the U.S. health system is that roughly one third of health costs and spending are wasted. A study in the Journal of the American Medical Association (JAMA) found that wasted health spending could reach from about $500 billion to almost $1 trillion each year. And...
Prevention and wellness care are widely recognized as means to reduce health costs and spending, while also improving outcomes for patients. Preventive services typically include screenings for diseases, such as cancer, or harmful conditions, such as obesity. They also include immunizations. For example: someone gets a flu shot costing...
A common story during the health reform debate was that of an uninsured person who went to the hospital for treatment and left behind a mountain of unpaid medical bills.  Uninsured and under-insured patients account for billions of dollars in uncompensated health care each year, which reached a total $57.4...
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...
Medicaid accounts for the largest share of state budgets and is growing still. Since fiscal year 2010, state Medicaid spending nationwide grew from 22.2 percent to about 24 percent of the average state budget, according to the National Association of State Budget Officers (NASBO). Since the recession began in...
Medicaid eligibility and enrollment is being substantially streamlined.  State Medicaid agencies and their contractors are busy adapting eligibility systems and processes to a dramatically new set of federal standards, all required under the Affordable Care Act.  Starting in January 2014, the new framework for Medicaid eligibility and enrollment will...
To support demonstrations to integrate Medicare and Medicaid for dual eligibles, the Centers for Medicare and Medicaid Services (CMS) offering state Medicaid agencies grants of up to $15 million each.  The funds are for implementation of CMS approved designs to integrate care for Medicare-Medicaid enrollees.  Most of the state...

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