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

Are you ready to be an Accountable Care Organization (ACO)? Significant new opportunities and challenges face health systems, hospitals, and physician practices as they decide whether to participate in the new Medicare Shared Savings Program and join together to form an Accountable Care Organization. Accountable Care Organizations: Your Guide to Strategy, Design, and Implementation is...
Medicare and Medicaid payment incentives are available for hospitals, physicians, and certain other healthcare professionals that implement and use Electronic Health Record (EHR) systems.  To receive the payment incentives, eligible providers must engage in meaningful use of federally certified EHR systems. The federal health information technology initiative, created under the...
The Centers for Medicare and Medicaid Services (CMS) plans to contract with an organization to help CMS modernize the business processes, information technology, data, and planning and analytical capabilities used to manage Medicare, Medicaid, and health reform at the federal level. Today, CMS faces extraordinary policy and management challenges...
The latest issue of the journal American Health & Drug Benefits includes a valuable mix of studies and articles of interest to decision makers. Topics include health reform, bundled payment, drug pricing, benefit design, Medicaid, medication therapy, and specific clinical conditions. The Health Reform Law: Key Changes to Be Implemented...
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...
The incoming leadership at the U.S. Department of Health and Human Services (HHS) face a number of serious management challenges. These challenges, recently identified by the Office of the Inspector General (OIG), will require close, sustained attention by the Secretary's Office and the agency heads, particularly at CMS and...
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...
Serious and costly performance problems riddle U.S. health care. Because of overuse, under use, and misuse of health care, researchers at the Juran Institute and elsewhere estimate that about 30 percent of health care costs are generated by poor quality. Therefore, poor quality medical care will cost about $720...
As part of a larger, federal government-wide congressionally mandated initiative to reduce inappropriate payments, CMS has published its final rule on Medicaid / SCHIP payment error rate measurement. As expected, it represents a significant expansion of federal oversight of day-to-day state Medicaid operations and of the lives of Medicaid...
In the Deficit Reduction Act (DRA), Congress authorized the new $150 million Medicaid Transformation Grant Program to help states design and implement reforms to increase quality and efficiency of Medicaid. This is a unique opportunity to help states restructure and modernize Medicaid, save taxpayer dollars, and improve services. But...

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