Wednesday, September 22, 2021

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

Medicaid has become a fiscal disaster for states. With spiraling costs, bulging enrollment, and a degree of complex only a quantum physicist could love, Medicaid is in desperate need of large-scale reform. The National Governors Association (NGA) has adopted an interim policy on comprehensive Medicaid reform. The policy, which all...
States continue to serve as laboratories for health care reform. In recent years, many of these state-based efforts have focused on: 1. Leveraging Employer-Based Coverage: With the goal of making health insurance coverage more affordable to small businesses and their employees, state tools include (a) premium assistance, (b) reinsurance to...

Rise of the Hospitalist

A new breed of physician is coming to a hospital near you: the hospitalist. And they hold tremendous promise for improving quality and lowering costs. Hospitalists, who specialize in caring for hospitalized patients, are specially trained to effectively diagnose and treat high-acuity patients. Assuming primary responsibility for managing medical and...
Congress could improve the newly created Medicare prescription drug benefit by applying the lessons of welfare reform, according to an excellent new article by Paul Barringer. In American Outlook, the Hudson Institute's quarterly journal, Mr. Barringer lays out what made welfare reform successful: ● Pay for performance: bonuses for performing well...
As a tool to control costs and improve care for vulnerable patients, disease management is now used in some form by over half of all state Medicaid programs. To help states craft their disease management programs, a variety of technical resources are now available. The National Pharmaceutical Council offers a...
The pay-for-performance (P4P) movement continues to grow: 1. The Medicare Payment Assessment Commission (MedPAC) is calling on Congress to incorporate quality incentives in Medicare payments to hospitals, physicians, and home health agencies. In 2003, MedPAC released similar P4P recommendations for Medicare managed care plans and dialysis facilities. MedPAC says the...
Community hospitals outperform teaching hospitals, according to a new study that compares cost and quality of hospitals in six states. The researchers conclude that patients served by lower-cost community hospital for secondary care receive care of similar quality to that provided in academic health centers. Findings include: - Inpatient costs per...
Over nine million American children - 12.8 percent of kids - have special health care needs. They face a wide range of conditions, including congenital anomalies, severe physical disabilities, severe asthma, complex organ system diseases (e.g. cystic fibrosis, sickle cell anemia), major depression, and the devastating effects of physical...
Medicaid health plans are the Ginger Rogers of managed care. They have to do everything commercial and Medicare health plans do but have to do it backwards and in high heels. Despite dealing with more complex requirements and the toughest, most vulnerable patient populations, Medicaid health plans often provide...
In an excellent new piece for HealthLeaders, E. Preston Gee asks an fascinating question with wide ranging implications for health care: "What if the mass merchandising giants like Wal-Mart or Target got into the healthcare delivery business in a big way?" Highly efficient, consumer friendly, and tech-savvy companies like Wal-Mart...

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