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

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...
Here is a summary of the Medicare, Medicaid, and other health care related provisions of H.R. 8, the American Taxpayer Relief Act of 2012, as passed by House and Senate as part of the fiscal cliff negotiations.  President Obama is expected to sign the law shortly. The Congressional Budget Office (CBO)...
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...
State Medicaid programs must increase primary care physician payment rates in 2013 and 2014 to at least 100 percent of Medicare rates.  The Medicaid-Medicare payment parity mandate is part of the Affordable Care Act (ACA). For the difference between prior rates and the necessary rate increase, states will receive a 100...
Medicare and Medicaid spending will exceed $1 trillion in FY 2013.  Together, the two programs now serve about 113 million Americans - over a third of the population.  Policymakers in Washington and the states face a daunting challenge to containing costs in Medicare and Medicaid – both health programs are...
The cost of hospitalizations, particularly hospital readmissions, is increasingly a concern for Medicare, Medicaid, and private health plans. The Centers for Medicare and Medicaid Services (CMS) in particular has emphasized reducing hospitalizations and readmissions. Results from the CMS Medicare Coordinated Care Demonstration pilot project show coordinated care for Medicare...
Much of the nation's long-term care is paid for with Medicaid funding. Medicaid pays 43 percent of all long-term care, while Medicare pays 24 percent and a mix of private health plans and consumers funds the rest, according to the Kaiser Family Foundation. Only half of people who need...
Somewhere between 11 million and 21 million will become newly insured under Medicaid thanks to the Affordable Care Act (ACA), depending on whether you subscribe to the latest estimates from the Congressional Budget Office (CBO) or the Urban Institute. The Supreme Court’s decision in NFIB v. Sebelius gave states...
Thanks to the Supreme Court’s ruling in NFIB v. Sebelius, states have a choice about whether to expand Medicaid eligibility as part of the Affordable Care Act (ACA). State Medicaid directors currently oversee a patchwork of eligibility standards, which for the most part cover low-income families and disabled people....
Leading-edge state Medicaid agencies across the country are exploring the potential of accountable care organizations (ACOs) to drive improvements in quality, delivery, and cost-effectiveness for Medicaid beneficiaries. Seven states in particular – Maine, Massachusetts, Minnesota, New Jersey, Oregon, Texas, and Vermont – are creating ACO models for Medicaid. The Center...

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