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

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...
Enrollees in both Medicare and Medicaid, called dual eligibles, are the most expensive and vulnerable group of beneficiaries. More than 40 percent of dual eligibles have severe cognitive disabilities, are likely to have severe physical disabilities, and have higher rates of chronic disease, such as diabetes and Alzheimer’s. All...
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...
Healthcare-associated infections (HAI) contribute significantly to U.S. health costs and spending. They can be a major problem in hospitals, with one in every 20 hospitalized patients contracting a healthcare-associated infection, according to the Centers for Disease Control and Prevention (CDC). Each year, HAIs kill more than 1.7 million people...
When Congress enacted the Medicare Modernization Act of 2003 (MMA), it set a spending target of about $400 billion over 10 years for the Medicare Part D drug benefit, after accounting for revenues from premiums and other sources. Seven years into the program’s life, Medicare Part D spending is...
Prescription drugs often play an important role in keeping people healthy, especially for people with chronic conditions. Medicare beneficiaries with diabetes or asthma, for example, might take regular medicines to prevent emergencies that would put them in the hospital. Hospital stays, doctor’s appointments, and other medical services covered under...
Health information technology (HIT) and electronic health records (EHR) increasingly play an important role in the U.S. health care system. Many providers and health plans are using technology to improve care coordination, engage patients in primary care, raise transparency, and lower costs. Health insurance exchanges (HIX), part of the...
Health care quality and patient safety have become increasingly important in recent years, particularly as part of efforts to prevent wasteful spending, hospital readmissions, and medical errors. Accountable Care Organizations (ACO), health information technology (HIT), electronic health records (EHR), and new health plan reporting requirements are among the many...
Medicare program payment methods are highly complex and change constantly.  The Affordable Care Act (ACA) makes further, very significant changes to how Medicare pays hospitals, physicians, post-acute providers, and Medicare Advantage health plans.  In a series of excellent briefs, the Medicare Payment Advisory Commission (MedPAC) explains the basics of Medicare reimbusement, including...
Employers have made major changes to their health benefits in the past decade. Premiums for employer-sponsored health insurance increased more than 60 percent from 2001 to 2009, and the employee’s share of premiums went up more than 90 percent. There has also been a decline in the numbers of businesses...

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