Hospital Readmissions: Conditions, Cost, and Utilization Differences in Medicare, Medicaid, and Private InsuranceKip Piper -
Hospital readmissions are costly but largely preventable. Reducing inpatient readmissions are a top priority for Medicare, state Medicaid programs, and private health plans. The opportunities to lower costs and improve patient outcomes are considerable. Therefore, healthcare purchasers are realigning hospital payment methods to reward hospitals for fewer readmissions and...
To control rising health care costs and improve outcomes, health care purchasers - Medicare, state Medicaid programs, and large employers - and health plans are eager to entirely replace traditional, inefficient, volume-based fee-for-service (FFS) physician and hospital reimbursement with value-based payment models. Value-based payment comes in various flavors but...
High hospital emergency room use by Medicaid enrollees is a perennial concern. What do we know about Medicaid emergency department visits? Are they medically necessary? What drives Medicaid emergency department visits? Is Medicaid ER utilization increasing under the Affordable Care Act? The Medicaid and CHIP Payment and Access Commission (MACPAC)...
State Innovations in Health Payment and Delivery Reform: $730 Million in New Federal Grants AvailableKip Piper -
States across the US are engaged in ambitious and critically important initiatives to reform health care payment and care delivery. Partnering with other major health care purchasers and payors, including employers and commercial health plans, State Medicaid agencies seek to improve health outcomes and decrease per capita health spending. This...
Improving care integration for Medicare-Medicaid dual eligible beneficiaries is one of the many initiatives embedded in the Affordable Care Act (ACA). The health reform law created the Medicare-Medicaid Coordination Office at the Centers for Medicare and Medicaid Services (CMS), and provided funds for state demonstrations to integrate care for...
Kip Piper -
Price transparency - or making price information publicly available - is an idea that has gained steam recently as one more way to reduce health costs and improve quality. So far, that has taken the form of online tools to help private health plan enrollees choose providers. But states...
Kip Piper -
Medicare-Medicaid dual eligibles are often talked about as a single type of patient. They have significant levels of disability and chronic disease, and account for a disproportionately large spending in both Medicare and Medicaid budgets. But dual eligibles are a diverse group. A few recent studies into health spending on dual...
Debate about whether consumers will pay more for insurance under health reform has become political, with conservative organizations saying Obamacare will increase premiums and liberals saying it won't, at least not when you take into account taxpayer-funded subsidies for health coverage. In a new study, RAND Corporation joins the latter group....
Medicare Spending, Beneficiaries, Providers, Health Plans, and Drug Plans: MedPAC Data Book for 2013Kip Piper -
Medicare will spend $598.4 billion on health care services for seniors and the disabled in 2013 and about $635 billion in 2014. Medicare expenditures will top $1 trillion in 2021, according to CMS actuarial projections. Medicare spending patterns and payment policies are highly complex and change constantly. The Affordable Care...
Hospital costs are of keen interest to Medicare, Medicaid, and private health insurers these days, who pay the vast majority of hospital costs. Which services are the most expensive? Which types of health coverage are responsible for most of the costs? A new statistical brief from the Health Costs...
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