http://www.piperreport.com/ en-us Copyright 2010 Tue, 27 Jul 2010 07:56:13 -0500 Sat, 31 Jul 2010 14:32:38 -0500 http://www.movabletype.org/?v=4.261 http://blogs.law.harvard.edu/tech/rss Comparative Effectiveness Research holds extraordinary implications for healthcare stakeholders, notably the pharmaceutical, biotechnology, and medical technology industries; patients; physicians; hospitals; the federal Medicare program; state Medicaid programs; and health plans. In addition to guiding and hopefully improving day-to-day decisions by clinicians and patients, Comparative Effectiveness Research will be extraordinarily influential in coverage and reimbursement decisions. Here is a quick primer... http://www.piperreport.com/archives/2010/07/comparative_effectiveness_research_primer_on_federal_comparative_effectiven.html http://www.piperreport.com/archives/2010/07/comparative_effectiveness_research_primer_on_federal_comparative_effectiven.html Health Care Policy Tue, 27 Jul 2010 07:56:13 -0500 As part of health reform implementation, states will create a large and complex new marketplace for the buying and selling of health insurance coverage. Through State Exchanges, individuals and small businesses may buy federally defined benefit packages from state licensed and certified Qualified Health Plans. For health plans, this is a huge new market with potential enrollment of 25 million... http://www.piperreport.com/archives/2010/07/state_health_exchanges_and_qualified_health_plans_briefing_for_health_plans.html http://www.piperreport.com/archives/2010/07/state_health_exchanges_and_qualified_health_plans_briefing_for_health_plans.html Access to Care Fri, 23 Jul 2010 11:18:09 -0500 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 in 2010 By Kip Piper, MA, FACHE Federal Drug Price... http://www.piperreport.com/archives/2010/07/american_health_drug_benefits_june_2010_issue.html http://www.piperreport.com/archives/2010/07/american_health_drug_benefits_june_2010_issue.html Access to Care Thu, 01 Jul 2010 10:34:24 -0500 Federally mandated rebates for prescription drugs in Medicaid were expanded significantly - by $38 billion - under the new health reform law, with extraordinary financial, administrative, and compliance implications for pharmaceutical manufacturers, Medicaid health plans, and state Medicaid programs. In a new journal article, I explain changes to the Medicaid drug rebate program and implications for drug makers, health plans,... http://www.piperreport.com/archives/2010/06/medicaid_drug_rebate_expansion_of_federally_mandated_prescription_drug_reba.html http://www.piperreport.com/archives/2010/06/medicaid_drug_rebate_expansion_of_federally_mandated_prescription_drug_reba.html Cost Containment Wed, 30 Jun 2010 13:57:58 -0500 MedPAC released its Medicare Data Book for 2010, with a wide range of useful information on Medicare spending, utilization, beneficiaries, providers, health plans, drug plans, access, and quality. The format is reader-friendly charts and tables with bulleted summaries. Specifically, the latest MedPAC Data Book includes information on: Medicare spending, including Medicare spending compared to national health care spending. Medicare beneficiary... http://www.piperreport.com/archives/2010/06/medicare_data_book_for_2010_medpac_data_on_medicare_spending_enrollment_pro.html http://www.piperreport.com/archives/2010/06/medicare_data_book_for_2010_medpac_data_on_medicare_spending_enrollment_pro.html Health Care Policy Wed, 30 Jun 2010 09:41:00 -0500 Please join American Health & Drug Benefits in Philadelphia on May 21, 2010 for The Patient Priority: Achieving Pharmaceutical Success in a Fractionated, Multi-Stakeholder Healthcare Environment. The program will help identify clinical, business, and policy governing dynamics and tactics for patient-centered drug development and commercial success. A dinner reception will follow with Xcenda's Managed Care Network, giving you unprecedented networking... http://www.piperreport.com/archives/2010/05/the_patient_priority_achieving_pharmaceutical_success.html http://www.piperreport.com/archives/2010/05/the_patient_priority_achieving_pharmaceutical_success.html American Health & Drug Benefits Sun, 16 May 2010 08:53:39 -0500 Medicare Advantage plans and Medicare Part D prescription drug plans face an extraordinary array of changes as a result of the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act (HCERA). These include: New payment benchmarks for Medicare Advantage (MA) plans, phased in and based on relative fee-for-service (FFS) costs. Other payment related changes... http://www.piperreport.com/archives/2010/05/impact_of_health_reform_on_medicare_advantage_and_medcare_prescription_drug.html http://www.piperreport.com/archives/2010/05/impact_of_health_reform_on_medicare_advantage_and_medcare_prescription_drug.html National Health Reform Tue, 04 May 2010 18:07:21 -0500 The latest issue of the journal American Health & Drug Benefits includes a valuable mix of studies and articles on economic, regulatory, and clinical issues of particular interest to payors, purchasers, and policymakers. Obesity: Effective Treatment Requires Change in Payers' Perspective by Rhonda Greenapple, MSPH and Jackie Ngai, MS, with Stakeholder Perspective by Jeff Januska, PharmD. Health Insurance Premium Increases... http://www.piperreport.com/archives/2010/04/american_health_and_drug_benefits_march_-_april_2010_issue.html http://www.piperreport.com/archives/2010/04/american_health_and_drug_benefits_march_-_april_2010_issue.html Health Care Policy Wed, 28 Apr 2010 18:48:19 -0500 Creating a wellness-based healthcare system is the focus on a new series of articles published by American Health and Drug Benefits, a peer reviewed journal. They cover a wide spectrum of topics on how to build and support prevention and wellness, particularly for chronic conditions. The ideas and information are particularly timely given the array of prevention and wellness initiatives... http://www.piperreport.com/archives/2010/04/wellness-based_healthcare_system_of_chronic_diseases_prevention_interventio.html http://www.piperreport.com/archives/2010/04/wellness-based_healthcare_system_of_chronic_diseases_prevention_interventio.html Xtras Sun, 25 Apr 2010 12:27:57 -0500 An interesting new report assesses a variety of medical malpractice reforms. The study synthesizes the evidence or theoretical predictions regarding several leading medical malpractice reform ideas. The report synthesizes published evidence on 8 reforms widely used by states: Caps on non-economic damages Pretrial screening panels Certificate of merit requirements Attorney fee limits Joint and several liability rule reform Collateral source... http://www.piperreport.com/archives/2010/04/medical_malpractice_evaluation_of_options_for_medical_malpractice_reform.html http://www.piperreport.com/archives/2010/04/medical_malpractice_evaluation_of_options_for_medical_malpractice_reform.html Health Care Policy Sat, 03 Apr 2010 13:56:27 -0500 The federal health reform legislation - Patient Protection and Affordable Care Act (PPACA) - includes an ambitious list of changes to long-term care (LTC) services for seniors and the disabled. Most include a massive infusion of federal funding to help state Medicaid programs provide more LTC through home and community-based settings. Here's a quick run-down of the new LTC reforms:... http://www.piperreport.com/archives/2010/03/long_term_care_new_ltc_reforms_in_patient_protection_and_affordable_care_ac.html http://www.piperreport.com/archives/2010/03/long_term_care_new_ltc_reforms_in_patient_protection_and_affordable_care_ac.html Health Care Policy Sun, 21 Mar 2010 21:34:10 -0500 The Medicare Payment Advisory Commission (MedPAC) has released its Medicare payment recommendations to Congress for 2011. In addition to specific recommendations for payment updates for fee-for-service providers and Medicare Advantage plans, MedPAC's report includes interesting information and analysis on spending trends, consequences of rapid spending on Medicare and the overall health care system, and the process of assessing payment adequacy.... http://www.piperreport.com/archives/2010/03/medicare_payment_policy_medpac_recommendations_to_congress_for_2011.html http://www.piperreport.com/archives/2010/03/medicare_payment_policy_medpac_recommendations_to_congress_for_2011.html Health Care Policy Thu, 18 Mar 2010 16:24:52 -0500 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: Orphan Drug Pricing and Payer Management in the United States: Are We Approaching the Tipping Point? by Rebecca Hyde and Diana Dobrovolny, with Stakeholder Perspective by... http://www.piperreport.com/archives/2010/03/american_health_and_drug_benefits_january_-_february_2010_issue.html http://www.piperreport.com/archives/2010/03/american_health_and_drug_benefits_january_-_february_2010_issue.html Health Plans Thu, 04 Mar 2010 07:02:57 -0500 The Centers for Medicare and Medicaid Services' Office of the Actuary (CMS/OACT) has released its projections of U.S. health care spending for the ten years 2010 through 2019, with premliminary estimates of 2009 health spending. The projections, released each year around this time, offer a fascinating, detailed look at patterns and trends in public and private health spending across programs... http://www.piperreport.com/archives/2010/02/national_health_expenditures_for_2009-2019_cms_actuary_projections.html http://www.piperreport.com/archives/2010/02/national_health_expenditures_for_2009-2019_cms_actuary_projections.html Health Care Policy Thu, 04 Feb 2010 12:01:00 -0500 Health Insurance Exchanges - either state-based exchanges favored by moderate Democrats and Republicans (reflected in Senate bill) or a national, federally-run exchange favored by liberal Democrats (version in the House bill) - are an essential component of national health reform. Bottom line, health insurance exchanges would provide a far more efficient, competitive, and seamless marketplace for consumers and small business... http://www.piperreport.com/archives/2010/01/health_insurance_exchanges_how_two_proposals_differ_an_unexpected_complicat.html http://www.piperreport.com/archives/2010/01/health_insurance_exchanges_how_two_proposals_differ_an_unexpected_complicat.html Health Care Policy Fri, 22 Jan 2010 11:12:15 -0500