Center for Medicare and Medicaid Innovation

Medicare and Innovation in the same sentence?  Yes indeed. As part of Health Reform [i.e, Patient Protection and Affordable Care Act (PPACA)], the government mandated the creation of the Center for Medicare and Medicaid Innovation (CMI). What does CMI do?  “The stated purpose of the CMI is to test innovative payment and service delivery models…

Getting Poor/Old People Drug Coverage: Part II

Yesterday, I mentioned that low-income individuals on Medicare can also qualify for Medicaid and, as full-beneift dual eligible beneficiaries, they have significantly lower cost sharing than the typical Part D beneficiary.  How does CMS identify these individuals? For currently beneficiaries on Medicaid who ‘age’ into Medicare, this process is fairly easy.  CMS can auto-enroll these…

Getting Poor/Old People Drug Coverage: Part I

Health insurers face a conundrum.  Increased cost sharing helps to reduce patient utilization of medical resources and–at least inititally–lowers the cost of care.  Too much cost sharing, however, can lead to decreased patient adherence.  In this case, the patients may get sick and require hospitalization,  which will actually increase cost.  Cost sharing’s affect on adherence…

International Healthcare Models: Japan

Here is my earlier review of the Japanese healthcare system.  Additional information on medical care in Japan is below. Funding The system is largely funded through payroll taxes.  Employees pay a larger share of the payroll tax than employers.     Insurance is bought from public sector sources. There is no private sector insurance companies. Co-pays…