Consulting Services of Kip Piper

Kip Piper – a skilled, creative business and policy strategist – is a top expert in health reform, Medicaid, and Medicare, with 30 years’ experience as an executive, public official, consultant, and speaker.   As a prominent consultant, Kip Piper advises clients on health policy and finance, business strategy, coverage, reimbursement, marketing, communications, public affairs, and business development:

  • Kip Piper provides consulting services for health insurers, hospitals and health systems, pharmaceutical and biotechnology firms, medical device makers, health information technology firms, state Medicaid agencies, and private equity firms and other investors.
  • Kip Piper has advised C-suite executives in Fortune 500 companies, corporate boards, governors, Members of Congress, foundations, and foreign leaders.
  • Across all facets of Medicare, Medicaid, and the Affordable Care Act, Kip Piper offers exceptional knowledge of federal and state policy, finance, and operations, including legislation, regulations, budgets, waivers, demonstrations, research, systems, management, and contracts.

Kip Piper’s Consulting Service Offerings:

As an expert on Medicare, Medicaid, and health reform, Kip Piper offers strategic and tactical counsel, policy analysis, actionable research, creative problem solving, business innovation, and thought leadership.  Kip’s consulting services for the health care industry and government include:

Health Policy Strategy, Analysis, Innovation, and Problem Solving:

Kip Piper is a skilled health policy strategist, with a wealth of experience dealing with all facets of federal and state health policy – legislation, regulations, budgets, and waivers.  Kip’s consulting services include:

  • Analysis, monitoring, and assessment of federal and state legislation, regulations, and budgets
  • Health policy formulation, including drafting of legislative, regulatory, and budget proposals and waivers
  • Forecasting, modeling, and analytical support
  • Impact analysis of federal and state legislative proposals, proposed rules, and budget changes
  • Identification of policy and business risks and opportunities
  • Federal section 1115 demonstrations, including waiver application drafting, budget neutrality, and negotiation support
  • Analysis of specific issues in Medicare, Medicaid, and Affordable Care Act
  • Actionable research on health policy and finance issues
  • Research and analysis to support policy positions and business objectives
  • White papers, issue briefs, business cases, case studies, and journal articles
  • Technical assistance for communications and government relations teams
  • Expert papers, analyses, and technical advice for legal counsel

Business Strategy and Tactics:

A creative health care business strategist, Kip Piper helps health care organizations – health insurers, providers, manufacturers – maintain and build business in the complex, ever changing Medicaid, Medicare, and health reform markets.  Kip’s strategic advisory services include:

  • Business opportunity identification and assessment, rapid identification of new business opportunities.
  • Strategic analysis, including environmental scans, competitor analysis, and SWOT assessments
  • Market analysis, forecasting, and financial analysis
  • Tracking of policy issues, including legislation, rules, budgets, and waivers at federal and state levels.
  • Competitive intelligence and monitoring of marketplace and competitor activity
  • Product development and innovation
  • Strategic planning support
  • Business model development
  • Market entry strategy
  • Marketing strategy and tactics
  • Proposal development and review, including strategy development, win themes, messaging, readiness reviews, and gap analysis
  • Due diligence
  • Mergers and Acquisition (M&A) support
  • Strategic counsel and technical assistance for C-suite executives, business-line executives, product / service managers, business development teams, and sales and marketing teams
  • Executive and board briefings and training

Health Coverage and Reimbursement:

An expert on coverage and payment, Kip Piper provides strategic counsel, market tactics, technical assistance, analysis, and creative problem solving on health care coverage and reimbursement, including:

  • Medicare Part B coverage and reimbursement strategy for biologics, other physician-administered drugs, medical devices, imaging, and other diagnostics
  • Coverage and reimbursement of prescription drugs by Medicare Part D and Medicaid, including rebates and discounts
  • Reimbursement of hospitals, physicians, pharmacies, post-acute providers, dialysis facilities, and durable medical equipment by Medicaid and Medicare
  • Capitation and rate setting for Medicaid health plans, Medicare Advantage plans, qualified health plans, integrated health plans for Medicare-Medicaid dual eligibles, and Medicaid managed long-term care plans
  • Medicaid coverage and reimbursement for long-term services and supports (LTSS), including nursing homes, home health, personal care, and home and community-based services (HCBS)
  • Supplemental payment programs for hospitals and physicians, including disproportionate share hospital (DSH) payments, upper payment limit (UPL) programs, and delivery system reform incentive payments
  • Coverage and reimbursement by qualified health plans in federal and state-based health insurance exchanges
  • Coverage decision making processes by the Centers for Medicare and Medicaid Services (CMS), Medicare Administrative Contractors (MACs), state Medicaid agencies, health plans, and drug plans
  • Pre-approval positioning of new products and services in Medicare, Medicaid, and commercial market
  • Comparative effectiveness research
  • Payment reform, including design, assessment, and implementation
  • Performance-based payment methods, including accountable care organizations, shared savings, bundled payment, global fees, episode and condition-based fees, and other pay for performance (PFP) incentives
  • Value-based purchasing practices and value-based benefit design in Medicare, Medicaid, and private health plans

Health Reform, Innovation, and Performance Improvement:

Kip Piper is a national expert on health care reform – particularly payment reform, care delivery reform, managed care, cost containment, program integrity, and value-based purchasing.  Kip’s consulting services include:

  • Advanced advisory services on national and state-level health reform issues, including financing, coverage, payment, and market regulation
  • State health reform strategies, including coverage expansion, cost containment, delivery system reform, payment reform, quality improvement, and program integrity
  • Design of innovative, value-based solutions to reduce costs, improve quality, and modernize care delivery
  • Technical assistance in the design and execution of successful health reforms
  • Development of demonstrations and waivers

Health Care Communications, Public Relations, and Public Affairs: 

Kip Piper advises health care companies – Fortune 200 firms, private companies, and start-ups – on communications, public relations, public affairs, and marketing strategies and tactics.  Services include:

  • Strategic communications
  • Policy advocacy
  • Issues management
  • Marketing communications
  • Pre-market strategy development
  • Product launches
  • Thought leadership
  • Crisis management
  • Strategic support for communications and government relations teams

Briefings, Training, and Education:

A popular professional speaker, Kip Piper is a frequent presenter at health care conferences, business retreats, and corporate boards.  On business and policy issues in Medicare, Medicaid, and the Affordable Care Act, Kip Piper also provides:

  • Briefings for executives, policymakers, and corporate boards
  • Training seminars
  • Webinars, podcasts, and blogs
  • Briefing papers, white papers, educational decks, and issue briefs

Consulting Practice Affiliations:

Kip Piper serves clients through:

  • Health Results Group:  A boutique strategic advisory service, the Health Results Group specializes in Medicare, Medicaid, and health reform.  Kip Piper is president.
  • Medonomics:  Medonomics is a new think tank dedicated to improving the economic, clinical, and management decision making and performance of health care programs (Medicaid, Medicare, and Obamacare) and organizations (health care providers, health plans, health agencies, and manufacturers).  Non-profit and non-partisan.  Kip Piper is president and CEO.