A Brief Note On Medicare And Medicaid Services

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Both Medicare and Medicaid are managed by the Centers for Medicare and Medicaid Services (CMS), which is a division of the U.S. Department of Health and Human Services. Medicare was created in 1965 when people of over 65 found it impossible to get private health insurance coverage. Medicare is a Federal health insurance program that pays for hospital and medical care for elderly and certain individual with disabilities. The program consists of two main parts for hospital and medical insurance (Part A and Part B), and two additional parts the provide flexibility and prescription drugs (Part C and Part D). Medicaid is a health and medical service program for certain individuals and families with low incomes and few resources. Primary oversight is handle at the federal level, but each state establishes its own standards, determines the type, amount, duration and scope of services, sets the rate of payment for services, and administers its own Medicaid program. Reimbursement to providers are through a fee-for-service model or through various prepaid arrangements, such as a HMO plan. ACOs create incentives for health care providers to work together to treat an individual patient across healthcare settings, which includes doctor’s offices, hospitals, and long-term care facilities. There are several factors, in my opinion, for ACOs to be successful. Buy-in from all involved with physician leadership, hiring the right professionals who are interested in having the mindset
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