Case Study: HCB Medicaid

In the state of Texas Medicaid is funded by state and federal programs. Those eligible to receive Medicare benefit is the low income individuals, families, children, pregnant women, elderly and individuals who suffer with disabilities (Hegar). The Texas Health and Human Service commission (HHSC) distributes the Medicaid (Hegar). Those receiving Medicaid benefits in the fiscal year of 2010 were found to be 55 percent female and 77 percent under the age of 21 (Hegar). Children accounted for 66 percent of all Texas Medicaid recipients in that year; however, 32 percent of those children actually received health care (Hegar).

Texas ranks number one with the highest uninsured rate in the nation, accounting for nearly 6 million people (1). The federal government has nearly $100 billion for Medicaid expansion, out of which $15 billion is needed for expansion in Texas (1). Opting out of Medicaid expansion has left 1.5 million eligible Texans without health insurance (2). Consequently, a 300 percent increase in costs for primary care services, being provided in the emergency department, has been observed (1). Similarly, most hospitals are facing nearly $3-5 billion in losses due to uncompensated care (1).

As Congress considers potential options to reform Medicaid, it is important to keep in mind patient access to prescription drugs and other healthcare services. Retail community pharmacies believe that Medicaid prescription drug benefit reform efforts should be focused on maintaining a Medicaid prescription drug benefit, maintaining patient access to adequate provider networks, fair and appropriate cost-based provider payments, and facilitating patient access to pharmacist-provided health care services.

Medicaid expansion is seen as a huge problem in this case it takes place among the 50 states. The environment includes the 50 states such as California, Texas, New York and New Jersey. Medicaid expansion offers financial protection. It also addresses the uncompensated care problem which involves paying and reimbursement for service rendered. Medicaid expansion also provides customers access to affordable coverage, as well as customers taking up that cover, which is a moral duty of the government. Medicaid also supports politically powerful interest groups who support expansion. The expansion of Medicaid helps rural hospitals stay afloat in states like Colorado, which added 400,000 people to the health insurance program under

On September 15, 2017, the Office of Eligibility received Ms. Heigle’s request for a State Fair Hearing, and her Medicaid coverage was reinstated pending the outcome of her appeal. The State Fair Hearing request was received in the Office of

The fertility rate is an important factor when evaluating the health of the public. Despite the United States having one of the best healthcare systems in the world, approximately 13% of women between the age of 18 & 44 have trouble conceiving. Although the US has implemented the Patient Protection and Affordable Care Act, a landmark policy, assisting millions of Americans in obtaining health insurance, unless altered, the policy could hurt the 3 out of 20 women who struggle with infertility. After evaluating the core essential benefits of the Affordable Care Act, the views of stakeholders, and the state mandates, an easy solution can be established to assist those suffering from impaired fecundity.

HCA is a healthcare provider that was established in 1968. Their main focus is on offering cliental with a number of different services to include: inpatient, intensive care, outpatient, diagnostic and emergency services. To achieve these objectives they operate a variety of facilities such as: outpatient, psychiatric, surgery centers, freestanding emergency care facilities, diagnostic / imaging centers and comprehensive rehabilitation / physical therapy centers. They are structured to create increasing earnings for its policy and shareholders. This is achieved by contracting with private doctors to deliver services to its preferred providers members. At the same time, they receive fees from these entities and they negotiate lower group rates.

Toward the end of the 1920s, in a little town in South Texas named Cotulla, a junior high teacher saw the injustice and poverty among his Mexican-American students (Del Bosque, 2013). After decades passed, that same man became the U.S. President; Lyndon B. Johnson signed the bill that constructed Medicaid in 1965, which is a program that is funded by the state and the federal government to provide health insurance to low-income Americans (2013). Johnson had an idea to create a “Great Society” which he defined as “a society where no child will go unfed, and no youngster will go unschooled” (2013) . Now even in 2015, we see that President Obama is still fighting for this dream of Johnson’s (Ura & Walters, 2014). President Obama’s Affordable Care

Prior to the enactment of the Affordable Care Act, many Americans did not have access to health care. According to Shi and Singh, assess is an individual’s ability to obtain health services when necessary (Shi &Singh, 2010). “After implementation of the ACA, the proportion of the U.S. population that was uninsured dropped from approximately 16% to roughly 12% in 2014 (Shi & Singh, 2010, p 11). More low to middle income American are eligible for health care services through the Affordable Care Act. Advancements in health information technology have helped to improve and streamline medical services and have helped with the lower cost of health care. “Essential insurance benefits required by the ACA include preventative and wellness services,

Four years after President Obama signed the Affordable Care Act into law there is still uncertainty regarding how it will affect small businesses. Because there were delays and exemptions granted by the, Obama administration and challenges that were still pending in courts. The effects on small businesses vary from state to state depending on the company size and the composition of the company's workforces. But the large corporations pay their employees medical bills and hiring insurers to administer health benefits. Most small businesses purchase group health insurance from insurers and face cost increasing regulations as they go through the annual ritual of renewing their coverage. While media has focus their attention on the state and federal health exchanges, employers are responsible for the growth in the

The Affordable Care Act (ACA) has been the biggest milestone to date in American health care policy (Saldin, 2011). There is nothing more complex or controversial in recent history than the passing of the ACA in 2010 (Davidson, 2016). The United States Supreme Court ratified the constitutionality of the Patient Protection and Affordable Care Act on June 28, 2012. With this, there were certainly challenges facing the full implementation of the provisions of this act by 2014.

Robbie’s accuracy affect the reimbursements the facility receives from Medicare and Medicaid reimbursement decides by and large give that the correct Medicare bearer to pay doctor cases is the Medicare transporter for the area in which the doctor or work on giving the administration is found as opposed to the Medicare transporter for the district in which the patient accepting the administrations is found. A large number of our associated radiologists are situated in a Medicare area that is unique in relation to the Medicare district in which the patient and treating healing center are found. It might be essential for our clients to enlist with extra Medicare bearers so as to appropriately submit claims for repayment. On the other hand, we

The Affordable Care Act expands access to health care coverage and reforms the health insurance, marketplace (Virginia Senate Finance Committee, 2012). The law gives states the choice to expand Medicaid for any individual whose income falls below 138 percent of poverty. In the state of Virginia, there are approximately 1 million uninsured residents. This is often caused by lack of insurance through employer and inability to pay the premiums if offered. According to the Kaiser family foundation, The Virginia’s Governor has included Medicaid expansion as part of his FY 2017 budget proposal. The overall cost to expand Medicaid in Virginia would likely be $220 million beginning in 2016-2018 biennial budgets not including administrator cost. The

Once again, we have a new president who is working hard to put change once again to America. Our new president Donald Trump is using executive orders to try and replace Obamacare. What are executive orders? Executive order are orders that the current president gives to the government and basically has the full force of power to make changes. Obamacare was a plan that our former president Barak Obama created to make affordable healthcare and insurance (Amadeo). The issue that Donald Trump was trying to go at was completely removing Obamacare and puting in a new plan that will be more affordable and more beneficial to people.

The Medicaid program has an extensive health service package for those who enlist and qualified for the service. It is claimed by the federal government absolute coverage of almost thirteen services, which includes items such as inpatient