Case Study Of Medicare Advantage Patients

The Affordable Care Act includes a requirement that all citizens must have some level of health coverage. The primary method through which the mandate is attempting to create 100% coverage in health care is by instilling fear into the minds of hardworking citizens as those who ignore the rule will have to pay a hefty fine. This mandate, unconstitutional according to the law, will deteriorate the quality of health care, hamper economic growth and cause spikes in insurance premiums. The hope of universal health care may or may not arise under the mandate but new dilemmas and hardships on U.S. citizens will undoubtedly surface.

The Affordable Care Act (ACA) was signed into law by President Barack Obama on March 23, 2010, and on June 28, 2012 the Supreme Court decided to uphold the law.¹ Some of the most notable features that the ACA will provide for individuals are access to healthcare for everyone, new consumer protections such as pre-existing condition coverage, free preventative care, protection against healthcare fraud, small business tax credits, as well as many other features.¹

When Medicare was first established, Medicare adopted the payment methods of Blue Cross Blue Shield which meant that the program was paid hospitals on the basis of their own costs and physicians were being reimbursed by the fees that they charged which caused hospitals and physicians to provide care without boundaries (Anderson et al., 2015). This method caused Medicare to dissipate the budget that was established for beneficiaries to utilize. Now, with the ACA being implemented, Medicare had done an overhaul of payment reimbursement. Medicare is now moving toward a volume to value payment initiative that links payment to patient outcomes, experience of care, while giving providers an incentive to limit spending

On viewing this video “The Story of Medicare” I was able to understand that the role of Medicare(MR) and Medicaid (MD) centers is to cover all people over the age of 65 or older regardless of their income, health status or residence. Medicare also provides benefits for people of any age that have certain disabilities. MR & MD services is a program that allows low-income families whether healthy or sick to receive health care coverage. Medicare has successfully increased the life expectancy of Americans over decades as before Medicare coverage, the life expectancy of white Americans was 61 years and black Americans 48. This number has increased for both white and black Americans adding 15+ years of life expectancy. I believe that Lindon B. Johnson

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,

There are over 45 million people in the United States who are uninsured when it comes to healthcare. Many are uninsured due to the expensive health care costs. To combat this, the Obama Care administration created the Patient Protection and Affordable Care Act to provide nationalized healthcare. The Affordable Care Act is meant to expand health coverage, lower health care costs and hold insurance companies accountable. The Affordable Care Act will allow more people to be insured but the issue lies in the question, do the costs outweigh the benefits? The Affordable Care Act will be used in an attempt to lower health care coverage costs for citizens. An example can be seen from a report in the Kaiser Family Foundation. The premium is required

What could be implications for OT with reduction of inpatient utilization and shorter hospital stays?

The passage of the Affordable Care Act in 2010 allowed for comprehensive health insurance reform that shifted the imperative for care delivery and reimbursement from a volume to a value-based approach. The Center for Medicare and Medicaid Innovation (CMMI) under CMS has been at the forefront of developing and testing innovative payment models that would support the premise of expanding access to beneficiaries and achieving better quality outcomes while lowering exorbitant spending. One such model, named the Independence at Home (IAH) Demonstration, was deployed through ACA section 3024, with the aim of transforming the way primary care is delivered. This demonstration project builds on the success of the Veteran’s Administration Home-Based

Medicaid is a cooperative program administered by federal and provincial government that insures individuals with chronic illness or disabilities who could not have had the means to obtain insurance elsewhere. However, Medicaid’s ability to run efficiently has started to be questioned due to growing budget pressure. This program is need of improvement, so it can benefit both the people and the country. Medicare faces its challenges too, as the population of elderly grows, so does the cost of the program. The coverage of Medicare is also questionable. The government covers about 60% of the medical expenses under Medicare, however 15% of Medicare recipients are so indigent that they would be entitled to Medicaid. Money is also the problem for

Do you have some durable medical equipment, prosthetics, orthodics or associated supplies (DMEPOS) in your medical office supplied by a home medical equipment (HME) supplier? Such an arrangement is often called a loan or consignment closet.

Medicare is designed to give people of 65 years of age or older, people who are younger than 65 years of age but have certain disabilities, and people of any age with end stage renal disease, medical coverage. This is funded through the federal government. Medicaid is for low income adults, children, pregnant women, elderly adults, and people with disabilities medical insurance. This is funded jointly by the state and federal government. In the United States, Medicare costs increased by 4.5% in 2015, Medicaid spending increased by 9.7%, private health insurance increased 7.2%, and out of pocket spending increased by 2.6% (NHE fact page, 2017). Virginia has increased in Medicaid costs by 7.78% since 2015 (Medicaid and CHIP in Virginia,

Both the Medicare and Medicaid programs are under the U.S Department of Health and Human Services administered by the Centers for Medicare and Medicaid Services. Under Medicare part A there is no premium if the beneficiary is eligible for Medicare.

I enjoyed your post. I never knew about Medicare Part D and I'm not sure why. Medicare Part D built the biggest addition and changes to Medicare in 2003 (Niles,2015). This program receives most of the funds from the federal government through tax revenues. The main purpose of this program was to provide aid for the costly price for prescription drugs for seniors. Like you mentioned, this is a voluntary program to enroll in and requires premiums. Additionally, Medicare part C has Medicare Part D already included in the benefits. The benefits of Part D include affordable prescription plans for those enrolled in Medicare Advantage, traditional Medicare health plan, and for low-income seniors (Niles, 2015). The Medicare Prescription Drug

Medicare Part C is “Medicare Plus (+) Choice plans offer a number of health care options in addition to those available under Medicare Part A and Part B.” Fordney, M. T. (2017). The plans on Medicare Part C include, “health maintenance organizations (HMOs), fee-for-service plans, provider-sponsored organizations, religious fraternal benefit societies (RFBS), and Medicare medical savings accounts.” Fordney, M. T.

The main reason behind the Medicare Plan F is so liked is that it will wage for all of the gaps in the Primary Medicare Part A as well as the Part B, comprising both of your hospital as well as the outpatient amount. It even wages the 20% that Medicare Part B does not covert. If you own a Medigap F policy, then though, all of these would be paying for with your insurance. So choosing the best company that fulfill your requirements will be your first step. Then you will be able to get the best plan among all other.