Case Study Of Medicare

think that Medicare is one of the greatest and most important programs for US society that was ever created. Followed by National Defense and Social Security program, Medicare is the third largest program in the Federal budget. In 2013 cost of Medicare was $492 billion which is 14 percent of total federal spending. According official information by the end of 2014 49,435,610 people received health coverage through Medicare program.

What is Medicare insurance? Medicare is a federal health program for an individual between the age 65 and older. Medicare has also helped certain younger people who suffer from some type of disability and also help an individual with kidney failure and need to place on a dialysis machine or need an organ transplant. Medicare insurance was created in the year 1965 it was signed by president Lyndon b, Johnson to help those Americans at the age of 65 who was not covered by health insurance received some types of insurance this insurance will be called Medicare. In the year 1972, Medicare starts to expand their program to people with disability and also patient suffering from kidney failure that required dialysis or needed an organ transplant to save their life. Medicare was designed to give the American people a choice how they want to manage their care that why Medicare insurance created two separate insurance called Type A and Type B. The insurance benefit of Type A generalized coverage, hospital care, skills nurse facility care, nursing home, hospice, home health service. The Medicare insurance of type B coverage service for supplies needed for diagnosis or treating a patient and also coverage preventive & screening for a patient that want to check for potential illness, for example, Mammogram & HIV screening. The insurance benefit of Type B cover ambulance service, inpatient and outpatient service, partial hospitalization, laboratory test and limited outpatient

The testimony given for the Medicaid at 50: Strengthening and Sustaining the Program (Medicaid at 50) begins with Chairman Joseph R. Pitts, representative from Pennsylvania, giving basic information regarding Medicaid, the current status of the program, and the future. Chairman Pitts lays out the basic issue at hand, the growing expense of Medicaid and that currently there are more individuals enrolled in Medicaid than Medicare and those growing numbers are requiring states to make difficult decisions regarding sustainability for the program both at the state and the federal level. In order to address and provide answers, the panel was composed of two women from the Center for Medicare and Medicaid Services and one from the Government Accountability Office.

What is Medicare and Medicaid? Medicare is the federal health insurance program for people who are 65 years or older. Medicare can also be used by Younger people who have disabilities. Medicaid is a jointly funded health insurance program for low-income and needy people. 64 million people are covered by Medicaid.

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.

On June 28, 2012, the United States Supreme Court issued a decision that made the enforcement mechanism for the ACA Medicaid expansion optional for states. Regardless of that decision, the Affordable Care Act (ACA) has reduced the uninsured rate since its complete implementation in 2014. The original intent and projections were that all states were expected to expand Medicaid. However, after that Supreme Court decision, some states chose not to expand Medicaid.

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

As the industry continues to move away from some of the Medicare programs that were created during the Obama presidency,  the Centers for Medicare & Medicaid Services (CMS) is also pulling away from specific value-based initiatives, such as mandatory bundled payments. The CMS officially canceled two of the models that were included in the Bundled Payments for Care Improvement (BPCI) Initiative.

Raising the Medicare qualification age is a smart thought, given the monetary allowance issues we confront and the way that Americans are living longer. In any case, it must be done painstakingly, to verify that more seasoned laborers still have wellbeing protection. Both Medicare and Social Security were proposed for resigned Americans. So it would bode well to set the ordinary qualification age of every project at the age where we have chosen as a country that retirement ordinarily starts. What's more, since working Americans create the cash to pay advantages, it's likewise essential for the qualification age to be set where the quantity of years Americans work is sufficient to pay retirement advantages. With Americans living longer, we have

What is the evolution of Medicare? In 1965, Congress passes Social Security Amendments of 1965; Medicare was made to give wellbeing protection to the country's seniors age 65 and older and Medicaid for the poor started July 1, 1966. A Timeline serves as a visual course of events of Medicare's history, including the verbal confrontation that prompted its creation in 1965 and consequent changes, for example, the entry and changes of the Medicare Catastrophic Coverage Act of 1988, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, the Medicare Improvements for Patients and Providers Act of 2008 and the Affordable Care Act (ACA) in 2012.

The referral system enacted between the physicians termed “ping-ponging”, is problematic. Such a problem can be classified as a crisis; crisis problem solving is instantaneous and addresses a present threat. In this case, failing to act promptly will cause untoward results, such as a decline in near-term performance (298). The financial performance of the hospital has begun to feel the negative effects of the physician's acquired referral system. The hospital has experienced above-average denials for Medicare reimbursements (320). As the case suggests, most of the patients are older, therefore, the likelihood of them having Medicare is high; a decrease in Medicare reimbursements can have catastrophic financial consequences.

Development and maintenance of organizational procedures, policies, and guidelines as it relates to the management of patients' medical health records.

Fundamental changes, one of which is managed care, have been introduced to the healthcare system to improve people’s health and deal with challenges of increased healthcare cost and uncontrolled healthcare utilizations (Steele & Merrick and 2013Shi & Singh, 2015).

This is a follow-up email in reference to your question for Authorized to Offer Medicare Supplement plans.

Marvelous work Dana, I greatly appreciate your contribution to this discussion. I would like to add on the Medicare Shared Savings Program (MSSP) you mentioned in the discussion. Since the passage of the ACA, there has been over 400 Medicare ACOs established throughout the U.S.; therefore, MSSP was created to incentivize the organization that ensures an efficient, valuable, and economical health care is delivered to Medicare beneficiaries. However, to ascertain the success and transparency of this program, participants like the Accountable Care Organizations’ (ACOs) activities were followed, not only by CMS, but by various researchers. Scholars studied the 338 ACOs’ legitimate web pages extracted from the CMS’ list that was started in 2014