Centers For Medicare And Medicaid Services (CMS): A Case Study

Both Medicare and Medicaid are administered through a division of Health and Human Services called the Centers for Medicare and Medicaid Services (CMS).

The ACA is meant to be an affordable coverage to 30 million Americans by making having affordable insurance for employers from middle to low income Americans and expanding Medicaid and Medicare. The main goal is to lower the healthcare cost and give better healthcare. ObamaCare is also meant to lower premiums and insurance costs. All Americans are required to have insurance and gives

The CMS.gov website provides information about Medicaid, Medicare and related government programs ("Cms.gov centers for”) to beneficiaries and other interested parties. It is a federal government website, created by the Freedom of Information Act (FOIA), which made government information to the public. All information provided must meet government standards for content and accuracy. The information is kept current and is clearly labeled with publication or modification dates. The government agencies are clearly identified and in-text references are available when appropriate.

When establishing a health agency, there are specific requirements established by the government and professional agencies that we have to adhere to. In addition to state or county rules, there are federal rules and non-government standards that apply throughout the field, regardless of location. These regulations affect both your organization’s

The Affordable Healthcare Act makes healthcare and health insurance more affordable and more available to more Americans. It is able to do this by new consumer protections, rules and regulations on the healthcare industry. This is shown when creating a marketplace for subsidized insurance, and reforming and expanding public healthcare programs. These include Medicare and Medicaid. This act can also include measures to cut the growth in healthcare spending in the United States.

Summary of Learning A. Impetus for Health Reform According to Medicaid.gov, the Affordable Care Act (ACA) provides Americans with better health security by putting in place comprehensive health insurance reforms that will, expand coverage, hold insurance companies accountable, lower health care costs, guarantee more access, and enhance the quality of care for all Americans.

CMS – Medicare/Medicaid The Medicare and Medicaid programs were signed into law on July 30, 1965 by president, Lyndon Baines Johnson. The Centers for Medicare & Medicaid Services (CMS) is an agency within the US Department of Health & Human Services in charge of administration of several key federal health care programs. CMS is responsible for health care programs such as, the Health Insurance Portability and Accountability Act (HIPAA), the Clinical Laboratory Improvement Amendments (CLIA), and the Children’s Health Program (CHIP) amongst other services.

The Affordable Care Act does many different things as we have started to state above. All of these are important factors to achieve the goal of affordable and quality healthcare for all. The ACA offers Americans a number of new benefits, rights and protection in regards to their healthcare. It is trying to improve Medicare, which is primarily for the elderly, and how they treat these seniors with long-term disabilities. It is trying to expand Medicaid, which is primarily for low-income or needy people, to all adults needing it in many states. The ACA set up a Health Insurance Marketplace where during

The Centers for Medicare & Medicaid Services (2010) states that the federal government in conjunction with the Affordable Care Act (ACA) are pushing for the integration of behavioral health care and primary care for individuals with serious mental illness (SMI).

The Basic Health program could be structure in several ways. It could expand programs such as Medicaid and CHIP and contract with managed care plans on behalf of its Medicaid and CHIP beneficiaries outside the private insurance market. These changes would allow both programs to continue as a "separate program with a separate financing mechanism and risk pool from that of Medicaid and CHIP, but would leverage the state's existing infrastructure for information technology, contracting, rate setting, and other function" (Angeles, 2012). Alternatively, a state could expand the Medicaid managed care by increasing the number and types of service through different network of providers, other than those that serve Medicaid and CHIP beneficiaries (Angeles,

Since the passing of the Affordable Care Act (ACA) in 2010, the healthcare revenue cycle has significantly change. Physicians and managed care organization saw a spike in the number of patients. iThe health care also law created initiatives to transition from the traditional fee-for-service (FFS) system to a payment-for-value delivery system, with key attention to cost containment and quality improvement. Managed care organizations are restructuring how they deliver care and receive reimbursement in a value-based system to maximize their profit.

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

1. Managed care plans (PPO/HMO) have had different successes in medicine and dentistry. Explain those differences and why you think they have occurred.

In 2006, an addition was made to the federal Medicare program in the form of Medicare prescription drug plans, also known as Medicare Part D. If you were already receiving Medicare benefits when the drug plans were introduced and you didn’t opt in or you’re nearing the age at which you’ll be eligible for Medicare benefits, there are some things you need to know about Medicare Part D that will help you to understand the program and make an informed decision about it.

Health Organization Case Study It was in 1977 that the United Healthcare United Health group was founded by Richard Burke. The headquarters of the company are in Minnetonka, Minnesota. This organization works towards the betterment of people's health, it help them in living a healthy life by providing them with the kind of health care that would be best for them. The main focus of United Healthcare which is a major division of the United Health group is to provide the people with better health benefits and coverage.