Healthcare Ecosystems

is admitted to is Medicare certified, Medicare Part A will pay for 100% of her

Specific coverage and benefit details vary from state to state (Raffel, 224). This is intended to help people with high medical costs that are not old enough for Medicare.

Healthcare facilities are required to maintain licensure, certification, and accreditation in order to receive payments from federal government programs such as Medicare. Healthcare facilities must meet the minimum standards in order to operate, such as sufficient staffing, personnel employed to provide services, the quality of equipment, buildings, and supplies, and services provided, including health records. (LaTour, 2013) Medicare has developed Conditions of Participation and Conditions for Coverage, which identifies specific criteria that must be met in order to receive reimbursement from Medicare. Medicare implements these guidelines in order to

The purpose of this paper is to give an overview of two federally and/or state funded programs. The programs that will be discussed are Medicare and Medicaid. In this paper will be information about who receives Medicaid/Medicare, the services offered by these programs, and those long term services that are not.

In response to the “Patient Protection and Affordable Care Act (ACA) amended by the Health Care and Education Reconciliation Act (Reconciliation Act), collectively referred to as healthcare reform” (); Wishard-Eskenazi Health of Indianapolis, Indiana has begun to make milestone changes to meet the requirements of the healthcare reform. Being a leader in today’s technology which began thirty years ago with development of one of the nation’s first electronic medical record and continues to excel in the healthcare informatics technology today continues to use this technology in quality improvement initiatives, support for future technology research and improving the quality care of the patient.

HealthCare.gov, if the individual is unemployed and cannot afford any health plan and does not

Comprehensive Primary Care Initiative will help the patients with more serious or chronic conditions, follow care plans personalized for their needs. (CMS,2014).

Pacing is the rate of action in which we put a plan into action. In accordance with Kotter who speaks to an eight step sequencing plan. The order in which your procedures are implemented is sequencing. (Kotter’s 8 step plan)

insurance for Americans that are aged 65 and over and younger people with disabilities. It was the

An example of this Act is the very popular Nancy Cruzan Case. Although Nancy was left in a vegetative state resulting from a car accident, her parents were able to make the decision to have her removed from feeding tubes because Nancy expressed before the accident that she never wanted to be kept alive from breathing or feeding tubes. This Act really promotes Advanced Directives and hospitals, clinics and other providers that receive Medicare or Medicaid funds to provide patients with written information about their right and the information must clearly state the institutions policies on withholding or withdrawing life-sustaining treatment.

Throughout the early 1980’s and 1990’s the Federal Medicaid program was challenged by rapidly rising Medicaid program costs and an increasing number of uninsured population. One of the primary reasons for the overall increase in healthcare costs is the

Medicare is one of the most widely acknowledged sources of health insurance coverage in the United States. It is often complemented by Medicaid, a similar health welfare program that includes children and the poor. Many Medicare beneficiaries are "dual eligibles" who use Medicaid to extend comprehensive inpatient and outpatient health care coverage, especially for prescription drugs, diagnostic and preventive care, and eyeglasses which fall outside of Medicare. Medicaid can also supplement Medicare deductibles, premiums, and up to 20% of uncovered charges (Goodman, 1991).

The terminology (i.e., Federal health care programs) contains any program that provides medical benefits, even if directly, by means of insurance, that is paid directly, in full or in part, by the US Government (i.e., Through programs such as Medicare, Federal Employees Health Benefits Act, Federal Employees’ Compensation Act, the Longshore and Harbor Worker’s Compensation Act) or any State health plan (e.g., Medicaid, or a program receiving funds from block grants for social service plan requirements. Guidelines, an industry should have

* Medicare/Medicaid, to be sure the doctor is not banned from caring for Medicare/Medicaid patients

Our healthcare system needs major restructuring. Major improvements needs to begin with "all health care organizations, professional groups, and private and public purchasers should adopt as their explicit purpose to continually reduce the burden of illness, injury, and disability, and to improve the health and functioning of the people of the United States", (Crossing the ……, 2001).