Medicare Changes

Republicans and economist want to privatize Medicare turning it into a voucher-like program that subsidizes purchases of private health insurance. House Republicans have proposed this bill in order to fulfill the GOP goal of balancing the budget in 10 years. Having said that, I can only hypothesize that the amount of capital available to the “new” Medicare population will dwindle and the needs of elderly patients may not be met.

Medicare changed overtime and in 1983 adopted the Prospective Payment Plan. PPS was designed to pay a facility a lump some to provide services for a set amount of patients covered by Medicare. One of the reasons behind it was to encourage health care practitioners to proved services in a timely manner in order to shorten the rehabilitation time of an individual.

However, hospitals and providers will be penalized for poor performances that result in readmissions and nosocomial infections (Anderson et al., 2015). Since Medicare has implemented these standards, Medicare has experienced a decrease in hospital readmissions by 18 percent as well as a decrease in nosocomial infections by 17 percent between the years of 2010-2013 (Anderson et al., 2015). By the year 2019, Medicare will have moved to Merit-based incentive payment system that will combine several current value based purchasing initiatives that will tie payment closer to performance measures. In addition to the payment reform, Medicare has implemented services to help Medicare beneficiaries to reduce the cost sharing of their health care. The ACA has allowed for beneficiaries to receive one free preventative visit a year to his/her primary care physician, mammograms and colonoscopies can be conducted without the patient being charged any portion of their cost sharing responsibilities, as well as beneficiaries saving on brand medications of 55 percent once the donut hole has been reached. Moreover, Medicare is working its way to eliminate the donut hole by the year

Medicare is absolutely is a state of crisis and if we do not make the necessary modifications to this medical entitlement, there will not be a Medicare

Medicare is very important. It provides much needed support for the elderly and disabled. Medicare’s importance only continues to increase. In order to keep Medicare running, the program is in need of reform. There are a few ways this can be done. I believe the best way to stabilize the financial crisis of Medicare is to completely reform the program into a defined contribution program.

The ACA provides various benefits to Medicaid enrollees by expanding coverage to include mental health, prescription drugs, family planning services, hospice care for children, tobacco cessation, preventive and obesity related services. The main provision of the act is to reduce cost while improve the quality of care and the way it is delivered. The law prohibits insurance companies from dropping coverage for any reason, provide insurance even if there is a pre-existing condition. Provide coverage for preventive services and immunizations. Dependant coverage is extended up to age 26. The law established a cap on insurance company’s spending on non-medical costs and administrative expenditures. Insurance companies cannot charge more money based on an individual’s health status, gender or salary. The ACA reforms Medicare by closing the coverage gap also known as the “donut hole” by continuing coverage for prescription drugs.

Since the late 1980s, Medicare has reimbursed physician services using the Medicare Physician Fee Schedule (MPFS), which encompasses 10,000 procedure codes. Each code is assigned resource-based relative value units (RVUs), which are designed to reflect physician work, practice expense, and malpractice expense. To adjust for local differences in cost of living, each RVU is modified using geographic practice cost indexes (GPCIs) and then converted to dollars using a “conversion factor.” This system rewards physicians who produce a high volume of services; not surprisingly, Medicare Part B expenditures have grown rapidly.

Fifty years ago, Lyndon B. Johnson signed the Medicare program into law. “It has been a reliable guarantor of the health and welfare of older and disabled Americans by paying their medical bills, ensuring their access to needed health care services, and protecting them from potentially crushing health expenses.” (Hamel, Blumenthal, Davis, & Guterman, 2015, p. 479). With the encouragement of George W. Bush, congress passed the Medicare Modernization Act of 2003 (MMA). The MMA extended Medicare to include prescription-drug coverage, known as Medicare Part D. In 2013, Medicare covered the health care expenses for 52.3 million Americans, costing $583 billon. Originally, Medicare had difficulty controlling costs; physicians and hospitals were

A number of changes to both state workers' compensation laws and the MSPA would eliminate the problems inherent in the current system. These solutions include modifying state workers' compensation laws to permit the parties to settle only the indemnity portion of the claim in states that do not already do so, applying the MSPA only to cases in which the primary payer is legally obligated to pay, instituting a safe-harbor threshold amount for settlements, creating a right of appeal from Medicare's rejection of a settlement proposal, and allowing claimant's to waive their rights to certain treatments under Medicare. Any one of these changes implemented on its own would be an improvement, but implementing all of them would create a much fairer system.

Implications that have been made to the Medicare program have changed the aspect of it tremendously. One fear that was held about Medicare is how the increase of government involvement when it came to disability and medical coverage would give the government too much power (American Medical Association). An aspect of Medicare is that it was created when hospitals were still segregated which negatively impacted the minority population. This posed as threat because many Americans were not receiving the proper treatment fast enough which put many lives on the line. The enactment of Medicare was a political struggle, in the early 1950’s and late 1960’s which brought to the attention of officials that actions needed to be taken to make it easier for elder Americans to access high costing health care. Officials concluded that this new social insurance would serves as means to aiding in paying for hospital care, post-hospital nursing home care and home health services. Bush and Clinton Administration added to the idea of health

The Patient Protection and Affordable Care Act (Obamacare) had mame dramatic changes in the field of the health care system, especially in Medicare, that will seriously take effect in American seniors. Indeed, much of the health law’s new spending is financed by spending reductions in the Medicare program. In addition to the provider payment reductions, Obamacare significantly reduces payments to Medicare Advantage (MA) plans by an estimated $156 billion from 2013 to 2022.( Elmendorf, letter to Speaker Boehner). About 27 percent of all Medicare beneficiaries are enrolled in MA plans, a system of regulated and private plans competing against each other as an alternative to traditional Medicare. MA plans are attractive to beneficiaries because they offer more generous and comprehensive coverage than traditional Medicare by capping out-of-pocket costs and offering drug coverage to a rasonable

The Medicare Access and CHIP Reauthorization Act (MACRA) was initi-ated by the U.S. Department of Health and Human Services to bring about big changes in quality of care by altering payment methods of doctors. MACRA was signed into law in April 2015 by former President Obama. The Medicare Access and CHIP Reauthorization Act (MACRA) is bipartisan legislation that was passed quietly by Congress without controversy. MACRA significantly alters how the government pays physicians and doctors who treat Medicare patients. It is transforming the way Medicare pays doctors and hospitals for their services by moving away from the traditional fee-for-service method and towards a new payment method that is based on how successful treatments are for

Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those with disabilities and those who have permanent kidney failure. There are several changes for Medicare enrollees in 2017. The average increase is more than $4/month, and average premiums will be about $109/month for about 70 percent of enrollees. But the exact amount they’ll pay will vary depending on the dollar amount of the cost of living adjustment on their Social Security checks.

enrolled in the new program. The $8 billion includes the state share of costs for both newly eligible adults and the additional Medicaid participation among currently eligible populations that would result from expansion. If all states implemented the Medicaid expansion, federal spending would increase by $800 billion, or 21 percent, compared to the ACA with no states implementing the expansion (Holahan, et al., 2013). Therefore, although the increase in spending per state is relatively small, the cost to our nation is exponential. With the national debt growing day by day, many believe that an exponential increase in national spending is a difficult thing to justify.

To add to the volatility, Medicare is going broke, and the government has to keep pumping money in it to keep it going which in turn adds to the debt. For the proposed changes in Medicare, congress has reserved $400 billion to be used over a 10-year period. With the current prescription costs, that covers less than a quarter for every dollar spent. In the next few years baby boomers are going to retire and according to a report by The Consumers union "drug spending will continue to explode, rising 17 percent a year" (Meckler). This would increase the number of citizens relying on Medicare and the cost of prescriptions strapping Medicare even more.