Medicare Reform

Medicare Part D is prescription drug coverage. It’s the newest part in Medicare. It adds prescription drug coverage to original Medicare, some Medicare cost plans, some Medicare PPS plans, and Medicare Medical Savings plans. Beneficiaries choose the drug plan and pay a monthly premium.

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.

As this baby-boomer generation continues to age there will be profound effects on the way that money is spent on health care and insurance. With approximately 77 million people turning 65 over the next several years, the amount of government spending on Medicare will greatly increase (Gigante, 2012). Thus, the demand for medical care associated with the aging population will so

One dominant economic feature of the healthcare industry is the growing need for both basic and specialized healthcare due to the continued aging of the “Baby Boomer” generation. This generation consists of over 79,000,000 individuals born in the US between 1946 and 1964. As this generation has aged, the need for healthcare has increased dramatically. Let us take a look at some statistics:

Medicare is the federal health insurance program for people with certain disabilities, end stage renal disease, and for those who are over the age of 65. There are four different parts to Medicare, part A, part B, part C, and part D. Medicare Part A, also known as hospital insurance, covers inpatient hospital stays, care in nursing facilities, hospice care, and some in home health care. Part B is often referred to as medical insurance; it covers certain doctors’ services, outpatient care, medical supplies, and preventative care services. Medicare Part C, otherwise known as Medicare advantage plan is offered by a private

Medicare, as nationwide social insurance passed into law as title XVII of the Social Security Act of 1965, currently using about 40 private insurance companies across the United States. The primarily purpose of Medicare was to provide financial support to elderly age sixty-five and older or younger people with a permanent disabilities. There are four different parts of Medicare plans to select from: “Part A provides hospital and skilled nursing coverage’s through Hospital Insurance Trust Funds. Part B covers physician services, ambulatory surgical services, and other miscellaneous services paid by Medicare beneficiaries. Part C is managed care coverage offered by private insurance companies. It can be selected in lieu of Part A and B). Medicare Part D covers

The year 2017, you will notice a change moving on into place for the healthcare. If you

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.

The Health Affairs published an article in about a proposed Medicare reform regarding the high levels of use of Medicare although there was little impact on individuals. Though this article dates back to 2002, the issue still remains true to this day. In this article, the authors explain that the high level of Medicare spending was mostly due to the increase number of physician visits, specialist consultations, and hospital stays, especially among those that had chronic illnesses. Although the spending is higher among such Medicare patients, this did not mean better effective care or health care outcomes. On the contrary, according to the article, more than 20% of the total

Parts A and B are apart of the “Original Medicare”. Meaning care that is managed by the federal government. Part A of Medicare is hospital insurance. This covers hospital care such as inpatient care, hospice care, home health care services, and nursing care facilities. Generally free of charge if the beneficiary has worked and paid Medicare taxes for at least 10 years. If not a monthly premium is established. Typically, part A doesn’t cover the whole hospital bill. For at least 60 days Medicare will pay for 100% of the hospital stay charges or 100% of 20 days at a skilled nursing facility, and after that a flat rate amount is paid up to the maximum number of covered days.

Medicare currently pays for many preventive services that can detect health problems early when they’re easier to treat, give better access to claims and personal health information, and allow for savings on brand-name and generic when coverage gaps are met. The actual benefits of Medicare will not be changing. There will however be a new plan that is key to the Affordable Care Act that will take place in 2014. This plan is the Health Insurance Marketplace that allows individuals, families, and employees of small businesses to get health insurance. (Services, 2013 ) The Marketplace offers insurance plans through private companies that will provide essential health benefits regardless of gender, preexisting conditions, or preventative

Part A covers inpatient hospital care as well as hospice care, Part B pays a portion of your outpatient care, medical equipment expenses, health care provider services and some preventive care like flu shots, Part C is a Medicare Advantage plan that is offer by a private insurer and approved by Medicare and Part D covers prescription drugs (Lewis, 2012).

Medicare is the nation’s largest health insurance program which benefits to more than 40 milliion Americans. However, billing and administrative fee overly cost that Medicare will soon can not handle the fee which leads to the disruption of health care in the U.S. The Medicare reform, various choices for Medicare and reduce fee-for-service plan are proposed to ensure Medicare program to continue. Medicare reform must be contained by injecting economic efficiency into the program, realigning the economic incentives of those who demand medical goods and services and those who provide them. Reduce fee-for service seems to be easy but not since there are many fees and charges should be taken care of in the form of insurance providers. While Medicare

Due to the upcoming presidential election, the two major political parties, and their candidates, have been focusing on the primary problems that the nation will face. Chief among those problems is the future of Medicare, the national health-insurance plan. Medicare was enacted in 1965, under the administration of Lyndon B. Johnson, in order to provide health insurance for retired citizens and the disabled (Ryan). The Medicare program covers most people aged 65 or older, as well as handicapped people who enroll in the program, and consists of two health plans: a hospital insurance plan (part A) and a medical insurance plan (part B) (Marmor 22). Before Medicare, many Americans didn't have health

Population trends have varied greatly over the course of U.S. history, as well as the dynamics that impact governmental and fiscal decisions. The evolution of the age structure of a population and the leading causes of death of that population are key determinants for establishing a plan for future financial sustainability and successful delivery of health care to that population.