Recent Changes In Medicare

Now a statute, the physician/hospital pay for quality, not quantity, public law number: 114-10 signed April 16, 2015 also referenced as H.R.2 —1st Session of 114th Congress (2015-2016), sometimes called the “Permanent Doc Fix” 04/14/2015 : Passed Senate; 03/26/2015 : Passed House (Medicare Access and CHIP Reauthorization Act of 2015, 2015), which defines the payment and reimbursement reform to doctors treating patients with Medicare. This extensive reform includes the CHIP program insuring children and those families that don’t qualify for Medicare but are unable to afford private insurance and is funded by the federal government and individual states.

As we become older, issues with our health begin to take affect and finding ways to fund for that care is becoming even more difficult. In the article “Some Elders Must Take Drastic Measures to Obtain Long-term Care”, national magazine journalist Mary A. Fischer (2011) states that many Americans must face demeaning and disempowering choices in order to qualify for Medicaid or Medicare—federal funded health insurance programs— such as refusing to pay for a spouses institutionalization, divorce, and spending down assets. The author argues that these choices leave the healthy spouse with decreased funds to plan for their own retirement expense (Fisher, 2011). Working in the health care field for 4 years, along with my family’s own personal experiences I can relate to this article, since I have seen a variety of ways that federal funded health insurances have been unable to meet the expectations and demands of its beneficiaries.

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.

On December 8, 2003, President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act of 2003 (Pub. L. 108-173).  This landmark legislation provides seniors and individuals with disabilities with a prescription drug benefit, more choices, and better benefits under Medicare. It produced the largest overhaul of Medicare in the public health program's 38-year history. The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin. One month later, the ten-year cost estimate was boosted to $534 billion, up more than $100 billion over the figure presented by the Bush administration

Medicare enrollees in Utah have saved about $78 million on prescription drugs due to the ACA. Coverage for both brand name and generic drugs will continue to increase until the coverage gap is closed. The ACA also allows Medicare beneficiaries to seek preventive services without worrying about cost, due to the lack of deductibles and copays. This aids in detecting and treating health problems early on. In Utah in 2014, 220,972 individuals with Medicare used free preventive services. In addition to that, fraud is at a minimum due to tougher screening procedures, penalties, and technology developments.

Are you aware of the various policies that are being enacted from each state to state regarding the qualification of Medicare? Medicare is funded by the federal government and each state is responsible for operating the

The Medicare bill was signed into law on July 30, 1965 by President Johnson. The signage came long after an attempt by President Truman to develop a national insurance fund that could be utilized by all Americans. During the signing of the bill, President Johnson explained that with the Medicare program an individual can insure themselves against illness that may present during their senior years. Additionally, he commented that there were more than 18 million low income Americans who are greater than 65 years of age and cannot afford to treat their illnesses. The Medicare program is overseen by The Centers for Medicare and Medicaid Services (CMS), and has evolved over time. Medicare now covers individuals under the age of 65 who

Medicaid and Medicare was created and called the Social Security Act of 1965 to provide coverage for medical treatment for qualified individuals and their families. Medicaid is a program that is jointly funded and managed by the federal and state governments that reimburse hospital and physician for providing care to qualified patients who cannot afford medical expense. To qualify for Medicaid he or she must be a United States or resident citizen which, includes low income adults and their children, people with certain disabilities and senior citizens. “Medicaid and Medicare is overlooked by the Center for Medicare and Medicaid,

There are many changes being made by the Affordable Care Act which will have an impact on Medicare. Affordable Care Act makes Medicare stronger as well as assists the elderly with taking responsibility of their health outcomes. The act will provide essential free assistances which include preventive services, yearly wellness appointments and a fifty percent price reduction towards prescription drugs for the individuals that are in the coverage gap called the donut hole. Medicare recipients can also work with their physicians to develop a personal prevention plan. Affordable Care

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.

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 may not be perfect but until this program is changed it is what we have currently. Medicare has gone through changes since its inception in 1965. The most significant legislative change to Medicare--called the Medicare Modernization Act or MMA--was signed into law President George W. Bush, on December 8, 2003 (CMS, 2013). In a country with a complex healthcare system, a healthcare system that is a hot political stand for every presidential candidate and for each side to have valid arguments for and against is to be expected. But to say that Medicare is heading for disaster can be a stretch. Baby boomers who are entering Medicare eligibility age should not fret; there will be doctors there to service them and Medicare to pay those doctors.

This article discusses about the impact of Medicare coverage expansion under the Affordable Care Act (ACA). In 2011, the Medicare coverage was expanded to fully cover preventive care visits; the annual wellness visit for the Medicare beneficiaries (Chung et al., 2015). The wide range of preventive services such as a review of the patient’s medical and family history; the measurement and recording of biometrics such as blood pressure and body-mass index; screening for cognitive impairment, depression, functional ability, and level of safety; planning end-of-life care; and education, counseling, and referrals for other personalized preventive services are covered under the annual wellness visit. Chung and colleagues conducted a study to determine the use of preventive care visits among older adults, who live in the Northern California. They looked at the data from 2007 through 2013, to assess the utilization of preventive services before and after the expansion among the Medicare fee-for service; also known as Medicare Part B enrollees. In addition, the usage among Medicare Part B enrollees were compared with the Medicare health maintenance organization (HMO) plan; also known as Medicare Advantage and private insurance.

In order to fully evaluate the tradeoffs associated with the Medicare-for-all policy, it is imperative that a source of funding, or a payment model, is identified. Without this information, it is difficult to determine not only who would benefit and who would suffer, but how the system as a whole will respond to the healthcare choices of over 323 million people. Another important detail lies in the potential cost savings and efficiency for middle-class families. The Medicare-for-all plan promises to save the average American family anywhere from $3,800 to $5,100 a year in health care costs (Qiu, 2016). Instead of a traditional monthly premium, consumers would pay a much lower health care tax based on their household income. A household

The major purpose of this work is to completely discuss about the Medicare Part D which will set an influence on the different interest groups and all the entities of government which have been set under the policy changing process. There has been a complete set environment which involved and shape the policy to make efforts as to how all the groups of the stakeholders are influences with the Medical Part D. All the legislation and the specific strategies are made in correspondence to the politics. (Powell et al., 2015). The Medicare Part D is also said to be Medicare prescription drug benefit which directs to setting the United States Federal government programs to work on the subsidizing costs of all the drugs of prescription which insure premiums for the Medicare in US. There is a great enactment which has been based on Medicare Modernization Act of 2003. In December 2003, there are major Medicare Prescriptions which have become into the Improvement and Modernisation Act to become a proper law. There has been a great benefit from the drugs which provides an entire coverage to all the disables and the elderly people who could not have the ability to manage it.