The Important Role Of Medicaid In Nursing Home

The government should pay for the cost of nursing homes because some family members are also too old to pay for the cost of care. Some countries have an aging population due to healthier lifestyles and the advanced state of medical technology. Take Japanese society as an example; it is predicted that one-third

Our elderly population is living longer than ever before and not all of them are entering into a nursing home. They are choosing to stay in their own home or their caregiver is choosing it for them. Some caregivers are choosing to move their ageing love one in the home with them. Whatever the case may be, there is an increased need for some type of home health as it applies to the elderly population. “Medicare will pay the full cost of professional help only if the physician

So why isn’t insurance for those sixty-five and older the biggest payer of long-term care? This contradiction to what you would think is a result of the restrictions put on long-term care by both types of insurance. Medicaid only sets the restriction that the person must be over twenty-one, have a medical need (verified by a doctor) for help with their daily living, and the care be given in a Medicaid certified facility. If these requirements are met Medicaid will cover nursing facilities, home health, and some day care facilities. However, each state set their own services so the Medicaid eligible services may be different from state to state (Meedicaid.gov, n.d). Medicare on the other hand does not cover long-term care that helps with the functioning of everyday life. Medicare only covers subacute care weather in your home or a facility. With the requirements being that the facility must be at a Medicare licensed facility, the patient has to be transferred from an acute hospital, the transfer must be prescribed by a doctor, and or the patient must have been released from a hospital stay within the last sixty days (CMS, 2014). Medicaid pays for long-term care users who have difficulty living everyday life, performing everyday activities, and have a lifelong medical disorder needing assistance to function at just about any age. While, Medicare pays for

The Affordable Care Act (ACA) highlighted the importance Medicaid played in insuring every American receive healthcare coverage. (42 U.S.C., 2010) Medicaid provides health benefits to over 71 million across the country. While involvement is optional, all 50 states participate in the program and requirements differ across the nation. The flexibility given to each state has allowed them to make their own decisions to work towards improvements that they believe would best benefit their region (Feldstein, 2015, p. 125-126).

Major amendments to the Social Security Act that were passed by Congress influenced the history of Medicaid. “The 1972 amendments created the Supplemental Security Income (SSI) program, which federalized existing State cash assistance programs for aged and disabled persons” (Klemm, 2000). According to the article “Medicaid Spending: A Brief History”, SSI recipients are almost always provided health insurance through Medicaid; this caused more aged and disabled individuals to enroll in the Medicaid program which influenced cost. As mentioned in class, individuals who received SSI but returned to work are protected groups and receive mandatory coverage through Medicaid.

This exercise point out some very important factors with regard to health care cost.  nursing homes and other health care delivery systems are faced with significant shortfalls in reimbursement for various reasons.  Medicare reimbursement often does not cover the full extent of treatment of individuals.  McPike (2008) notes that, “The insurance and hospital industries released a study today showing that underpayment by Medicare and Medicaid costs consumers and employers $88 billion more a year for health care as providers attempt to make up the difference.” Today with continue cutbacks in medicare reimbursement this number is significantly higher.  In an attempt to reclaim these losses, both self pay and privately insured patients are charge

The Medicaid program is a federal health insurance program for the under-privileged and incapacitated. The plan is managed by states within comprehensive limits instituted by the federal government. Together the federal and state governments finance the program, with the federal share ranging from 50 percent to 74 percent. Now Medicaid currently makes up 7 percent of the federal budget and 23.7 percent of all state expenses. Approximately sixty million people are enrolled in the Medicaid program and 400 million is spent annually.

As the government’s role in public health remains, major changes have been put into effect, precisely dealing with long-term care. Before the 1930’s, providing care for the elderly was exclusively a local and state run industry. However, after the great depression, a growing demand was placed on providing some type of insurance for that population. The Social Security Act of 1935 was established to assist with “Federal old-age benefits” and was signed into effect by President Roosevelt on August 15, 1935. (Home, 2015) Another major impact to long-term care has been the creation of Medicaid that went into effect in 1965 and was an amendment to the Social Security Act of 1935. “Title XIX of the Social Security Act is a federal and state entitlement program that pays for medical assistance for certain individuals and families with low incomes and resources” Medicaid is a collective effort between state and the government to help provide insurance for eligible citizens. Among those covered under this insurance, are the elderly, disabled and pregnant. Medicaid is the largest source of funding for medical care. The new changes to Medicaid are ongoing and will be put into effect as part of Obamacare.

Another important aspect is long-term care in the Unites States. Some long-term care facilities in the United States are considered either private or state owned. The state-owned facilities need to improve the quality of care. Due to people living longer have put a large demand on long-term facilities. A lot of state owned facilities are unstaffed and over pullulated. Americans should have access to universal healthcare coverage and log-term coverage care from a quality long-term facility.

The government has two programs that provide health care to specific groups of people in the United States known as Medicaid and Medicare. After President Johnson signed the Social Security Act in 1965, the government created these two programs. Each of the programs have their own eligibility requirements, coverage, and cost. The Healthcare reform effected both programs eligibility requirements, cost, and coverage.

Congress. Codified as section 1819 and 1919 of the Social Security Act, the landmark legislation declared that every nursing home must protect and promote the rights of each resident, including, “The right to be free from … any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms.” When the Nursing Home Reform Act was adopted it was widely accepted to use restraints as an acceptable and widely-used option to manage the behavior of residents who wandered; were agitated; or who in the view of treatment staff, simply needed to be restrained. However, the standard use of restraints was not supported by a body of research that found that physical restraints had

The first author of the article, Medicaid Funding for Assisted Living Care: A Five-State Examination, is Eric Carlson. Carlson is the directing attorney under the National Senior Citizens Law Center (NSCLC). He graduated summa cum luade from the University of Minnesota, and obtained his law degree from Boalt Hall School of Law at the University of California Berkeley. Most of his career has been spent advocating for older adults in nursing homes and assisted living facilities. Carlson is very knowledgeable on these topics, and frequently presents to other attorneys and social workers at conferences nation-wide about these issues (NSCLC).

Medicaid is a government program that effects millions of people in the united states by providing health care. These individuals that receive these benefits include low-income adults, children, pregnant woman, the elderly, and people with disabilities (medicaid.gov). Because of the many different types of people that this program serves, it has the ability to effect many people across America. In the United States, each individual state administers and makes decision about their own medicaid program. There are certain services that the states are required to provide to a pateint with medicaid. A few, but not all, of these services are home health services, in and outpatient hospital services, X-ray services, family planning services,

Part A (Hospital Insurance program) covers inpatient hospital stays, home health service, and skilled nursing facility. In addition to this, Medicare pays for 100 days of care in Medicare-certified skilled nursing facilities as well as for the patients staying in Medicare certified hospice. Some people do not pay any premium for part A due to the taxes paid by them or their spouse during their working years. Moreover, contribution comes to Medicare through payroll taxes paid by individuals which make them eligible for the benefits. In order to become eligible for this premium free Part A program, individuals or their spouse must have forty credits after working at least 10 years. However, people, who do not have forty credits, will pay a monthly

Since its passage in 1965, Medicaid has become the nation’s main public health insurance program for the low-income population. It is also the major source of handling and funding of long-term care services for the elderly and individuals with disabilities. (Olson, 2010) Medicaid plays many roles in our healthcare system and was increased significantly as a center of coverage for the low-income population under the Affordable Care Act. (Foundation, Medicaid Timeline, 2015)