Health Care Reform

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heyheyman28

Santé & Médecine Business

Health Insurance Coverage in the U.S. in 2006

[object Object],[object Object],What is Medicare?

[object Object],[object Object],How are benefits provided?

[object Object],[object Object],Quick Facts on Medicare

[object Object],[object Object],Financing Care for Future Generations

[object Object],[object Object],[object Object],Quick Facts on Medicare

[object Object],[object Object],[object Object],Medicare Fraud

[object Object],[object Object],[object Object],What is Medicaid?

[object Object],[object Object],[object Object],Is Medicaid the same as Medicare?

[object Object],[object Object],[object Object],[object Object],Quick Facts on Medicaid

[object Object],Cost of Medicare and Medicaid Medicaid Medicare + $440 billion $760 billion

[object Object],[object Object],[object Object],Who are the uninsured?

[object Object],[object Object],[object Object],How does being uninsured harm individuals and families?

[object Object],[object Object],[object Object],How it Affects You

[object Object],[object Object],How it Affects You (con’t)

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Running Head: MEDICARE POLICY OF 2019 MEDICARE POLICY Medicare Policy of 2019 Maria Williams Southern New Hampshire University 05/10/2020 Medicare Policy of 2019 Purpose The purpose of the Medicare program is to provide health insurance for people who have attained 65 years of age and over. Medicare is also intended to assist people below 65 years but have specific disabilities through health insurance. The health insurance program is also aimed at increasing affordable quality healthcare services among people across all age groups affected with End-Stage Renal Disease (Centers for Medicare and Medicaid Services, 2020). People with a disability aged below 65 are also eligible for Medicare. Scope The scope of Medicare includes provision of health insurance coverage for the aforementioned populations. It concerned with the health interests of minority or underrepresented individuals such racial or ethnic minority groups, rural populations, the disabled, and members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) (CMS, 2020). The Ministry of Health (MOH) CMS office actively takes part in health-policy development, regulations, planning, and coordination of minority healthcare initiatives through stakeholder engagement (CMS, 2020). Besides, the CMS of Minority health researches, collects, and analyzes data to identify target groups and identify healthcare disparities; eliminate barriers to affordable healthcare; and develop appropriate solutions (CMS, 2020). Medicare is also applied to collect data and share knowledge on the quality, access, and costs of the available healthcare services relating to minority groups and the eligible populations. Stakeholders The main stakeholders of the Medicare healthcare program are healthcare workers and institutions such as physicians and nurse managers, and public and private healthcare facilities. Other stakeholders include health insurance companies; pharmaceutical firms and suppliers of the required healthcare resources such as wheelchairs; government institutions and healthcare organizations such as the MOH, Centers for Disease Control and Prevention (CDC) (CMS, 2020). Beneficiaries such as minority groups and races, and the eligible populations such as people of age 65 and older, and disabled individuals aged below 65 years are also part of the Medicare stakeholders. Constituents Medicare consists of three parts namely Part A. Part B and Part C. Part A is concerned with hospital insurance and covers hospital-based inpatient care. Services covered include critical hospital access, skilled nursing facilities, and hospice care for some healthcare homes ((CMS, 2020). Formally employed people pay for the premiums through payroll taxes. Part B covers medical insurance. The services include doctors’ and outpatient services. It further covers some services not covered in Part A such as physical and occupational therapy, and specific home care services (CMC, 20.

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Affordable Care Act Summary Provisions of the act are phased in over ten years. 2010 National temporary high risk pool for those denied coverage. >82,000 previously uninsured persons gained coverage including more than 250 in Nebraska Young adults up to 26 y.o. covered under parents’ plans. >3 million previously uninsured young adults covered, including 18,000 in Nebraska No lifetime or annual limits on coverage 105 million people benefit, including 700,000 in Nebraska No denial by insurers of children for pre-existing conditions No co-payments for preventive care 10-12 million have accessed preventive care, including approximately 360,000 in Nebraska Tax credits for small employers (<25 employees) to provide health care coverage. An estimated 360,000 small businesses with 2 million employees benefited in 2011 $250 rebate for Medicare beneficiaries in Part D coverage gap (doughnut hole) 4 million seniors benefited in 2010 including 26,072 in Nebraska Scholarships and loan forgiveness programs for health professionals choosing primary care Primary care & other health professions training grants A number of grants have been made to Nebraska institutions Comparative Effectiveness Research Grants Prevention Research and Service Grants A number of these grants have also been made to Nebraska institutions. 2011 Grants to employ and train primary care nurse practitioners No co-pay for Medicare preventive services including comprehensive risk assessment and prevention plan In 2011, an estimated 32.5 million people with traditional Medicare or Medicare Advantage received one or more preventive benefits free of charge. In 2012 alone, >25 million people with traditional Medicare, including nearly ~250,000 in Nebraska, have received at least one preventive service at no cost to them. Requires insurers to maintain Medical loss ratios or 80 (small group) or 85% (large group). Provides for states to review and approve premium rate increases 12.8 million subscribers received insurance rebates totaling >$1 billion, including $4.8 million for 22,500 Nebraska families. Insurance rate reviews have saved consumers another $1 billion in premium costs. 50% discount on brand name prescriptions filled during Part D coverage gap Since inception 5.4 million seniors have saved $4.1 billion; in Nebraska seniors have saved $27.5 million since 2010 because of donut hole rebates or discounts. 10% Medicare & Medicaid bonus for primary care physicians and general surgeons in shortage areas Increase Medicare payments to hospitals in low cost areas Increased funding for Community Health Centers Nebraska Community Health Centers have received >$19 million in additional funding 2012 Bonus payments to high quality Medicare Advantage plans Incentive Medicare and Medicaid payments to Accountable Care Organizations that demonstrate quality and efficiency. ACOs have been demonstrated to lower annual health c.

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Medicare or Medicaid – which has greater impact in Florida? Above is the answer of 2 peer. I need a response for them PEER 1 Medicare and Medicaid are the greatest insurance programs run by the government. However, they are operated and funded by different parts of the government and primarily serve different groups. Medicare is run by the federal government and mainly provide health coverage to individual aged 65 years and above and those with disability. Medicaid entails collaboration between the state and federal government and provides health coverage to low-income. However, there are those how meet dual eligible criteria. Therefore, as a state and federal-run program Medicaid has greater effects on state governments. State governments co-fund the program and are expected to match federal funding. From modest beginnings in 1965, Medicaid has grown significantly from $5.3 billion four decades ago, to $449 billion in 2013. In Florida, Medicaid expenditures have grown by 33% between 2012 and 2016. In 2016, the combined state and federal spending on Medicaid increased by 22%. Over these years, the federal government has provided between 55% and 60% of Medicaid funding. During the same time, Medicaid has growth to more than 75% of the Medicare expenditure and its share of national health expenditure has almost doubled. Following the passage of the Affordable Care Act, 2010, states were requested to expand their Medicaid program (Sutter, 2016). According to Ward (2020), the expansion of the Medicaid program has met significant resistant because of its presumed impact on state budgets. Florida is one of the states that have failed to expand its Medicaid plan under the Affordable Care Act. Some stakeholders argue that expanding the illegibility criteria is likely to have significant fiscal implications. Florida is among the states with the highest personal healthcare spending, ranking 5th nationwide. According to Buettgens (2018), the growing Medicaid expenditure are not necessarily driven by increased coverage, but also by changing medical needs, changes in demographics, and other factors affecting consumption of health care services. The debate on the cost implications of expanding Medicaid are likely to persist, but is evident that more Americans have health insurance. PEER2 More often individuals tend not to understand the difference between Medicare in addition to Medicaid. Regardless of them providing assistance to the senior citizens as well as the disabled ones in catering for most of the expenses that are health-related. Medicare is basically a type of health insurance for the people who are disabled, senior or anyone who is known to be suffering from a failure of the kidney which is considered to be permanent. Additionally, it is financed via the contributions of tax security which is contrary to the Medicaid (Hu and Mortensen, 2018). Florida Medicaid is basically a program that depends on the necessities with benefits whic.

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