Throughout American History our government has done their best to provide adequate health care coverage to all Americans. The focus of this paper is to explain the history Medicare, Medicaid and evaluate the role of the Centers for Medicare & Medicaid Services in healthcare and to provide insight on the socioeconomic drivers.
The Centers for Medicare and Medicaid Services a Division of Health and Human Services and previously known as the Health Care Financing Administration was established to oversee the administration of several health care programs which include Medicare, Medicaid, Children’s Health Insurance Program (CHIP), the Health Insurance Portability and Accountability Act (HIPAA) and the Clinical Laboratory Improvement Amendments. Socio-economic drivers in health outcomes have been similar throughout history and continue to be a factor …show more content…
The QIO is made up of health quality experts, healthcare providers and consumers organized to improve the care delivered to the people with Medicare. The QIO works with Medicare providers on quality improvement and reviews quality concerns to protect beneficiaries and the Medicare Trust Fund. CMS outlines the function of the QIO as followed, improving quality of care for beneficiaries, protecting the integrity of the Medicare Trust Fund by ensuring that Medicare pays only for services and goods that are reasonable and necessary and are provided in the most appropriate setting and lastly protecting the beneficiaries by expediting individual complaints, beneficiary complaints, provider-based notice appeals, violations of the Emergency Medical Treatment and Labor Act and related responsibilities outlined in the QIO-related law. This program has been instrumental in advancing national efforts to motivate providers in improving quality, and in measuring and improving outcomes of
The Centers for Medicare and Medicaid Services a Division of Health and Human Services and previously known as the Health Care Financing Administration was established to oversee the administration of several health care programs which include Medicare, Medicaid, Children’s Health Insurance Program (CHIP), the Health Insurance Portability and Accountability Act (HIPAA) and the Clinical Laboratory Improvement Amendments. Socio-economic drivers in health outcomes have been similar throughout history and continue to be a factor …show more content…
The QIO is made up of health quality experts, healthcare providers and consumers organized to improve the care delivered to the people with Medicare. The QIO works with Medicare providers on quality improvement and reviews quality concerns to protect beneficiaries and the Medicare Trust Fund. CMS outlines the function of the QIO as followed, improving quality of care for beneficiaries, protecting the integrity of the Medicare Trust Fund by ensuring that Medicare pays only for services and goods that are reasonable and necessary and are provided in the most appropriate setting and lastly protecting the beneficiaries by expediting individual complaints, beneficiary complaints, provider-based notice appeals, violations of the Emergency Medical Treatment and Labor Act and related responsibilities outlined in the QIO-related law. This program has been instrumental in advancing national efforts to motivate providers in improving quality, and in measuring and improving outcomes of