Medicare and Medicaid

Medicare vs. Medicaid What I learned is that both are financed some way through the government paid via taxes and although they sound very similar that both have different benefits and eligibility requirements. From my understanding Medicare is a program for long term coverage for the elderly and Medicaid is supposed to benefit those with lower incomes. I noticed Medicare is done through social security and it has parts A-C and the newly added D in 2003. Medicare is also offered to everyone when they reach eligibility, while Medicaid is not. According to the videos, Medicare A covers hospitalization, B is medical insurance, C is purchasing private insurance through Medicare which sounds better out of the four because with this policy they…

Medicaid and Medicare are two very different things in America,. The one thing they have in common is they are both Used Health insurance ,but they are used for two different types of people. Medicare is used by people aged 65 or older.Medicaid is used by people who cannot afford health insurance.(Funk & Wagnalls) People should know the differences between Medicaid and Medicare. Medicare benefits are split into four parts. The 1st part is for basic infirmary insurance plan covering inpatient…

procedures to Medicaid, Medicare and third-party payers. HCPCS codes are split into to two levels: Level II and I. Level I includes CPT codes. HCPCS Level II consists of five characters, both numbers and letters and used to present services outside of a health provider’s office, ambulance, supplies and other non-physician services. CPT codes are used for the description of surgical, laboratory and other services of health care providers. It consists of five number or letter components. CPT…

the initial office of the director of the Joint Commission on Accreditation of Hospitals. Then in 1953 the Joint Commission on Accreditation of Hospitals started offering accreditation through them instead of the American College of Surgeons since they had officially transferred there onsite accreditation program over to the newly developed organization (The Joint Commission, 2015). . The Joint Commission on Accreditation of Hospitals develops their own set of standards and had the new…

For example, nursing home residents who wish to be eligible for Medicaid find they cannot have more than $1,600 in assets, yet this does not mean their spouse is limited to this amount. The healthy spouse retains certain assets which the courts have deemed exempt, such as a home regardless of its value. Furthermore, the healthy spouse can have a monthly income of a set amount, determined by the state, and this amount is currently $2,980. Individuals who wish to have nursing home care for a loved…

Methods to Evaluate Effectiveness of Plan Pressure ulcer is huge concern for health care industry as pressure ulcer distresses health of the patient, upsurges stay that further escalates cost for patient. Hospitals do not get reimbursement from Medicare and Medicaid. “Estimates of pressure ulcer prevalence range from 0.4 to 38 percent in acute care hospitals, 2 to 24 percent in long-term nursing facilities, and 0 to 17 percent in home care settings and prevalence of facility-acquired pressure…

The first group is high risk patients who are identified by frequent emergency department (ED) visits more than 12 times in six months and those who have an extended or complicated hospitalization typically requiring complex needs after discharge. The second manner of identification is through Diagnosis Related Groups (DRG) 291-293 found on paid claims data. DRG ‘s established through the inpatient prospective payment system are part the methodology of reimbursement created by the Centers of…

The hope is a multidisciplinary approach to care would produce a more comprehensive assessment and plan of care for the individual. Sometimes this is the case and other times it’s not. It really truly depends on the team members. Recently, we had a discharge planning meeting for a resident at our facility. The resident’s daughter is the Director of Admissions at our facility. Our social worker called her to explain that her father was making very little progress and she did not expect him to…

Long-term care is defined as health, mental health, residential or social support provided to a person with functional disabilities on an informal or formal basis over an extended period of time with the goal of maximizing the person’s independence. The goal of long-term care is help people achieve functional independence, in contrast to the goal of acute care, which is to cure. The fundamental reason that a person needs long-term care is because they suffer from one or more functional…

Long-Term Care Administrators Long-term care (LTC) industry is predicted to experience a significant growth because of the simultaneous aging of the baby boomers, and consequently, their need for long-term care. Thus, the jobs or duties of LTC administrators will become more demanding, and more stressful. There are, however, some traits and training that LTC administrators will need in order to succeed. LTC administrator’s job is not for the faint-hearted because the job entails a lot of hard…