Medicare and Medicaid

Republicans and Democrats have not agreed on much for a long time, since the late 1700’s, in fact. They are not afraid to let people know that they disagree and they have no filter on how they show it. In fact, this year has been a huge year for the political parties because it is an election year. Also this election has been none like others, because of the name calling, private e-mail leaks and so much more. It has shown the true sides of both parties. In-between all of that, the parties did…

Manage care organizations (MCOs) are types of health insurance that involve the creation of provider networks as well as prevention benefits, utilization review for medical necessity and standards of care, and often care management (Kongstvedt, 2013; Medline Plus, 2014). The beginnings of managed care in the United States reaches back to the early twentieth century and continue to thrive, but managed care has not been born from a single force or entity but from many sources seeking differing…

The inpatient reimbursement plan for Medicare Part A is based off the payments for operating costs that are related to inpatient stays in hospitals under the Medicare Part A rates. The rates are defined under the payment system as inpatient prospective payments. The rates are configured by using a mathematical configuration of determining the inpatient reimbursement. The rates are configured as a base payment rate, and then divided to split the labor related share and the non-labor share. Once…

United States of America and Canada are both highly developed countries bordering each other, yet they have two completely different healthcare systems in place for their citizens. The United States has a multi payer, heavily privatized system while Canada has a single payer, mostly publicly funded system. Public health expenditures are carried out by national and local government and public sector enterprises while private expenditures are carried out by individuals and businesses that are not…

expanding Medicare to offer Dental, vision and listening to Care Medicare’s achievement almost 52 years in the past Medicare - one among our country's most popular and a success programs - turned into signed into regulation by President Lyndon Johnson. considering the fact that then, Medicare has helped carry generations of American citizens out of poverty. earlier than the enactment of Medicare in 1965, most effective 50 percent of seniors had health insurance and 35 percentage lived in poverty…

eligibility, you must be a Medicare part A and B recipient and also receive full Medicaid benefits. There are an estimated 9 million people in the United Sates that receive this dual benefits. Medicare is the primary payer for most services, but Medicaid covers benefits not offered by Medicare such as payment for all or part of Medicare copayment, coinsurance, and deductibles. Dual-eligibles are often in poorer health and require more care compared with other Medicare and Medicaid beneficiaries.…

We thank the Centers for Medicare and Medicaid Services (CMS) for the opportunity to provide comments on the proposed rule Medicare Program: Part B Drug Payment Model (CMS-1670-P) published in the Federal Register on March 11, 2016. Under the proposed rule, CMS would implement a two-phase model to test whether alternative drug payment designs will lead to a reduction in Medicare expenditures, while preserving or enhancing the quality of care provided to Medicare beneficiaries. The first phase…

The act was designed to offset the budget by lowering payments to hospitals, Increasing Medicare taxes on higher income households, assessing penalties on employers who don’t offer, and individuals who don’t take, health care insurance, assessing taxes on various health related activities, and reducing overhead by consolidating the higher education…

What is Medicare? Medicare is federal health insurance for people 65 and older individuals 65 and under with certain disabilities, and any person with End Stage Renal Disease (ESRD) and Lou Gehrig’s disease also known as Amyotrophic Lateral Sclerosis (ALS) (Medicare Matters, n.d.). Medicare is one of the largest federal government programs that provide health care benefits to the elderly. The Centers for Medicare & Medicaid Services is the organization in control of the Medicare program.…

providers to promote their drugs, and compensating pharmaceutical sales reps based on the number of prescriptions written by the doctors they call on” (Archer 2013). The Huffington Post cites how “Big Pharma has been systematically price-gouging the Medicare program for seniors and people with disabilities -- and raking in billions in excessive profits. The 11 largest global drug companies made an astonishing $711 billion in profits over the 10 years ending in 2012, and they got a turbo-charged…