Medicare and Medicaid

The Affordable Care Act entails several key moving parts of what it does for the American people in health care and costs. Many unintended consequences do occur from what the ACA provides in its lengthy document. Each section of the Affordable Care Act has specific sections and it’s imperative to examine each section to see the unintended consequences of the policy that may be the future. It’s hard to narrow it down to one topic to focus, which is why it’s worth mentioning some topics of…

Value Base Purchasing (VBP) is an imitative by the Centers of Medicare and Medicaid Services (CMS), that rewards acute care hospitals with incentive payments for the quality of care provided. Hospitals are rewarded based on three district measures; the first is the quality of care provided to Medicare patients, the second is how closely clinical best practices are followed and the third is how well patient care experiences were during their hospitalization. Hospitals are no longer paid based on…

two primary care practice tracks to deliver better care and improve health outcome. In the first track, the CMS would pay a risk adjusted monthly payment for each Medicare beneficiary’s care management services, in addition to fee for service for primary care visits. In the second track, physician practices will receive average Medicare fee-for service payments and more generous upfront care management payments. This “hybrid” payment model would break the cycle of traditional face to…

governmental or non-governmental organization, assesses and identifies a hospital as gathering pre-determined requirements or standards (Rooney. 1999). • It is not compulsory that means it is necessary only when a hospital wants to take part in Medicare and Medicaid (Shi & Singh, 2015). • Hospitals must generally obey with the rules and regulations of participation—federal standards for well-being, security, and health care quality. • Organizations that have a certification are approved by other…

Currently the organization of the Healthcare system within the United States is completely lop sided, and unrealistic. Normal good working citizens in society are being taken advantage of, or just being completely ignored. The video “Sick Around America” displays multiple examples of how healthcare in America is not accomplishing what it is supposed to. The personal accounts of the people in the video play a special part in its message because it explains the problem at an individual level.…

and surgical processes. Ambulatory surgical centers (ASC) are dedicated outpatient surgical settings, and as such, are reimbursed according to specific regulations and industry standards that fall under Medicare, Medicaid, and contractual financial agreements with private health insurers. The Medicare program and its’ regulatory rules set the standard for all other payers. Medical coders for ambulatory centers need to have specialized training and expertise in the field of ambulatory…

Throughout President Obama’s two terms it could clearly be seen that deficit has decreased by a significant amount. According to the nonpartisan Congressional Budget office numbers show that this year deficit has been the lowest ever since Obama has served. These major differences occurred because of cuts in federal spending and because of economic growth. Most estimates conclude that unemployment rate will actually go down due to more encouragement for the people in the work force. Also, the…

Documentation requirements for JCAH The Joint Commission established in 1975 accredits more than 80% hospitals in the United States through a deemed status agreement with the Center for Medicare and Medicaid services (CMS) the commission specifically addresses the requirements for maintenance, testing and inspection of fire safety equipment and building features. It requires concise documentation for the Name of the activity, date of the event, required the frequency of the activity, name and…

THE EFFECTIVENESS OF FEDERAL BUREAUCRACY The term bureaucracy has been defined as "a body of non-elective government officials" and/or "an administrative policy-making group". Historically, bureaucracy was government administration managed by departments staffed with non-elected officials. Today, bureaucracy is the administrative system governing any large institution1. Bureaucracy encompasses both public and private sector organizations that are large, hierarchically organized and highly…

Through out the years many people have been suffering from this chronic disease called obesity. Obesity is a condition that affects a person’s body mass index; also know as BMI, it is when someone has exuberance adipose tissue in the body. It is one of the most prominent causes in the United States for disability and morbidity and has given a big rise in healthcare costs. The U.S population has grown tremendously within the years and obesity has taken over one- third of the adult population…