On March 23, 2010, the former President signed a law called the Affordable Health Care Act, also known to everyone as ObamaCare. The Affordable Care Act didn’t happen until January 1, 2014. The goal for the Affordable Health Care Act was: expanding coverage, hold insurance companies accountable, lower health care costs, guarantee more choices, and enhance the quality of care for all Americans. Medicaid is a jointly funded, Federal-State health insurance program for low-income and needy people. It also covers children who are disabled and other people who are eligible to receive federally assisted income maintenance payments.
Under the Balanced Budget Act (BBA), the Health Care Financing Administration (HCFA) put into effect a nationwide Prospective Payment System (PPS) within Skilled Nursing Facilities to reimburse inpatient service costs for beneficiaries covered under Medicare Part A as of July 1,1998 (Skilled Nursing facility PPS, 2013). Generally, Medicare Part A covers beneficiaries within the following inpatient settings: SNFs, hospitals, nursing homes, hospice, and home health services (What Part A Covers, n.d.). Medicare Part A uses a Prospective Payment System at a per diem rate. In other words, Medicare Part A pays SNFs pre-determined daily rates for patient care, meaning they are dictating the daily allowance of expenses used for services (Skilled Nursing
If it is time for healthcare open enrollment or you are starting a new job that offers flexible spending accounts, here are a few things you need to know about the accounts and how they can help you with your health-related costs. • Flexible spending accounts, known as FSAs, are an employee healthcare benefit that allows you to set aside pretax income in an account to help you pay for healthcare costs. • FSAs help cover health-related costs not covered by traditional health insurance such as copays, fertility treatments, alternative medicine or medically necessary supplies. • Employers will ask their employees how much pretax income they would like to contribute to the FSA at the beginning of each plan year, which is normally the first week
The majority of seniors would prefer to live at home as long as possible, even if they have a long-term health condition that limits their independence. Home care or aging at home is beneficial to the public health care system because it is generally less costly than hospital or hospice care. To live at home safely and maintain a good level of well-being, however, seniors frequently require help with their daily activities such as personal care, medical care, household maintenance and transportation. With the growing number of seniors in Canada it will be necessary for the government to introduce more social programs to support caregivers and seniors in their homes. Many studies show that seniors who receive social support and professional home care services
A NP can participate in the care but a physician must have their name on the chart as the attending to comply with federal regulations. If a NP does not follow the Medicare guidelines that can be charged with Medicare fraud. • Billing and care of the patients covered by Medicare. A nurse practitioner is reimbursed at a lower rate than a physician (85%).
What outcomes will be analyzed and how they will be analyzed? Although the veterans are asked their full name and last four of their social security, the scanning provides the added comfort of providing the security or safety for everyone involved. The outcome of this research will show data that will be analyzed pre and post implementation of the BMCA system, which the approach is to show a significant change in the medication error rate. The outcome will be based on pre and post implementation of the barcode medication system by measuring the medication error rate.
Our proposal is to set up a policy that financially assists adults as they become older. An account will be created to help support the long-term health care for adults. The benefits from this policy is to help ensure the long-term care and to assist financially with medical expenses. Some services that this policy can assist with are hospital visits, hospice, nursing home care, home healthcare, medical equipment and medications. We feel that our policy will better prepare aging adults for long-term health care, rather than other alternatives that have already been explored, for example medicare.
Managed Care Organization (MCO) is healthcare delivery system that attempts to keep cost down by managing the care to eliminate unnecessary treatment and reduce expensive hospital care. The most familiar models are HMOs and PPOs. Indemnity Plan also called (fee-for-service) is the type of plan most Americans were covered under until tha past two decades. Under this plan patients can go to any healthcare provider or hospital they choose, medical bills are sent to the insurance carrier, and the patient or (healthcare provider) is reimbursed according to rules of the
Why do LTCF/nursing homes play an important role in the continuum of care? Goldberg, T., (2014), explained how Medicare and Medicaid supports nursing homes in the continuum of care for the elderly. He stated that from their establishment in 1965 as a part of the Social Security Act both Medicare (Health Insurance for the Aged and Disabled) and Medicaid (Medical Assistance for the Poor) cover aspects of long-term care (LTC) but in different ways. He added, that Medicaid covers long-term nursing home care for those who qualify financially and medically, but generally does not cover residential care/assisted living. The coverage provided under Medicare is more complicated because of its four different parts: • Medicare Part B covers physician services and therapies, generally regardless of location (i.e. physicians bill Medicare Part B for patients seen in hospitals, outpatient or LTC settings, but using different billing codes based on setting).
At some point in everyone’s life they or a family member will have to visit a physician regardless of whether it’s for a sinus infection, a necessary surgery, if they’re insured or not. Everyone will at some point need medical attention, thus utilizing the money taken out of the publics’ paycheck being put towards healthcare spending. According to Fleming, “By 2020, healthcare spending is projected to be 19.8 percent of GDP, nearly one-fifth of economic output, increasing from 17.6 percent in 2010.” Since, Medicaid and Medicare are funded by Federal and State taxes (Medicare, 2015) with a fee-for-service system; the public will continue to pay for services provided. However, with a pay-for-performance system, providers will be required to make changes within their area of care to ensure that quality is administered and at a lower cost (Better Care, 2015).
The focus of the course was on showing the political economical changes affect the health care policies. President Obama has made considerable changes in the U.S. health care system by expanding the access to care to uninsured individuals. In fact, his principles for a modern health care system are as below: enabling individuals to have the right to choose their health care providers reducing the administrative costs of health care insurance companies and making it more affordable for individuals protecting families from becoming bankrupt after a medical problem planning public plans to change the lifestyle of individuals and encouraging them to follow wellness programs, and shift the focus from disease treatment to preventive