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Running Head: MEDICARE POLICY OF 2019 MEDICARE POLICY Medicare Policy of 2019 Maria Williams Southern New Hampshire University 05/10/2020 Medicare Policy of 2019 Purpose The purpose of the Medicare program is to provide health insurance for people who have attained 65 years of age and over. Medicare is also intended to assist people below 65 years but have specific disabilities through health insurance. The health insurance program is also aimed at increasing affordable quality healthcare services among people across all age groups affected with End-Stage Renal Disease (Centers for Medicare and Medicaid Services, 2020). People with a disability aged below 65 are also eligible for Medicare. Scope The scope of Medicare includes provision of health insurance coverage for the aforementioned populations. It concerned with the health interests of minority or underrepresented individuals such racial or ethnic minority groups, rural populations, the disabled, and members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) (CMS, 2020). The Ministry of Health (MOH) CMS office actively takes part in health-policy development, regulations, planning, and coordination of minority healthcare initiatives through stakeholder engagement (CMS, 2020). Besides, the CMS of Minority health researches, collects, and analyzes data to identify target groups and identify healthcare disparities; eliminate barriers to affordable healthcare; and develop appropriate solutions (CMS, 2020). Medicare is also applied to collect data and share knowledge on the quality, access, and costs of the available healthcare services relating to minority groups and the eligible populations. Stakeholders The main stakeholders of the Medicare healthcare program are healthcare workers and institutions such as physicians and nurse managers, and public and private healthcare facilities. Other stakeholders include health insurance companies; pharmaceutical firms and suppliers of the required healthcare resources such as wheelchairs; government institutions and healthcare organizations such as the MOH, Centers for Disease Control and Prevention (CDC) (CMS, 2020). Beneficiaries such as minority groups and races, and the eligible populations such as people of age 65 and older, and disabled individuals aged below 65 years are also part of the Medicare stakeholders. Constituents Medicare consists of three parts namely Part A. Part B and Part C. Part A is concerned with hospital insurance and covers hospital-based inpatient care. Services covered include critical hospital access, skilled nursing facilities, and hospice care for some healthcare homes ((CMS, 2020). Formally employed people pay for the premiums through payroll taxes. Part B covers medical insurance. The services include doctors’ and outpatient services. It further covers some services not covered in Part A such as physical and occupational therapy, and specific home care services (CMC, 20.
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Affordable Care Act Summary Provisions of the act are phased in over ten years. 2010 National temporary high risk pool for those denied coverage. >82,000 previously uninsured persons gained coverage including more than 250 in Nebraska Young adults up to 26 y.o. covered under parents’ plans. >3 million previously uninsured young adults covered, including 18,000 in Nebraska No lifetime or annual limits on coverage 105 million people benefit, including 700,000 in Nebraska No denial by insurers of children for pre-existing conditions No co-payments for preventive care 10-12 million have accessed preventive care, including approximately 360,000 in Nebraska Tax credits for small employers (<25 employees) to provide health care coverage. An estimated 360,000 small businesses with 2 million employees benefited in 2011 $250 rebate for Medicare beneficiaries in Part D coverage gap (doughnut hole) 4 million seniors benefited in 2010 including 26,072 in Nebraska Scholarships and loan forgiveness programs for health professionals choosing primary care Primary care & other health professions training grants A number of grants have been made to Nebraska institutions Comparative Effectiveness Research Grants Prevention Research and Service Grants A number of these grants have also been made to Nebraska institutions. 2011 Grants to employ and train primary care nurse practitioners No co-pay for Medicare preventive services including comprehensive risk assessment and prevention plan In 2011, an estimated 32.5 million people with traditional Medicare or Medicare Advantage received one or more preventive benefits free of charge. In 2012 alone, >25 million people with traditional Medicare, including nearly ~250,000 in Nebraska, have received at least one preventive service at no cost to them. Requires insurers to maintain Medical loss ratios or 80 (small group) or 85% (large group). Provides for states to review and approve premium rate increases 12.8 million subscribers received insurance rebates totaling >$1 billion, including $4.8 million for 22,500 Nebraska families. Insurance rate reviews have saved consumers another $1 billion in premium costs. 50% discount on brand name prescriptions filled during Part D coverage gap Since inception 5.4 million seniors have saved $4.1 billion; in Nebraska seniors have saved $27.5 million since 2010 because of donut hole rebates or discounts. 10% Medicare & Medicaid bonus for primary care physicians and general surgeons in shortage areas Increase Medicare payments to hospitals in low cost areas Increased funding for Community Health Centers Nebraska Community Health Centers have received >$19 million in additional funding 2012 Bonus payments to high quality Medicare Advantage plans Incentive Medicare and Medicaid payments to Accountable Care Organizations that demonstrate quality and efficiency. ACOs have been demonstrated to lower annual health c.
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Medicare or Medicaid – which has greater impact in Florida? Above is the answer of 2 peer. I need a response for them PEER 1 Medicare and Medicaid are the greatest insurance programs run by the government. However, they are operated and funded by different parts of the government and primarily serve different groups. Medicare is run by the federal government and mainly provide health coverage to individual aged 65 years and above and those with disability. Medicaid entails collaboration between the state and federal government and provides health coverage to low-income. However, there are those how meet dual eligible criteria. Therefore, as a state and federal-run program Medicaid has greater effects on state governments. State governments co-fund the program and are expected to match federal funding. From modest beginnings in 1965, Medicaid has grown significantly from $5.3 billion four decades ago, to $449 billion in 2013. In Florida, Medicaid expenditures have grown by 33% between 2012 and 2016. In 2016, the combined state and federal spending on Medicaid increased by 22%. Over these years, the federal government has provided between 55% and 60% of Medicaid funding. During the same time, Medicaid has growth to more than 75% of the Medicare expenditure and its share of national health expenditure has almost doubled. Following the passage of the Affordable Care Act, 2010, states were requested to expand their Medicaid program (Sutter, 2016). According to Ward (2020), the expansion of the Medicaid program has met significant resistant because of its presumed impact on state budgets. Florida is one of the states that have failed to expand its Medicaid plan under the Affordable Care Act. Some stakeholders argue that expanding the illegibility criteria is likely to have significant fiscal implications. Florida is among the states with the highest personal healthcare spending, ranking 5th nationwide. According to Buettgens (2018), the growing Medicaid expenditure are not necessarily driven by increased coverage, but also by changing medical needs, changes in demographics, and other factors affecting consumption of health care services. The debate on the cost implications of expanding Medicaid are likely to persist, but is evident that more Americans have health insurance. PEER2 More often individuals tend not to understand the difference between Medicare in addition to Medicaid. Regardless of them providing assistance to the senior citizens as well as the disabled ones in catering for most of the expenses that are health-related. Medicare is basically a type of health insurance for the people who are disabled, senior or anyone who is known to be suffering from a failure of the kidney which is considered to be permanent. Additionally, it is financed via the contributions of tax security which is contrary to the Medicaid (Hu and Mortensen, 2018). Florida Medicaid is basically a program that depends on the necessities with benefits whic.
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Less than 10 % similarity References APA This is another student post to which i have to react adding some extra information related this post. short answers. The current American model (ACA) is based on private healthcare. Americans lack universal access to health, so they depend on private insurance for health care. There are three ways to get coverage in the US: through a job - companies with more than 50 full-time workers must pay for part of the policy - buying it individually or, in the case of people without resources and older age 65, through two public programs. In the present year, 2020, the Covid-19 pandemic has brought into sharp focus the need for health care reforms that promote universal access to affordable care. About half of Americans receive health coverage through their employer, and with record numbers filing for unemployment insurance, millions find themselves without health insurance in the midst of the largest pandemic in a century. Even those who maintain insurance coverage may find care unaffordable. (King, 2020) Before the pandemic, research showed that more than half of Americans with employer-sponsored health insurance had delayed or postponed recommended treatment for themselves or a family member in the previous year because of cost. The loss of jobs, income, and health insurance associated with the pandemic will greatly exacerbate existing health care cost challenges for all Americans. (King, 2020) The pandemic has wreaked havoc on the country's health system but at the same time has exposed the serious shortcomings of the American health system. However, it should not be hidden that before this event a health reform was necessary in which universal access to quality care for all Americans was guaranteed. An adequate reform could be based on the Canadian health model, much like the British health model. In both countries, the health system is financed by the government and is based on five principles: it is accessible to all regardless of income, it offers complete services, it is publicly managed, and it is universally accessible to citizens and permanent residents. However, in the Canadian model some services such as dental and vision services are not covered. (Thomson, 2012) Clearly, no health model will be 100% perfect and mishaps may arise along the way that must be addressed and improved, but health is a right that all people must have and a country that is a world power such as the United States, with excellent management can achieve a quality health system that is truly affordable for each and every one of its habitants. 10 essential health benefits in the ACA Ambulatorypatient services Emergencyservices Hospitalization Maternityand newborn care Mentalhealth and substance use disorder services, including behavioral healthtreatment Prescriptiondrugs Rehabilitativeand habilitative services and devices Laboratoryservices Preventiveand wellness services and chronic disease manageme.
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Affordable Care Act Summary Provisions of the act are phased.docx
Affordable Care Act Summary Provisions of the act are phased.docx
Health Care Reform Goes Live: The Affordable Care Act in 2014
Health Care Reform Goes Live: The Affordable Care Act in 2014
Universal american healthcare
Universal american healthcare
Medicare or Medicaid – which has greater impact in Florida Abov.docx
Medicare or Medicaid – which has greater impact in Florida Abov.docx
N.J. Health Reform update - 2019
N.J. Health Reform update - 2019
ObamaCare: Why Should You Care?
ObamaCare: Why Should You Care?
3 3-11 How We Got Here
3 3-11 How We Got Here
SC Hospital Association Presentation: Health Care Reform - What Does It Mean ...
SC Hospital Association Presentation: Health Care Reform - What Does It Mean ...
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Less than 10 similarityReferences APAThis is another s.docx
Candian Health Care
Candian Health Care
Morgan2011
Morgan2011
Health policies in u.s.a
Health policies in u.s.a
Medicare, Medicaid
Medicare, Medicaid
Project Assignment 2
Project Assignment 2
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7 steps How to prevent Thalassemia
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
Lifecare Centre
These are simplified slides discussing the regulation of cardiac output and venous return. Learning objectives: 1. Comprehend the determinants of cardiac output and factors affecting cardiac output 2. Comprehend the factors affecting stroke volume and heart rate and total peripheral resistance 3. Identify the factors regulating venous return 4. Discuss the causes of high and low output cardiac failure 5. Enlist the functions of veins and recognise the significance of venous reservoirs Study Resources: 1. Chapter 20, Guyton and Hall Textbook of Medical Physiology, 14th edition 2. Chapter 30 and 32, Ganong’s Review of Medical Physiology, 26th edition 3. Chapter 10, Human Physiology by Lauralee Sherwood, 9th edition 4. Physiology, Cardiac Output - StatPearls https://www.ncbi.nlm.nih.gov/books/NBK470455/
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their Regulation
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In this lecture on circulatory shock, Dr. Faiza, an Assistant Professor of Physiology, delves into the profound implications of inadequate blood flow throughout the body, leading to tissue damage. The session begins by defining circulatory shock and elucidating its physiological causes, including decreased cardiac output, diminished blood volume, decreased vascular tone, obstruction to blood flow, excess metabolic rate, and abnormal perfusion patterns. Dr. Faiza categorizes shock into various types, such as cardiogenic shock, hypovolemic shock, neurogenic shock, obstructive shock, anaphylactic shock, and septic shock, and explores the pathophysiological basis of each. Furthermore, the lecture examines the stages of shock, from the non-progressive phase where compensatory mechanisms aim for full recovery to the progressive phase where shock worsens steadily without intervention, potentially leading to irreversible damage. Dr. Faiza discusses therapeutic interventions for shock, including replacement therapy, blood and plasma transfusion, sympathomimetic drugs, and other adjunctive treatments like head-down positioning, oxygen therapy, and glucocorticoids.
Circulatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanisms
MedicoseAcademics
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Dr. Faiza delivers an insightful lecture on the distinguishing characteristics of skeletal, smooth, and cardiac muscles, offering a comprehensive understanding of their histology, physiological anatomy, electrophysiological properties, and contractile mechanisms. Through meticulous tabulation and comparison, she aims to equip learners with a detailed comprehension of the unique features and functionalities of each muscle type. Beginning with a detailed exploration of histological differences, Dr. Faiza outlines key distinctions such as multinucleation in skeletal muscle, mononucleation in smooth and cardiac muscles, and the presence of striations in skeletal and cardiac muscles. She meticulously elucidates the structural arrangement of each muscle type, highlighting their cellular morphology and organization within tissues. Transitioning to physiological anatomy, Dr. Faiza navigates through various aspects including innervation, level of control, initiation of contraction, and modification by hormones. By delineating the role of the somatic nervous system in skeletal muscle control, and contrasting it with the autonomic nervous system's influence on smooth and cardiac muscles, she offers a nuanced understanding of neural regulation in muscle physiology. Furthermore, Dr. Faiza delves into electrophysiological properties, elucidating the mechanisms underlying action potential generation, duration, and ionic basis in each muscle type. Through insightful analysis, she reveals how differences in action potential characteristics contribute to variations in muscle contraction speed, duration, and resistance to fatigue. Finally, Dr. Faiza meticulously examines the contractile mechanisms of skeletal, smooth, and cardiac muscles, shedding light on the sliding filament theory, mechanisms of calcium action, and speed of contraction. By comprehensively comparing these mechanisms, she provides learners with a deep understanding of the intricate processes governing muscle contraction and function. Through engaging presentation and meticulous analysis, Dr. Faiza's lecture serves as a valuable resource for students seeking a thorough understanding of the fundamental differences between skeletal, smooth, and cardiac muscles.
Difference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac Muscles
MedicoseAcademics
Explore the fundamentals of the human reproductive system in this concise presentation, suitable for medical students and professionals alike. Covering anatomy, physiology, and Pregnancy, it offers essential knowledge for understanding reproductive health.
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
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Cardiac Output, Venous Return, and Their Regulation
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Circulatory Shock, types and stages, compensatory mechanisms
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Health Care Reform
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in the U.S. in 2006
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Medicare Revenue and
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