Medicaid Part A Case Study

Medicare Part A is otherwise called the Hospital Insurance and covers up to 100 days of the Skilled Nursing Facility stay. To be qualified for it the patient first has to have been hospitalized for more than 3 days in a hospital (qualifying hospital stay) so the stay in it would not be considered outpatient. After the hospital stay the doctor that followed the patient in the hospital or the PCP that releases the patient from the hospital needs to write the order for the SNF services. In order for a patient to receive the services from the SNF they have to:

Medicare part A is hospital coverage for inpatient hospital stays. More specifically, Part A is coverage for critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals. Part A also covers inpatient care in a skilled nursing facility (not supervisory or long-term care), hospice care services and some home health care services. Inpatient care in a Religious Nonmedical Health Care Institution is also covered. In the scenario provided, Mrs. Zwick is admitted to the hospital as an inpatient because she had a stroke. The patient was deemed by the physician to need continued treatment after discharge due to the patient 's condition and was discharged to a skilled nursing facility.

True or false: Medicare Part A is for inpatient hospitalization and requires a premium payment from the patient.

Part A is predominantly financed through taxes paid by employees and employers (Facts, 2015). There is a 2.9% tax on earnings, and taxes account for 87% of Part A revenue. The taxes are deposited into the Hospital Insurance Trust Fund (Medicare, 2014). Additionally, the article (2015) states that employers and employees pay a payroll tax of 1.45% each, while higher-income taxpayers pay a higher payroll tax of 2.35% on earnings. Part B is funded by general revenue and premiums paid by beneficiaries. Medicare pays premiums for Part B on the behalf of beneficiaries who qualify for Medicaid based on their low incomes and assets (Medicare, 2014). Alternatively, beneficiaries with higher incomes pay a higher monthly premium based on their incomes (Medicare, 2014). According to data collected in 2014 by the Kaiser Family Foundation (2014), these premiums can range from $146.90 to $335.70 per month. The article (2014) states that the income thresholds for the

Bill Haslam, the Tennessee state governor, announced that the state of Tennessee would accept the Medicaid expansion offer. The Medicaid expansion expands Medicaid eligibility to the region’s underserved populations living near or below the poverty line. The Medicaid expansion offer looked to be a major win for the state; however, others disagreed with this idea. Some of Tennessee’s lawmakers decided to deny the federal government’s Medicaid offer, even though many others wanted the offer to be accepted. The deal’s breakdown might be the result of “squabbling along party lines” which is a common theme at all levels of government. Although the deal was denied, it is still possible that the bill could still be passed with the help of the governor. The likelihood of Tennessee reviving its Medicaid expansion is a difficult one considering the state would have to fight. The Medicaid expansion could offer the state low-income citizens medical insurance, the state would come out of the deal with a net financial gain, and the state hospitals would come out on top.

Texas ranks number one with the highest uninsured rate in the nation, accounting for nearly 6 million people (1). The federal government has nearly $100 billion for Medicaid expansion, out of which $15 billion is needed for expansion in Texas (1). Opting out of Medicaid expansion has left 1.5 million eligible Texans without health insurance (2). Consequently, a 300 percent increase in costs for primary care services, being provided in the emergency department, has been observed (1). Similarly, most hospitals are facing nearly $3-5 billion in losses due to uncompensated care (1).

In the state of Texas Medicaid is funded by state and federal programs. Those eligible to receive Medicare benefit is the low income individuals, families, children, pregnant women, elderly and individuals who suffer with disabilities (Hegar). The Texas Health and Human Service commission (HHSC) distributes the Medicaid (Hegar). Those receiving Medicaid benefits in the fiscal year of 2010 were found to be 55 percent female and 77 percent under the age of 21 (Hegar). Children accounted for 66 percent of all Texas Medicaid recipients in that year; however, 32 percent of those children actually received health care (Hegar).

Medicaid expansion is seen as a huge problem in this case it takes place among the 50 states. The environment includes the 50 states such as California, Texas, New York and New Jersey. Medicaid expansion offers financial protection. It also addresses the uncompensated care problem which involves paying and reimbursement for service rendered. Medicaid expansion also provides customers access to affordable coverage, as well as customers taking up that cover, which is a moral duty of the government. Medicaid also supports politically powerful interest groups who support expansion. The expansion of Medicaid helps rural hospitals stay afloat in states like Colorado, which added 400,000 people to the health insurance program under

This paper outlines the impacts that the Affordable Care Act (ACA) has had on different groups in North Carolina since its signing in 2010. First the paper discusses health care financing as outlined in the case study about "The Impact of the Affordable Care Act on North Carolina’s Uninsured Population" published in Health Policy and Politics Nurses’ Guide. Next it discusses the impacts that ACA has had on the affected population. The topic that follows analyzes the impact of the act on both small and large organizations. Finally, the paper discusses how this act has affected patients and concludes by analyzing its ethical implications.

Following the death of a Medicaid recipient, the program not only can but must attempt to recover costs from the estate of the deceased. Medicaid's official site says:

People don’t like being sick, however, some Missourians forego preventive care, required doctor visits and beneficial medicines because they cannot afford them. They may be working in part time jobs, seasonal jobs or other unskilled labor jobs and lack affordable health insurance. They are the poor people below the 138% federal poverty level (FDP). According to Chris Kelly, a former Representative of the Missouri House for district 24, the West Plains hospital Ozark Medical Center’s (OMC) service area includes more than 9,000 uninsured adults (p1). So, what do you do when you are poor and sick and can’t afford a doctor’s visit? You go to the emergency room of a local hospital and the hospital absorbs that

Medicare is the federal health insurance program for people with certain disabilities, end stage renal disease, and for those who are over the age of 65. There are four different parts to Medicare, part A, part B, part C, and part D. Medicare Part A, also known as hospital insurance, covers inpatient hospital stays, care in nursing facilities, hospice care, and some in home health care. Part B is often referred to as medical insurance; it covers certain doctors’ services, outpatient care, medical supplies, and preventative care services. Medicare Part C, otherwise known as Medicare advantage plan is offered by a private

The Affordable Care Act (ACA) highlighted the importance Medicaid played in insuring every American receive healthcare coverage. (42 U.S.C., 2010) Medicaid provides health benefits to over 71 million across the country. While involvement is optional, all 50 states participate in the program and requirements differ across the nation. The flexibility given to each state has allowed them to make their own decisions to work towards improvements that they believe would best benefit their region (Feldstein, 2015, p. 125-126).

This paper covers the topic of Texas refusing to expand Medicaid. We will look at where the social welfare program came from, and also look at Obama and his affordable healthcare act in relation to how that is ties into the expansion of Medicaid and why Obama president felt that it was important. We will look at Governor Rick Perry’s along with Governor Greg Abbott’s viewpoints and why it is they that feel expanding Medicaid would not have been in the best interests of Texas. Finally we will take a look at my viewpoints on all of the issues currently at hand.

States are being pressured to expand Medicaid to families earning up to $30,000 a year, just like the Affordable Care Act permits. While several respected governors have agreed to expand the program, many other governors and state legislators are cautious. These officials do not want to deny Americans their access to health care, however they do want to slow the expansion of a program that will provide them with limited access to quality care while destroying state budgets. One of the strongest arguments that can be made against the expansion of Medicaid is the fact that States simply can not afford it. The appeal to states to expand Medicaid is that the federal government will cover 100% of the cost through 2016 and eventually lowering to