Medicare-Recent Changes In Healthcare

Many proposals to reorganize Medicare could increase the financial and health risks faced by the vulnerable elderly. Turning Medicare into a premium-support system a voucher set randomly at the value of the second-least-expensive insurance plan could shift costs to elderly households. Increasing the Medicare eligibility age from 65 to 67 will leave many Americans ages 65 and 66 without insurance. The basic idea of part A Medicare payment is simple. The patient pays a deductible that approximately equal to the cost of the first day in the hospital;

Medicare changed overtime and in 1983 adopted the Prospective Payment Plan. PPS was designed to pay a facility a lump some to provide services for a set amount of patients covered by Medicare. One of the reasons behind it was to encourage health care practitioners to proved services in a timely manner in order to shorten the rehabilitation time of an individual.

Since the late 1980s, Medicare has reimbursed physician services using the Medicare Physician Fee Schedule (MPFS), which encompasses 10,000 procedure codes. Each code is assigned resource-based relative value units (RVUs), which are designed to reflect physician work, practice expense, and malpractice expense. To adjust for local differences in cost of living, each RVU is modified using geographic practice cost indexes (GPCIs) and then converted to dollars using a “conversion factor.” This system rewards physicians who produce a high volume of services; not surprisingly, Medicare Part B expenditures have grown rapidly.

Medicare has gone through many changes through the years since President Johnson signed the programs, including Medicaid into law in 1965. Almost ¾ of the senior population, over 65 were uninsured. Even before that President Truman was eager to start a national health insurance plan, in 1945. In 2003, President GW Bush added a prescription drug plan to Medicare. Even President Teddy Roosevelt proposed a national health insurance plan when he was running in 1912. In 1972, President Nixon signed a bill allowing people with long-term disabilities under the age of 65 and patients with ESRD (End Stage Renal Disease), to be covered. Over the years more services were accepted for Medicare coverage, including hospice and home health. 2010 brought good

Why do the elderly feel that Medicare is an insurance program, not a welfare program? Is this perception accurate?

Since 1965, Medicare has been attempting to provide low cost, guaranteed access to much needed healthcare for senior citizens over the age of 65 and other age groups that suffer from disabilities and terminal diseases. These people represent some of the most vulnerable population groups in the United States. Most do not work, and rely on Medicare to provide them the access to healthcare they need. Unlike privatized health insurance companies, Medicare is a social insurance program that is paid for through federal mandates and tax payer funds. Billions of dollars are spent annually on over 50 million Americans in need (Alonso-Zaldivar 1). The care structure itself is broken into several main parts: Medicare Part A covers hospital costs, Part B cover most outpatient care costs, and Part C and D cover prescription drug costs through dealing with other private insurance. Yet, the upcoming election in November is threatening to change and alter the structure. Each candidate has his own plan to deal with Medicare; both are trying to reign in the costs of operating Medicare, but with some elements being obviously more beneficial for Medicare recipients than others.

One of the issues is the increasing cost of healthcare which is dominating the health policy in U.S. this is accompanied by an increase in spending on healthcare. According to projections by the government, the spending on medical care will continue to rise. U.S spends more money on health care than any other nation globally (Holtz, 2013). The increase in the spending is as a result of improved tools for disease diagnosis, better surgical interventions among others. This raises an issue for the policy makers on the maximum GDP percentage that a country has to spend on healthcare, and whether the nation will afford the cost that is continually growing. In contemplating any change in the health policy, policy makers should consider the cost of the healthcare and the ability of the nation to support that high cost.

The Patient Protection and Affordable Care Act (Obamacare) had mame dramatic changes in the field of the health care system, especially in Medicare, that will seriously take effect in American seniors. Indeed, much of the health law’s new spending is financed by spending reductions in the Medicare program. In addition to the provider payment reductions, Obamacare significantly reduces payments to Medicare Advantage (MA) plans by an estimated $156 billion from 2013 to 2022.( Elmendorf, letter to Speaker Boehner). About 27 percent of all Medicare beneficiaries are enrolled in MA plans, a system of regulated and private plans competing against each other as an alternative to traditional Medicare. MA plans are attractive to beneficiaries because they offer more generous and comprehensive coverage than traditional Medicare by capping out-of-pocket costs and offering drug coverage to a rasonable

Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those with disabilities and those who have permanent kidney failure. There are several changes for Medicare enrollees in 2017. The average increase is more than $4/month, and average premiums will be about $109/month for about 70 percent of enrollees. But the exact amount they’ll pay will vary depending on the dollar amount of the cost of living adjustment on their Social Security checks.

Access to Medicare services to the implementation of Affordable Care Act, commonly called Obamacare, some say that some will have difficulty finding doctors to accept new Medicare patients and to think that the service provided to Medicare beneficiaries will decline is also a myth. Looking at the findings from the 2011 Medicare Current Beneficiary Survey Access to Care research files, one can see the care given to Medicare beneficiaries. In 2011, 96.7 percent of surveyed Medicare beneficiaries claimed that they were satisfied with the quality of care given, which is an increase from 95.1 percent, just ten years ago (CMS, 2012). Giving their doctors good to excellent ratings for the services they provided to them while in their care. These beneficiaries are those who have private health insurance and also expect access to healthcare when Obamacare is implemented next year. But Medicare is gearing up to keep with the coming changes with plans to help beneficiaries. First thing beneficiaries should know is that Medicare is protected, so beneficiaries have the same coverage they had this year, regardless if it’s traditional Medicare or Medicare Advantage Plan. Medicare now covers certain preventive services, like mammograms or colonoscopies, without charging you for the Part B coinsurance or deductible, to include free wellness visits (Medicare, 2013). This is not the only good news; Obamacare ensures Medicare protection for another 12-year through 2029. Doctors will see more support from CMS programs through new initiatives and resources to support care coordination (Medicare,

A newest way to finance health care now days is the health care reform which it is also called Obama Care. The Affordable Care Act was signed into law in 2010. The main objective behind the Affordable Care Act was to ensure that affordable health care insurance was available to every U.S citizen. This law is an extensive document that contains many regulations and laws that relate not only to health care but also to the regulation of insurance companies. One of the best known regulations is that group health plans can no longer put limitations or deny benefits to individuals under the age of 19 due to pre-existing conditions and individuals under the age of 26, are now eligible to be covered under their parents’

Medicare enrollees in Utah have saved about $78 million on prescription drugs due to the ACA. Coverage for both brand name and generic drugs will continue to increase until the coverage gap is closed. The ACA also allows Medicare beneficiaries to seek preventive services without worrying about cost, due to the lack of deductibles and copays. This aids in detecting and treating health problems early on. In Utah in 2014, 220,972 individuals with Medicare used free preventive services. In addition to that, fraud is at a minimum due to tougher screening procedures, penalties, and technology developments.

If you are 65 or older, you may have many questions about Medicare and Medicare supplements. With so many choices on the market, it can become quite confusing as to what coverages you have available through your basic Medicare and what supplemental plans offer.

The growing concern regarding the financial security of Medicare is one of particular interest to the nearly 72 million baby boomers that become eligible for this government-assisted, and tax-payer bolstered, program over the next two decades. According to the U.S. Census Bureau (2010), there will be a rapid increase in baby-boomers between 2010 and 2030, as the entire baby boomer population move into the 65 years and over category (p.3). Political and financial revisions must be made to ensure the security of Medicare as the numbers of individuals paying into this program are soon to be surpassed by the number of individuals drawing-off this program (U.S. Census Bureau, 2010). The elderly are also at a disadvantage with transportation to health care visits, picking up prescriptions, and rehabilitation services. There needs to be an establishment of access not only to primary care providers, hospitals, and rehabilitation services, but access to other aspects of the health care system for the elderly population.

Some of the recent changes in health care include and problems we are facing include ; development of the integrated care models, increase in suicide rates among adolescents, shortage of availability of child psychiatrist resulting in expanded role of the pediatricians in treating children with mental illness