Medicare is a federal health insurance program for people, who are age sixty five or older, or people that have End Stage Renal Disease and permanent disabilities. There are four different entities of Medicare to include; Medicare Part A which is the Hospital Benefit that covers inpatient hospital services, hospice treatment, skilled nursing facilities and other home health services. Medicare Part B that covers the Professional component of the physicians' services, preventive services and medical supplies then there is Medicare Part C which is considered a Medicare Advantage Plans that is offered by a private company that has a contract with Medicare to provide the patient with both Part A and Part B benefits. A Medicare Advantage Plans consist of Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), and Private Fee for Special Needs Plans, Service Plans, and Medicare Medical Savings Account Plans.
Medicare suppliers must be accredited by the Joint Commission (JC) or by a state regulated survey, which is performed by selected state agencies on behalf of the Centers for Medicare and Medicaid (CMS). As of July 2010 the CMS monitor and provide guidelines which the Joint Commission incorporates into its review processes. Accreditation consists of a in depth review of a hospital's physical plant, patient care , medical staffing and services based on quality factors and standards produced by CMS, as well as conditions of participation requirements under the Title 42, Part 482, of the United States Code.
§ 482.1
(a) Statutory basis. (1) Section 1861(e) of the Act provides that
(i) A Hospitals participating in Medicare must meet certain specified requirements; and
(ii) The Secretary may impose additiona...
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... financing, mathematics, computer science or business as well as four to five years of work experience handling intricate database and information management.
Medicare impact the Health Informatics workplace by implementing the changes in the healthcare industry such as health insurance plans and the increase in healthcare costs as Medicare and other organizations seek to create efficiencies to reduce their costs it is beneficial for them to do so through technology by building more systems and being optimized. Health Informatics is in high demand for many practices that use Electronic health records to maintain standards defined by the Centers for Medicare & Medicaid Services (CMS) Incentive Programs that governs the use of electronic health records and allows eligible providers and hospitals to earn incentive payments by meeting specific record keeping criteria.
Kaiser Permanente’s mission is to provide care assistance to those in need. As a health maintenance organization, Kaiser Permanente provides preventive care such as prenatal care, immunizations, diagnostics, hospital medical and pharmacy services. Also, they take responsibility and provide exceptional training for their future health professionals for better clinical performance and treatment for the patients. The organization is to ensure fair and proper treatment towards their employees for a pleasant working environment in hospital and to provide medical services especially in a growing population in suburban communities, such as Tracy and Stockton in California.
The objective of the MCEG is to provide channels to exchange information between managed care/health plan information systems executives and to provide opportunity for personal networking. MCEG provides a forum to develop policy which relates to the use of information technology and healthcare. MCEG provides feedback to vendor sponsors and other vendors on the trends and types of technology needed to ensure that their products and strategies meet their customer’s present and future managed care needs. Additionally, their objective is to “educate executives on clinical and administrative trends in health care, new and emerging technologies, and other pertinent information to assist in achieving the key goals of cost containment, effective service and high quality health care.” (Why We Matter, 2011)
Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities and people of any age with End-Stage Renal Disease. There are four subcategories of Medicare. Part A is for hospital stays or, with certain restrictions, at-home care for a limited number of days. Part B is more like regular medical insurance. It covers ambulatory care and physician fees. There is a deductible and are sometimes co-pays as well. Part C is presented as an alternative to parts A and B. It is where private insurance companies can contract with the federal government to offer Medicare benefits through their own policies. It can offer benefits not covered under original Medicare, although there might be a premium charged. Part D is the prescription plan for enrollees. (Centers for Medicare and Medicaid Services, 2010)
There are four components to the Medicare program, part A, B, C and D. Part A of Medicare covers in patient hospital services; patients have a financial responsibility to cover a deductible that is equivalent to 1 day of hospitalization, thereafter cost is covered at 100 percent for a maximum of 60 days. This also includes nursing facilities, home and hospice care. Part B covers outpatient surgery and physician office visits. This is an elective component of Medicare in that there is a premium associated with this plan that is paid for directly through social security payments. Part C is know as Medicare Advantage and is a supplemental policy that is purchased directly from employers; one may be denied for health reasons depending one when the plan is acquired. Part D is prescription drug coverage that is eligible to all individuals that qualify for Medicare. Beneficiaries of the Medicare choose which prescription plan they want and pay a corresponding monthly premium.
Conditions of Participation was created to ensure all facilities participating in Medicare follow a set of regulations that protect the safety of Medicare recipients. In 1986 revisions were made to reinforce accreditation and certification procedures. Participating hospitals that are accredited by the Joint Commission on Accreditation of Healthcare Organizations or American Osteopathic Association have been deemed to meeting Conditions of Participation requirements on the wellbeing of Medicare Recipients. The Joint Commission on Accreditation of Healthcare Organizations also requires that the facilities are licensed by their state. (Lohr, 1990, p.
If I can turn back in time, I would advise my young self to join the Kaiser Permanente volunteering program sooner and to skip the small conversations in meetings. Those talks may seem necessary for the first few times, but this communication method can become meaningless since people do not interact on a personal level. Joining the program had supported me by allowing me to associate with various friends through teamwork and encouraged me to thrive beyond my comfort zone.
According to Medicare’s WebPage Medicare is a Health Insurance Program for people 65 years of age and older, some disabled people under 65 years of age, and people with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant). Medicare has two parts, Part A which is for basically hospital insurance. Most people do not have to pay for Part A. In addition it has a Part B, which is basically medical insurance. Most people pay a small monthly fee for Part B. Medicare first went into effect in 1966 and was originally administered by the Social Security Administration. In 1977 the control of it was switched over to the newly formed Health Care Financing Administration. Beginning in July 1973 Medicare was extended to persons under the age of 65 with certain disabling conditions. In 1988 Congress passed legislation to expand the program to cover health care costs of catastrophic illnesses.
There are several issues concerning the uninsured and underinsured patient population in America. There are many areas of concern the congressional efforts to increase the availability of health insurance, the public image of the insurance industry illustrated by the movie "John Q", the lack of good management tools, and creating health insurance coverage for all low income Americans. Since the number of uninsured Americans has risen to 43 million from 37 million in the flourishing 1990s and could shoot up even more severely if the economy continues to decrease and health care premiums keep increasing (Insurance No Simple Fix, 2001).
Obamacare: the Temporary Solution to an Evolving Issue The need for universal health care within the United States has been evident, and needs to be addressed. The old healthcare system was plagued with issues, including expensive premiums that were on the rise, along with an inflated average infant mortality rate and limited average life expectancy, which ultimately led to many people being left uninsured (“Affordable” 2). In the 2012 presidential election, one key issue was how to reform America’s broken health care system, and to instate a successful universal healthcare system that has resolved the previous issues. Being one of the last influential and competitive countries in the world without universal healthcare, the pressure was on for the United States to develop its own system.
The two major components of Medicare, the Hospital Insurance Program (Part A of Medicare) and the supplementary Medical Insurance program (Part B) may be exhausted by the year 2025, another sad fact of the Medicare situation at hand (“Medicare’s Future”). The burden brought about by the unfair dealings of HMO’s is having an adverse affect on the Medicare system. With the incredibly large burden brought about by the large amount of patients that Medicare is handed, it is becoming increasingly difficult to fund the system in the way that is necessary for it to function effectively. Most elderly people over the age of 65 are eligible for Medicare, but for a quite disturbing reason they are not able to reap the benefits of the taxes they have paid. Medicare is a national health plan covering 40 mi...
Medicare is a federally governed insurance program, primarily serving Americans over the age of 65, younger disabled meeting specific disability criteria, and dialysis patients having permanent kidney failure. Medicare is linked to Social Security, is not income based, and is available to every American meeting the requirements of the program. Those entitled to Medicare can select Original Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) paying co-insurance and deductibles or opt to add Part C (Medicare Advantage Plans) paying a monthly premium and co-payments normally less than the out-of-pocket expenses for Original Medicare.
Medicare is a national social insurance program, run by the U.S. federal government since 1966 that promises health insurance for Americans aged 65 and older and younger people with disabilities. Being the nation’s single largest health insurance program, covering a large population for a wide range of health services, Medicare's funding is a fundamental part of it sustainability. Medicare is comprised of several different parts, serving different purposes, some of which require separate funding. In general, people at the age of 65 and older who have been legal residents of the United States for at least 5 years are eligible for Medicare. Same is true with people that have disabilities under 65, if they receive Social Security Disability Insurance benefits. Medicare involves four parts: Part A is hospital insurance. Part B is additional medical insurance, that Part A doesn't cover. Part C health plans, also mostly known as Medicare Advantage, are another way for original Medicare beneficiaries to receive their Part A, B and D benefits. Medicare Part D covers many prescription drugs, some of which are covered by Part B. Medicare is a major operation, not only needing adequate administering but the necessary allocated funds to keep this massive system afloat.
Access to health care refers to the ease with which an individual can obtain needed medical services. Many Americans face barriers that make it difficult to obtain basic health care services. These barriers to services include lack of availability, high cost, and lack of insurance coverage. "Limited access to health care impacts people's ability to reach their full potential, negatively affecting their quality of life." (Access to Health Services, 2014) Access to health services encompasses four components that include coverage, services, timeliness, and workforce
...ue to numerous medical errors. With the amount of medical errors that currently do occur which is a current health care issue it cost the health care billions of dollar each year to fix the mistakes that were made.
Health care has always been an interesting topic all over the world. Voltaire once said, “The art of medicine consists of amusing the patient while nature cures the disease.” It may seem like health care that nothing gets accomplished in different health care systems, but ultimately many trying to cures diseases and improve health care systems.