More handpicked essays just for you.
Case study on end stage kidney disease
End stage renal disease case study
Comparing managed care medicare and medicaid
Don’t take our word for it - see why 10 million students trust us with their essay needs.
Recommended: Case study on end stage kidney disease
Medicare and Medicaid are both government owned programs that provide health care insurance policies to those who meet the aligned criteria. Medicare being one that is specifically for people 65 years of age or older with some loop holes for people younger than 65. Medicaid is one for low-income earning adults and is available to anyone in general. There are some similarities that are few and far in between. But there are some obvious differences between the two.
A few things about Medicare is that it is a federal health insurance program for people who are 65 years of age or older, although certain people under the age of 65 that have disabilities and people with End-Stage Renal Disease can also qualify for Medicare. There are four types to
The Joint Commission is a nonprofit organization that focuses on improving the Healthcare system. They do this by regulating and evaluating health care organizations, helping them improve and give a more effective and safe care (The Joint Commission, 2012). The National Patient safety goals are ways in which the joint commission strives to improve the way health care is provided (The Joint Commission, 2012). Effective on January 1, 2012, the Joint commission came up with new ways to improve the Care of Medicare Based Long term Care facilities and provided Safety regulations to be followed. In order to better understand the impact that this regulations have in the healthcare, it is necessary to identify and describe the purpose of each regulation, and emphasize on the impact that falls in particular, can have among the geriatric patients.
What exactly is Medicaid? Medicaid is the largest health insurance in the United States, and it services many low-income families. This government health program is state regulated and varies among states due to having their own guidelines. Medicaid was signed into law on July the 30th, 1965. Medicaid’s guidelines come from the old Welfare law. “Medicaid has never matched that of food stamps, for which eligibility standards are linked to financial need alone. As Smith and Moore explains, the federal government, using its extraordinary demonstration powers under section 1115 of the Social Security Act, has allowed states to experiment with “decategorization” over the years, but Medicaid’s statutory bar against coverage of poor adults remains perhaps its most obvious failure” (Rosenbaum). Regardless of the many faults of this programs design, Medicaid helps close to 60 million low-income families in the United States. The people it helps would include: pregnant women, young children and their parents, the disabled, and the elderly, and other members of society that have low income. Medicaid is involved in many pregnancies and newborn care from a financial standpoint. It allows parents to have medical care for the child while in a low-income household. Medicaid has a huge impact on each states health systems and is used in a wide variety of ways.
Medicare is a social policy many of our seniors look to for their stability when they reach 65
As many are aware, in most cases, when you turn 65, you qualify to apply for Medicare. In most cases, to qualify for Medicare, you need to be 65 and you or your spouse have worked and paid Medicare and Social Security payroll taxes for at least 10 years (Parker, 2014). Medicare is US’s national health insurance program for the citizens and legal permanent residents. Medicare evolved over years and now has four parts. There are mandatory for all to enroll and others are optional.
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)
Implemented (along with Medicare) as a part of the Social Security Amendments of 1965, Medicaid’s original purpose was to improve the health of the working poor who might otherwise go without medical care for themselves and their families. Medicaid also assisted low income seniors with cautionary provisions that paid for the costs of nursing facility care and other medical expenses such as premiums and copayments that were not covered through Medicare. Eligibility for Medicaid is usually based on the family’s or individual’s income and assets. When the ACA came into effect in 2010, it began to work with the states to develop a plan to better coordinate the two ...
Medicare was designed as a universal healthcare program for individuals 65 years old and older. This program is funded by Medicare taxes and general federal funding withholding taxes. Medicare is a partnership between federal and state with the goal to provide medical insurance to the elderly that is poor and disabled. Generally all people who are 65 years or older and qualify for social security will automatically qualify for Medicare.
for Medicare, you must meet certain conditions. A person qualifies if they are 65 years of age
Medicare provides healthcare coverage for individuals over the age of 65, in addition, to others meeting certain criteria. The government funds Medicare through the administration of the federal Centers for Medicare and Medicaid and spends billions annually, on the program. Fraud runs rampantly throughout the healthcare program due to the enormous amount of money spent and the large number of people enrolled in the program. Fighting fraud of this nature necessitates diligence by everyone. Protecting oneself entails understanding what constitutes fraud, identifying it, noting suspicious practices, and taking steps towards prevention.
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.
Medicare was designed for beneficiaries sixty five years and older and enrollees who are permanently disabled and are unable to work. Medicare benefits are applied for at the Social Security office, where proof of eligibility is required. Medicaid however is health care benefits for those who are low income and do not have insurance through their job (Medicare.gov, 2008).
Medicare Advantage plans is different insurance companies that offer insurance coverage for patients that qualify for traditional Medicare. These plans are produced by private companies and approved by Medicare. Medicare in turns pays a fixed amount to the companies to provide coverage for these patients. Each company has different out-of-pockets and different rules. Some may require referrals or authorizations for services and some my only offer in network benefits to name a few (How do Medicare Advantage Plans work?).
Medicare is the nation’s largest health insurance program. Generally, you are eligible for Medicare if you or your spouse worked for at least ten years in Medicare-covered employment and you are 65 years old and a citizen or permanent resident of the United States. Medicare-covered services include hospital insurance, inpatient hospital care, skilled nursing facility care, home health care, hospice care, and medical insurance (Medicare U.S.) With such an encompassing effect on the health insurance field, Medicare provides a haven for older individuals, and end-stage renal disease (ESRD) patients who require the best medical care for whatever possible reason. The only problem with this scenario is that doctors are turning many older patients away because they have Medicare. Why do doctors turn away Medicare patients? Is there a reason why certain doctors turn away certain patients?
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.
Health reform and health policy has taken over in the United States in recent years. Medicaid is one of the top policies being implemented throughout our nation today. To understand how Medicaid and federalism cross paths with each other one must understand the basic definitions and concepts each one brings. Federalism is “system of government in which the same territory is controlled by two levels of government. Generally, an overarching national government governs issues that affect the entire country, and smaller subdivisions govern issues of local concern.” In short, federalism is a government system that has an overseeing central government over state government. While, “Medicaid is a health insurance program for low-income individuals and families who cannot afford health care costs. Medicaid serves low-income parents, children, seniors, and people with disabilities.” Medicaid is a test based welfare program for United States Citizens. Now the question is how does Medicaid intersect with federalism? These two intersect because Medicaid is a need-based program that is funded by the federal government and the state government and administered at the state level. The issue with Medicaid is that if it expands then a crowding-out effect may occur. Meaning, that the more the government spends on Medicaid then less they would be able to spend on other programs such as: education, transportation, or other state priorities. Medicaid is supposed to provide access to health insurance for approximately half of our nations uninsured citizens. Without Medicaid a vast amount of low-income citizens will go without having a healthcare insurance plan.