Medicare, is so underfunded that in 2012, the Medicare trustees reported that the Medicare trust would
Medicare, is so underfunded that in 2012, the Medicare trustees reported that the Medicare trust would
This paper is an overview of the Medicare system and how it works. The document is intended…
of payment for care provided, the focus of our nation’s health care dilemma should be focused…
Medicare is not in a good position right now: rising costs are predicted to bankrupt the present system. The steady rise in costs due to technology and an aging population necessitate changes to Medicare. There are proposed alternatives to reduce costs of Medicare over the long run. The current health care system has to be more flexible, participant-controlled, and outcomes-oriented.…
It is common knowledge that the ACA has granted more Americans access to health care insurance. As discussed earlier, the increase in insured persons means more patients in the already burdened health care system. The up-front cost of providing care to nearly 16.4 million Americans will be great to health care providers and organizations. The ACA presented new concepts to health delivery that move away from the traditional fee-for-service payment model in hopes to increase quality of care, improve patient outcomes, reduce costs, and increase savings to providers and organizations. The Accountable Care Organization (ACO) is a model implemented by the ACA to allow economic incentives for organizations.…
“In light of the high and rapidly growing cost of healthcare in the U.S., there has been growing interest both in the federal government and in states and regions across the country in finding ways to encourage health care providers to take greater accountability for the overall cost as well as the quality of healthcare delivered to patients. A healthcare provider or group of providers that accepts accountability for the total cost of care received by a population of patients has been termed an “Accountable Care Organization”’ (http://www.chqpr.org/)…
The healthcare system in the United States runs primarily as a private multi-payer system, with a couple of public choices. Private physician offices, hospitals, and healthcare facilities are moving away from fee for service healthcare, and transitioning to value based care. The intent is to change the way America spends on healthcare by causing providers to get paid not by the number of visits or test they order, but on the value of care they deliver (Brown, 2016). Medical insurance in the country is also supplied mostly by private health insurance companies.…
health care system is dysfunctional and can no longer continue as it currently operates. With or without Affordable Care Act (ACA), there is a need for a deep change. The United States spends more money on health care because a nation is less healthy on the average than the rest of the developed world. The system is dysfunctional and ACA is fast-tracking the process of changes that will be faced by the economic and business challenges by health care organizations. The required adjustments to healthcare organizations operating budgets and methodologies for delivering medicine may become a big issue. Health care organizations will have to go from volume-based reimbursement in medicine based on the number of procedures done or patients seen to a value-based system that will give the same money for every patient regardless of the procedure performed. Health care organizations may have lower income since they will treat more patients. They may face cost-pressure factors such as the overall cost of medical care and the increased incidence of chronic disease, cost transparency and reference pricing, increased government role in paying for care, increased coverage and limited highly skilled medical workforce There is a prediction that forty million more people will be covered nationally, at reimbursement rates below the cost of providing that care (Adams et al.,…
Private divisions of insurances are not only enduring obstacles due to the health care spending, but Medicare and Medicaid are also being affected greatly. With having The Health Care Reform Act in effect soon it will hopefully assist in driving down or maintain the cost of health care received and used by citizens. The reform also stated that it will offer a distribution system that works more efficiently for medical professions and…
The idea that each individual is able to pay for and afford private health insurance has become less of a reality in the last 25 years. Under the new social contract, health care consumers would have to take a new level of responsibility for their care and their health. Those who can afford healthcare will be expected to pay, while those who cannot will be cared for by Medicaid or Medicare. The Medicaid program will be available to an estimated 20 million new patients in 2014 (Davis, Abrams & Stremekis, 2011). The future of care is about personal and social responsibility.…
Obamacare leaves the Medicare payment system defective in its place, leaving no solution to the perpetual problem faced by Medicare physicians, the flawed physician payment system. Doctors expected the government to find a solution to this problem, but the government did not. Doctors will now have to rely on unreliable government reimbursement for medical services they provide. Now, doctors will have to face the threat of payment cuts that make their work harder and more stressful than it already is. By 2014, doctors are facing a cut of 25 percent of payments unless Congress passes a law to stop this. Obamacare also imposes more rules, regulations and restrictions to physicians. According to Senger (2013) , " Since 2010, with few exceptions, the law prohibited physicians from referring Medicare patients to hospitals in which they have ownership. Thus, a whole class of physician-owned, specialty hospitals has been removed from competition, even though they enjoyed an undisputed record of providing high-quality patient care.’…
With the ever-changing difficulties of our health insurance landscape, the government has taken a more active role in the health care and well-being of American citizens. With this shift, programs like Medicare and Medicaid, become polarizing topics in an environment where individual finances are tight, our economy is struggling, and the future is no longer as predictable or financial secure as we once believed it to be. Medicare and Medicaid programs will be the focus of this analysis. The paper will explore the history behind these programs, some common fraud and abuse methods and techniques, and will finally discuss possible solutions and tactics in place to mitigate future manipulation of these programs.…
Private medical insurance is valuable to have, but can come with many disadvantages for the consumer. The article “the U.S. Healthcare system” focused on the faults of the United States healthcare system when compared to other countries with Universal healthcare. America has the most expensive healthcare system in the world. One reason for the rising cost of healthcare in America is that an estimated “19.3 to 24.1 % of the money is spent on administration cost. Obama wants to make sure that America is not being taken advantage of by insurance and prescription drug companies. Some insurance companies are overcharging doctors for their malpractice insurance, which is causing patients to have to pay more in order to be seen by a doctor.…
The HITECH act will promote the meaningful use of health information technology and electronic medical records. This will enable the development of a nationwide infrastructure allowing the electronic use and exchange of information. The Patient…
Dr. Don Berwick, Head of Medicare/Medicaid 2010-2011 whom talks about how unsustainable the healthcare system is. We’re spending almost twice as much in America as any other country on earth. Yearly, we have been spending $2.7 trillion in healthcare. The average per capita cost of healthcare in the developed world is about $3,000, but in the United States, it was around $8,000 annually, more than double. Due to these astronomical amounts, healthcare has not become affordable anymore. Insurance companies are raising their rates they are charging for premiums, covering less on patient care, which in turns takes even more money out of our pockets because we now not only have to pay the premiums, but are now left with the portion of the care given that we must pay for out of our pockets.…
In the past fifty years, health care costs have continued to rise to the point that some low-income families and the elderly are unable to get medical treatment. Decentralization of the hospital care system has prompted private companies to enter the health care industry. The 21st Century ushered in the biggest "can of worms" our health care system had ever seen!…