Medicare and Medicaid

Centers for Medicare and Medicaid Services (CMS) developed a methodology Diagnosis Related Groups (DRGs) under the Inpatient Prospective Payment System (IPPS) to describe all kinds of patient services provided in an acute care hospital. Later, in 1987 3M developed an all patient DRG (AP-DRG) system based on a New York’s hospital reimbursement program for non-Medicare discharges. In 1989, Yale University came up with Refined DRG (RDRG) system to identify the severity of illness incurred to…

due to the war in Korea. President Kennedy made a push as well but was thwarted. However, President Johnson did gain some traction in 1965 with the enactment of Medicare and Medicaid. But these public programs still failed to provide universal, government-sponsored healthcare for all. Medicare covers healthcare for the elderly and Medicaid covers the poor and disabled. These programs were easy to sell to fellow Americans’ as they saw these groups worthy of government assistance. But as for the…

role the Doctor of Nursing Practice (DNP) education plays in VBP collectively. VBP is a transition from fee for services to a service based on outcomes initiatives for patient care improvements. The program is overseen by the Centers for Medicare and Medicaid Services (CMS), however the concept…

employer, and are covered for whatever benefits their coverage provides (Palfreman et al., 2009). Due to the market system, the price of healthcare has skyrocketed and healthcare is roughly eighteen percent of the nations GDP (Centers for Medicare and Medicaid Services,…

therapists, aides as well as case workers are employed to provide the best care possible at the end of someone’s life. Since the terminally ill are provided medical services, there are certain rules and regulations they must follow according to Medicare, Medicaid and insurance companies. A challenge comes when you are trying to accommodate the needs of the dying with respect and dignity and at the same time comply with the rules created by the government and insurance companies. Hospice…

law includes many new benefits and protections for health care consumers. Some of the major benefits include: elimination the life-time and annual benefit limits, insuring people with pre-existing conditions, free preventive care, and expanding the Medicaid program. ACA requires most Americans to have health insurance coverages. Individuals, families and small business employers can choose and buy health insurance policies through competitive insurance markets, and can receive premium tax…

Other healthcare providers are part of the interprofessional healthcare team that takes part in creating a wholesome care plan. Communication among all healthcare providers is essential to provide the best care possible for the patients. Upon arriving at Wesley Place, if the patient does not already have a physician of their own they are assigned a physician to oversee their care. Nurses check vitals, administer medications, and check for changes in symptoms. The OT’s and SLP’s help to provide…

uninsured. After the Affordable Care Act was passed, roughly 13 million people were uninsured. Obamacare overall helps the elderly get more affordable health insurance. Obamacare lowers the premiums and deductibles for the 57 million elderly using medicare. Obamacare also lowers the cost of prescription drugs. The Affordable Care Act allows more people to have health insurance by forcing companies with at least 50 workers to provide healthcare to their employees, as long as they work more than…

through Medicaid, this is funded by state and federal taxpayers. The term long term car means people with chronic illnesses, disabilities, and conditions that require daily assistance. The older you get, the better chance you are to be in a long term care facility, 70% of people over 65 can sooner or later be in a nursing home. The regulations state and federal are to protect the patients from neglect and abuse. Nursing homes are required in order to participate in Medicare and Medicaid to…

The Older Americans Act (OAA) was enacted by congress in 1965 and was signed into law by former President Lynden Johnson. OAA generated the groundwork to coordinate and provide community-based services and supports for older adults and their families. Its mission is extensive: “to help older people maintain maximum independence in their homes and communities and to promote a continuum of care for the vulnerable elderly” (nhpf, 2012). Aging is an uncontrollable process in life. It is defined as…