Health care facilities are instated for the ostensible reason of offering quality healthcare to the people that need these services. However, the healthcare sector has been experiencing various setbacks in its objectivity of offering high quality services to the public…
The people that need these services are directly affected when the health sector is not up to their task (Thorpe and Cascio, 2013). Therefore, it is in the best interests of the health care sector to guarantee it has contained all its challenges and setbacks in ensuring the public is getting the much needed services without delay.
The stagnating problem in the health care sector is provision of high quality services that are affordable by all the people in the region. According to the recent statistics, many people find it hard to afford the health care services and in most cases, they have to struggle in acquiring such services (Elliott, 2012). They have constrained budgets and have to minimize these budgets to continue living. As such, some people find it a prudent idea to forego healthcare services as they find these resources useful in other needy situations. This is a repulsive problem in many populations that find health care services expensive (Shortell, Casalino and Fisher, 2010). Similarly, there is a stagnating problem when governing bodies try to improve the quality of health care and delivery of these services. The health care is marred with costs that are increasing with every move they take to improve the delivery of health care services (Rogers, 2006). As such, the healthcare sector is in a bizarre situation where it is trying to reduce costs in delivering affordable health care, but on the other hand, the costs keep bulging due to the need to improve the service delivery. (CMS Innovation Center, 2012). How Addressed by ACA The ACA created the centre for Medicare and Medicaid innovation to deal with the issue. The institution is crafted for the ostensible reason of perfecting health care delivery and focusing on the payment systems (The Center for Medicare and Medicaid, 2012). Similarly, the institution is mandated to support care coordination in the health care sector and enhancing professional practice in healthcare. This institution was instated to deal with the menace of high spending in the health care sector while dealing with provision of high quality services. There are various approaches that are used by the CMS (Sharamotaro, 2011). First, it was to test the delivery and payment models in the institutions which would be used to measure the improvement in service delivery. Secondly, the institutions considered relaxing some laws that were governing relationships in the financial sector especially directed towards the providers (Cosgrove, 2012). Thirdly, there was waiving of some acts in order to enhance testing. Some of the acts that were affected include the social security act. Pros and Cons There is both positivity and negativity in the approach taken by the institution. To begin with, there is positivity in that many people will have access to affordable medical care. The people that need these services will only spend part of their income in acquiring high quality healthcare services (Centers for Medicare & Medicaid Services, 2012). Secondly, there is positivity in that people will have access to high quality services that are provided in the institution (Baron, 2012). Many institutions will step up ...
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(Center for Medicare & Medicaid Services Term Paper)
“Center for Medicare & Medicaid Services Term Paper”, n.d. https://studentshare.net/nursing/96542-center-for-medicare-medicaid-services.
The paper is being carried out to give the subpopulations in the Hierarchical condition category and Centers for Medicare & Medicaid Services model and their adjustments. The implementation of the Hierarchical condition category and Centers for Medicare & Medicaid Services models in the payment of the risk adjustment consented to medical costs predictions for the Medicare advantage enrollees.
The program was created through the Medicare Prescription Drug, Improvement and Modernization Act of 2003 and started providing coverage to users on January 1, 2006(Salzman, 2004). The prescription drug coverage is provided by private firms with Medicare through stand alone programs, PPOs and PFFs.
This is a clear indication that the predominant role played by private business corporations (in the form of hospitals and insurance companies) has hampered our healthcare system from meeting its full potential. In a well-functioning system, the private involvement will be limited to the extent that it brings efficiency and innovation to the system.
The percentage has also increased for those patients who pay for themselves. In terms of Medicaid the percentage has increased from 12% two years previously to 16% in the current year. There was also an increase from 32% to 35% in relation to Medicare. The percentage of insured using the facility has declined from 50% to 41%.
Nevertheless, institutions at times shift overheads between grant programs to obscure cost overruns and mischaracterize the objectives for which they are using the funds. Such acts are what brought about the formation of the False Claims Act lawsuit – Healthcare Qui Tam.
Medicaid is a joint federal-state program that began in 1966. It is an open-ended entitlement program, meaning that anyone who is eligible for it is guaranteed coverage, no matter how much the program costs. The federal
As the CEO here are the solutions to the problem the hospital has faced (Fawcett & Karban, 2005).
First as the hospital main clients are those in lower end of the economy and the elderly thus most funded by the Medicare and Medicaid. This
In both countries, regulation of legislation of health care systems direct the kind of care offered, to whom, and on what basis. In both systems, some healthcare costs are usually borne by the patientsduring
e the affordability of health insurance, reducing cost of health care for individuals as well as lowering the rate of insurance by expanding insurance coverage in an effort of enhancing quality patients care delivery across all levels of care opening doors for affordable and
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