Medicare and Medicaid
Medicare and Medicaid
After completing this module, students will be able to do the following:
Understand the history of Medicare and Medicaid enactment and how both have evolved in the United States since their enactment under the presidency of Lyndon B. Johnson.
Discuss the changes in Medicare and Medicaid coverage since the implementation of the ACA.
Explain why all people living in poverty do not qualify for Medicaid coverage under current health care system.
Describe some of the differences between states in the administration of their Medicaid programs.
Examine the role that regulations and federal mandates play in improving the quality of Medicaid and Medicare services for all beneficiaries.
Overview
Throughout the course, you have explored topics about advocacy and healthcare policy, discussed the current healthcare system in the United States and the impact of healthcare reform especially on the uninsured. You have articulated the significance of collaboration among nurses and other healthcare professionals in leading change and ensuring that all patients receive culturally competent, cost-effective, quality healthcare. In addition, you have explored healthcare from a global perspective and have articulated issues that may impact vulnerable populations in the future.
This week’s module explores two major payers of healthcare: Medicare and Medicaid. You will examine how the Centers for Medicare and Medicaid Services (CMS) greatly influences healthcare finances as these payers move from the traditional fee-for-service payment model to the more patient-centered, quality-driven, value-based reimbursement model. Further, you will gain a clear understanding of how the ACA impact Medicaid and Medicare recipients.
Learning Materials
Nickitas, D. M., Middaugh, D. J., & Feeg, M. D. (2019). Policy and politics for nurses and other health professionals: Advocacy and action. (3rd ed.). Sudbury, MA: Jones and Bartlett Publishers. Read Chapters 11 & 12.
Additional Resources
Amadeo, K. (2019) Federal poverty level guidelines and chart.
Assignment:
Signature Assignment: Medicare and Medicaid
Consider how people qualify to receive Medicare and/or Medicaid and write a paper that addresses the bullets below. There should be four (4) sections in your paper; one for each bullet below. Separate each section in your paper with a clear brief heading that allows your professor to know which bullet you are addressing in that section of your paper. Start your paper with an introduction and include a “Conclusion” section that summarizes all topics. This paper should consist of at least 1750 words and no more than 2000.
This week reflect upon the Medicare and Medicaid programs to address the following:
Describe the Quality Improvement Organization (QIO) and explain how the QIO improves policies and healthcare for Medicare beneficiaries.
Briefly define the qualifications for Medicare and Medicaid benefits. How can qualifications be modified to serve more people who are considered a vulnerable population?
Discuss the impact (including at least two positive and two negative aspects) that the ACA has had on benefits and coverage for Medicare and Medicaid recipients.
Describe your role(s) as a healthcare leader as it applies to the practice of advocating for cost effective care for vulnerable populations.
Assignment Expectations.
Length: 1750-2000 words in length, including a title page, reference page in APA format. Your essay must include an introduction and a conclusion. **Header and Footer and page #
Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (3) scholarly sources are required for this assignment. (no earlier than 2017)
Format: Save your assignment as a Microsoft Word document (.doc or .docx).
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