Nursing Home Care Case Study

The Affordable Care Act has provided many Americans access to affordable healthcare. The group of newly insured Americans have reported that they have timely access to physicians and healthcare. Previously there was concern that the Affordable Care Act would limit access to physicians based on provider networks. Provider networks have proved less of an issue than previously anticipated partially because many of the previously uninsured Americans were not able to secure a relationship with a set provider or physician group. Some areas of concern that remain are high out of pocket expenses incurred with some marketplace plans.

Shi and Singh (2015) states that the MedPac was established by the Balanced Budget Act of 1977 as an independent federal agency to advise the US congress on different issues that affect the Medicare program. MedPac regulations consist of analyzing payments to private health care providers that participates in Medicare, access to care, and quality of care (p. 214). Article written by Jill Wechsler (20090 states that MedPac concluded that Medicare payment system should reward value instead of volume to help encourage coordination of care with the different providers as well as constrain cost growth. They proposed alternatives that could help improve physician’s practices by support for graduate medical education, improve chronic care and

The authors of this journal discuss the healthcare systems cutbacks and its impact on the population. Every few years the Ontario government and the Ontario Medical Association (OMA) negotiate their contract called The Physician Services Agreement (PSA) The contract details how much physicians can bill for their services, as well as where health care funding should be invested in or where a cut back could be. In March of 2014, the contract had expired, which has led to negotiations for over the year. Over that year negotiations for the new PSA contract had many conflicts mostly due to the government’s goal try to end the province's deficit by 2017-2018.

Since 1965, Medicare was the primary payer for all Medicare covered health services except for services covered by Worker’s Compensation. From 1964 until 1980, Medicare paid benefits without considering whether another insurer could potentially cover the losses. Although litigation involving Medicare beneficiaries certainly existed, the government made no effort to subrogate claims by beneficiaries in the event that Medicare had already paid for medical expenses resulting from the injuries involved in the litigation.

Medicare is a federal government administered healthcare program originally implemented on July 1, 1996. Medicare has four parts (A, B, C and D) that provide different areas and differing levels of coverage. All Medicare programs provide coverage for cover healthcare services to qualifying individuals, known as beneficiaries, which includes Social Security beneficiaries over the age 65, people under 65 with certain disabilities, and people of all ages with end-stage renal disease. Each program provides coverage for medically necessary care and services to covered beneficiaries and has deductibles or copays for covered services. Medicare Part A, Medicare Part B and Medicare Part C all provide coverage for medical services.

Epstein, Saif S. Rathore, Caleb Alexander, and Jonathan D. Ketcham has given the view of the physicians on Part D of Medicare. In this peer reviewed article the authors also has done some research to examine the attitude of physicians about the impact of Medicare Part D. The authors tried to research on how Medicare Part D varied among the senior citizen specially the citizen has Medicare and Medicaid dual eligibility. For the study they have designed a web based survey in four states North Carolina, Florida, Texas and Massachusetts. However, the researchers mainly focused of the differences in result of North Carolina from the other states.

Understanding Medicare Part D (Prescription Drug Coverage) the benefits of Medicare, a significant healthcare program, that provides comprehensive benefits to retirees in order to fulfill their healthcare needs cannot be overemphasized enough. There are several parts to the program based on specific healthcare needs including Part A, B, C, and D. While every plan has specific advantages, it is important to understand the plan D in detail before deciding to opt for the Medicare prescription drug coverage. In this article, we are going to discuss the specifics and benefits of Medicare Part D in more detail. Specifics and benefits of Medicare Part D

First, the ACA has brought about considerable improvements in access to affordable health insurance in the United States. On the basis of their own reports, newly insured Americans are also able to see physicians within reasonable periods of time, and anecdotal reports about restricted access to out-of-network providers, although a concern, have not yet caused a major backlash. Second, the implementation of the ACA has coincided with another important development — a slowdown in the rate of increase in national health care spending. From 2010 through 2013, per capita U.S. health care expenditures increased at the historically low rate of 3.2% annually, as compared with 5.6% annually over the previous 10 years. As a percentage of the gross domestic product, health spending has stabilized at approximately 17%.

A Second Look at the Affordable Care Act David E. Mann, ABA American Military University POLS210 Abstract Since the passing of the Patient Protection and Affordable Care Act (PPACA), twenty-eight states have either filed joint or individual lawsuits to strike down the PPACA. This document will examine a few key elements that the President of the United States must take into consideration when reviewing the act and moving forward to either ratify the act, replace the act, or leave the act as it is. Topics that will be presented will include; the current issues being debated, two competing thoughts on how to fix the ACA, an evaluation of the preferred solution, and finally the responsibility of each level of government. Patient

How managed care plans contribute to public health practice. This article looks at alliance between Health plans and public health agencies. They discuss how public health care plans have similar needs also may have similar needs for the expertise and clinical capacity to serve vulnerable and underserved populations. Health care plans that are in place now to assist people with having access to health care.

In the beginning, Medicare was thought of as a "sickness insurance program. " There were concerns that large segments of the population, especially laborers, who could not afford to pay their medical bills. While Medicare was in its planning stages, the American Medical Association (AMA) opposed a national plan from the start. " The AMA, in common with many Americans, thought of medical care as largely a private transaction between a medical practitioner and a patient.

The first editorial is in favor of the universal healthcare system. The author supports the claim with statistical reasoning when presenting the argument. The editorial focuses more on facts, logic, and reasoning rather than emotions and opinions.

Over the late years the quantities of uninsured Americans has fundamentally expanded. The 2.2 million late development of uninsured is for the most part because of age and salary changes. At that, most Americans trust that protection scope and access to human services framework are the issues that ought to be organized, and it is the immediate obligation of the central government to guarantee restorative watch over those natives that need protection, even through raising expenses. Today, the US society confronts the continuous problem of "whether the administration ought to make a noteworthy or a constrained push to give medical coverage to the uninsured" (The Henry J. Keiser Family Foundation 1). On the other hand, no choice has yet got

Health care should not be considered a political argument in America; it is a matter of basic human rights. Something that many people seem to forget is that the US is the only industrialized western nation that lacks a universal health care system. The National Health Care Disparities Report, as well as author and health care worker Nicholas Conley and Physicians for a National Health Program (PNHP), strongly suggest that the US needs a universal health care system. The most secure solution for many problems in America, such as wasted spending on a flawed non-universal health care system and 46.8 million Americans being uninsured, is to organize a national health care program in the US that covers all citizens for medical necessities.

Santo, C. (2014). Walking a Tightrope: Regulating Medicare Fraud and Abuse and the Transition to Value-Based Payment. Case Western Reserve Law Review, 64(4),