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Medicaid
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A 4 page paper that provides a brief overview of Medicaid. The writer discusses mandatory and operational groups to be covered and reports statistical data that are available. Bibliography lists 4 sources.
Filename: PGmdcid.RTF
Medicare Managed Care: History and Implications
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A 5 page paper discussing the history of Medicare managed care, economic implications and outlook for the future. The paper focuses on the history of the Medicare managed care, which saw its greatest growth throughout the decade of the 1990s. Medicare managed care has as much difficulty as other types of HMOs, however, and many are ceasing operations. This leaves seniors in a pool of uncertainty as increasing numbers of physicians turn away Medicare patients. Bibliography lists 3 sources.
Filename: KSmediHist.rtf
Medicare Policy Change Proposal Memorandum
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A 2 page memo to Thomas Scully, Administrator, Centers for Medicare and Medicaid Services proposing a 6 – 9 month moratorium on health care provider reporting compliance. The purpose of this waiver will be to allow providers to design and implement operational changes designed to streamline their communications with CMS while enabling them to adopt the TQM (total quality management) principle of continuous improvement. The ultimate result is intended to be a more effective reporting and accountability system that the private sector – rather than taxpayer dollars – designs for CMS and for all of health care providers associated with Medicare. Bibliography lists 6 sources.
Filename: KSmediPolChgMemo.rtf
Medicare Policy Memo
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A 3 page memo discussing two leading problems of Medicare. The two primary problems facing Medicare is (1) the requirement that all individuals aged 65 and older participate even when they have no specific need; and (2) annual automatic increases in allowable charges for service to Medicare. Bibliography lists 3 sources.
Filename: KSmedPolProbM.rtf
Medicare PPS Legislative Environment
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A 5 page paper discussing some of the legislative issues regarding the prospective payment system (PPS) Medicare reform system. Few legislators disagree that "something" must be done with Medicare. One attempt at reform has been implementation of PPS designed to replace the fee-for-service approach to payment under Medicare coverage. PPS addresses cost containment, though it is lacking in prescription assistance. It also raises questions regarding patients' rights to continued coverage. Bibliography lists 7 sources.
Filename: KSmedicarePPS.rtf
Medicare PPS Regulations and Regulatory Agencies
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A 5 page paper discussing Medicare’s attempts to find and halt abuses. The regulatory environment is such that many facilities employ workers for the sole purpose of reporting and filing claims, decreasing the facility’s ability to operate efficiently. The Health and Human Services Department instituted Operation Restore Trust in 1995, and the program has evolved into one that saves far more than it costs. Care providers can benefit from increased regulation and accountability in that they are forced to adopt sound business practices. Bibliography lists 6 sources.
Filename: KSmediRegulat.rtf
Medicare: What We Can Learn From the Past
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A 10 page overview of the history behind Medicare. The author asserts that to find a solution to
Medicare's current problems we must examine both the similarities and differences between the era in which Medicare was initiated and today's
environment. We must be cognizant of just who the current stakeholder is and constantly remind ourselves of how important they are. To fully
assess Medicare and the potential impact its fall would have it is prudent to obtain input from these stakeholders, evaluate that input, and initiate measures which have the most likelihood of stabilizing the top heavy system and halting its rapid spiral to the bottom. Bibliography lists 10 sources.
Filename: PPmedic2.rtf
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