University of Phoenix Oregons Innovative Health Care Reform Questions

Please answer these 3 questions with replies in a min 150 words w a scholarly reference.

1. Please go to the link and share your thoughts on this type of health care reform.

https://nam.edu/case-study-medicaid-and-public-hea…

2. Today, over 72.5 million Americans are beneficiaries of the Medicaid program (Kino & Kawachi, 2018). The joint state and the federal program provide health coverage to all demographics, including children, parents, pregnant women senior citizens and people with disabilities. The program is today the single largest source of health insurance coverage in the United States. The federal government requires states to provide coverage for the specific disadvantaged population, including low-income families, qualified children and pregnant women and individuals receiving supplemental security income. The state government may choose to extend coverage to foster care children and Americans receiving community-based and home-based services. All the low income American below age 65 are eligible for coverage under the Affordable Care Act, 2010 (Kino & Kawachi, 2018). The program extends coverage to adults with 65 years and with at least 133%federal poverty level. Medicaid eligibility is determined through financial eligibility, non-financial eligibility and the effective date of coverage. Coverage is effective on the application day or the first day of the month of the application once one is determined eligible.

Medicaid provides numerous benefits which are either mandatory or optional. Some of the mandatory benefits include inpatient and outpatients’ services, home health services, EPSDT services, physician services and nurse-midwife service, among others. Optional services include drug prescription, physical and occupational therapy and respiratory care, among others. Medicaid efficiency can be improved by improving the accuracy of information and report (Kino & Kawachi, 2018). Access to care does not guarantee the quality of care, and it is therefore essential for the AMA to work with states advocates to increase physician’s participation and fully fund the Medicaid program to help streamline enrolment and improve care management. Medicaid can collaborate with the healthcare institutions to ensure that physicians offer services based on the standard of care but not based on the patient’s ability to pay.

References

Kino, S., & Kawachi, I. (2018). The impact of ACA Medicaid expansion on socioeconomic inequality in health care services utilization. PLOS ONE, 13(12), e0209935.

3. Medicaid is financed by the state and federal government since the 1930s. Every penny is matched by both parties. In the beginning stages of Medicaid it was designed to give assistance for anyone who needed healthcare . As time went on , anyone with permanent disabilities or disabled was added on. Medicaid today, eligibility is determined if the family is using TANF ( Temporary Assistance for Needy Families), the poor received Supplemental Society Income ( SSI), and children ( up to 19 years old) and pregnant women with very low income. The benefits that are included are basic primary and pediatric care ( early prevention care , labs ,x-rays, inpatient hospital care , obstetric care, and counseling for conditions. Improvement of Medicaid is very difficult because government and some of its citizens are in debt. I really do not see there being a way to make it cost efficient. The only way is to zero all the debt out and start over with a new formulated and fair policy. As each years passes, you receive less benefits, while provider fees continue to increase . Now we obligated to pay partial premiums for service. Each paycheck gets tax deducted and it still does not help. As well as , “many physicians and some other providers do not serve Medicaid-covered patients”. ( Shi, 2019, pg. 243, para 5) This deters a patient from going to get care because they cannot afford it. I cannot say it is a great system anymore.

Shi, L. & Singh, D.A. (2019). Delivering health care in America. A systems approach. 7th edition. Jones & Bartlett. Retrieved September 25 from https://www.gcumedia.com/digital-resources/jones-a…