Medicare and Medicaid Programs

Introduction

Medicare and Medicaid are the US programs, which help particular population groups to get high quality and affordable medicine by covering some costs for health-related services. Although the central aim of these programs is helping the patients, they can also be beneficial for medical organizations. This paper explains what Medicare and Medicaid are, and how they can affect my future practice.

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Understanding of the Concepts

What is Medicare?

Medicare is a term that refers to the health insurance program, which covers particular expenses on the healthcare procedures. There are three groups of patients who can count on Medicare (“What’s Medicare?” par. 1). The first group consists of people in years who are 65 years old or more. The second includes younger individuals with disabilities. And, finally, the last group whose expenses Medicare can cover comprises people suffering from chronic renal failure (or so-called end-stage renal disease).

The Medicare insurance program consists of four parts (Plans A, B, C, and D), each of which covers different expenses. The basic plans are A and B: the first one can help with inpatient hospital stays, hospice and home health care while the second covers outpatient care and particular services of physicians. Plans C and D are the advanced ones and can be provided by private companies only. Those offer additional services for additional costs. Plan D covers the expenses on prescription drugs. Plan C provides people with all benefits of Plans A and B. Moreover, it can also encompass Plan D as well.

What is Medicaid?

Medicaid is aimed to help people with low earnings to cover the expenses on various health-related services. The program entered into force in 1965 “as a legislative afterthought to Medicare” (Rosenbaum 1). It is “created by the federal government, but administered by the state” (“What is Medicaid?” par. 1). Therefore, every state has its own rules relatively applying Medicaid and people who can count on it. However, there are general rules, which identify individuals who are eligible for this program. Those are the old-aged (65 years old and more), people with disabilities, children younger than 19, pregnant women, single-parent families and some others (“What’s Medicare & Medicaid” 3). Medicaid can cover hospital stays, various doctor’s services, maternity care and even some long-term services.

Medicare and Medicaid in My Practice

How Medicaid Can Benefit My Practice?

Now, I am studying to get my degree in health management and become a manager of a medical facility in New York City. I also hope that one day I will be able to start my own practice and provide affordable healthcare to the neighboring communities. As far as I want to do this, Medicaid will be the backbone of my practice.

Presently, Medicaid is the core financial element for many nursing homes, safety-net hospitals, and other healthcare centers that provide services for people with low incomes. According to Julia Paradise, there is a very promising statistics, which reveals that approximately 16% of all personal healthcare and medicine spending are covered with the help of Medicaid (par. 1). Besides, as far as Medicaid can cover even long-term healthcare spending, it will enable me to make more services affordable for people with low income.

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How Medicare Can Benefit My Practice?

Medicare will be beneficial for my practice as well. As Bob Doherty states, earlier “much of the care that physicians provided to seniors was on a charitable or uncompensated care basis” (par. 5). The Medicare insurance program improved this situation greatly since it provided the healthcare system with hundreds of billions of US dollars to take care of the elderly and people with disabilities. Besides the fact that the majority of costs for services for those people will be covered by Medicare, I am also sure that the number of elderly coming to my future organization will vastly increase. Therefore, I will need more staff, and my business will grow. According to Doherty, Medicare not only enabled affordable doctor’s services but also increased the number of people who came to the physicians, so their payments grew by 13.7% between 1967 and 1993 (par. 5). That proves that Medicare is beneficial not for the patients only.

Surely, the Medicaid program will be more useful for my future practice but still, due to Medicare, my organization will be able to take care of the old-aged and make the services affordable for them.

Payment Issue

Finally, I would like to discuss the payment issue. It may seem that working with Medicare and Medicaid is hard and even disadvantageously since the services for certain groups of people are entirely or partly free. However, that is a false conclusion. Both Medicare and Medicaid programs are strictly regulated by the government and states, and none of the healthcare centers for people with low incomes does not operate at a loss. Moreover, as it has already been mentioned before, Medicare and Medicaid even bring some advantages, and the prime example of that is an increase in demand for the healthcare. That is why I would not have to sacrifice good quality care for my patients, working within the system of Medicare and Medicaid.

To conclude, both Medicare and Medicaid are irreplaceable and valuable programs, which can be beneficial not only for people who are eligible for them but for the healthcare organizations as well.

References

Doherty, Bob. How Medicare benefits doctors: A complicated history 2015. Web.

Paradise, Julia. Medicaid Moving Forward 2015. Web.

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Rosenbaum, Sara. “Medicaid.” The New England Journal of Medicine 346.8 (2002): 635-640. Print.

What is Medicaid? 2015. Web.

What’s Medicare? n.d. Web.

What’s Medicare & Medicaid 2015. Web.

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NerdyTom. (2022, April 16). Medicare and Medicaid Programs. Retrieved from https://nerdytom.com/medicare-and-medicaid-programs/

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"Medicare and Medicaid Programs." NerdyTom, 16 Apr. 2022, nerdytom.com/medicare-and-medicaid-programs/.

1. NerdyTom. "Medicare and Medicaid Programs." April 16, 2022. https://nerdytom.com/medicare-and-medicaid-programs/.


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NerdyTom. 2022. "Medicare and Medicaid Programs." April 16, 2022. https://nerdytom.com/medicare-and-medicaid-programs/.

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