Overview of Medicare Policies and budget of Medicare Impact of past decisions regarding Policies...
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Transcript of Overview of Medicare Policies and budget of Medicare Impact of past decisions regarding Policies...
Overview of Medicare
Policies and budget of Medicare
Impact of past decisions regarding Policies
Estimate costs for Revising Policy
Government Role & Responsibilities
Special interest groups’ effect
Desired Policy vs. Outcome
Part A Hospital insurance (HI)
Part B Supplemental Medical Insurance (SMI)
Part C Medicare Advantage Program
Part D Supplemental Medical Insurance (SMI)
Freedom of Information Act (FOIA)
Protection of Privileged Information
The Affordable Care Act
Affordable and Quality Care
Medicare Prescription Drug, Improvement, and
Modernization Act Benefits of Prescription drug Cost of Patient Care
BUDGET TAXES
Congress
Authorized
Recipient Premiums
Trust Fund
Investment
Balanced Budget
Act
Payroll Taxes
Social Security
Income tax
Trust FundsTrust Funds
Hospital Hospital Insurance Trust Insurance Trust
FundFund
Supplementary Supplementary Medical Medical InsuranceInsurance
1972 – End-stage renal disease
1983 - Medicare Prospective Payment System
1989 - Medicare Fee Schedule
2003 - Medicare Prescription Drug,
Improvement, and Modernization Act
2006 - Medicare Advantage
2010 - Patient Protection and Affordable Care
Act
Affordable Care Act of 2010
National Health Care Increases
Medicare Advantage Plans (Part C)
Increased Medicare Regulations
Medicare Fraud Prevention
Politics over the enactment
Ideological & partisan divisions
Accommodation in Medical Industry
Open-ended payments
Regulatory revolution
Control in Budget
Market-driven Medicare Reformation
Medicare Prescription Drug, Improvement and
Modernization Act
Campaigned for Medicare Part D
Pharmaceutical Research and
Manufactures of America (PhRMA)
Secondary insurance companies
Beneficiaries of Medicare
Decreased Health care Costs
Decreased Drug Prescription Costs
Supplement paying medical expense for senior citizens
Less Medicare Funding
Expansion of Medicare Enrollment
Increment in Medicare Fraud
Overview of Medicare
Policies and budget of Medicare
Impact of past decisions regarding Policies
Estimate costs for Revising Policy
Government Role & Responsibilities
Special interest groups’ effect
Desired Policy vs. Outcome
AARP. (2011). Part D. Retrieved from https://www.aarpmedicareplans.com/medicare-education/what-is-medicare/medicare-part-d.html
Centers for Medicare & Medicaid Services. (2008). How is Medicare Funded. Retrieved from
http://www.medicare.gov/Publications/Pubs/pdf/11396.pdf CMS Office of the Actuary (2010). Affordable Care Act Update: Implementing Medicare Cost Savings. Retrieved
from mmapinc.org/pdfs/ACA-Update-Implementing-Medicare-Costs-Savings.pdf Donut Hole, Medicare Prescription Drugs. (n.d.). Retrieved from http://healthcare.gov/glossary/d/donuthole.html Donvan, J., & Patrick, M. (2010, December 31). Baby Boomers Expected to Drain Medicare. ABC
news. Retrieved from http://abcnews.go.com/US/baby-boomers-projected-drain- medicare/story?id=12507968
Department of Health & Human Services. (2005). Balanced Budget Act overview. Centers for Medicare and Medicaid Services. Retrieved from http://www.cms.gov/Deeming/
Medicare Fraud: A $60 billion crime. (2010, ). CBS News. Retrieved from http://www.cbsnews.com/stories/2009/10/23/60minutes/main5414390.shtml
Morone, J. A., Litman, T. J., & Robins, L. S. (2008). Health politics and policy (4th ed.). Clifton
, NY: Delmar Cengage Learning PhRMA. (n.d ). Medicare: Part D: A Success Story for Seniors. Retrieved from
http://www.phrma.org/issues/medicare Polinski, J., Kilabuk, E., Schneeweiss, S., Brennan, T., & Shrank, W. (2010). Changes in drug use and
out- of-pocket costs associated with Medicare Part D implementation: a systematic review. Journal Of The American Geriatrics Society, 58(9), 1764-1779. doi:10.1111/j.1532-5415.2010.03025.x
Rettenmaier, A. J. & Saving, T. R. (2007). The Structure of Medicare. Publication no. 299.
Retrieved from http://www.ncpa.org/pub/st299?pg=4
Retrieved from http://www.ncpa.org/pub/st299?pg=4 The Henry J. Kaiser Family Foundation. (n.d.). U.S. Health Care Costs. Retrieved from
http://www.kaiseredu.org/Issue-Modules/US-Health-Care-Costs/Background-Brief.aspx The Official U.S. Government Site for Medicare. (2011). Medicare Advantage (Part C).
Retrieved from http://www.medicare.gov/navigation/medicare-basics/medicare- benefits/part-c.aspx
The White House. (2010). The Affordable Care Act: Strengthening Medicare, combating
misinformation and protecting Americas senior. Retrieved from
http://www.whitehouse.gov/the-press-office/affordable-care-act-strengthening-medicare-
combating-misinformation-and-protecting- U.S. Department of Health & Humans Services and U.S.Department of Justice. (n.d.). About Fraud.
Retrieved from http://www.stopmedicarefraud.gov/aboutfraud/index.html U.S. Department of Health &Human Services.(2010). Strengthening Medicare. Retrieved from
http://www.healthcare.gov/law/features/65-older/strengthening-medicare/index.html