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2 pages/β‰ˆ550 words
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APA
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Health, Medicine, Nursing
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Essay
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English (U.S.)
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Topic:

Medicare Incentive and Medicaid Policy Options

Essay Instructions:

Class 4 Activity
Medicare: What’s My Incentive?
Your group represents one of the six stakeholders: (1) hospitals; (2) insurance plan; (3) a physician group; (4) a nursing home chain; (5) a consumer group; and (6) a state government
Policy Proposal: Currently, Medicare will not pay for care in a skilled nursing facility unless the beneficiary has been hospitalized for at least 3 days. CMS is now considering lengthening the mandatory hospitalization period to a week (7 days).
Your job: What position would your stakeholder group take? (for or against?) Identify three points you would make on your stakeholders’ behalf (i.e. why you are for or against the proposal).
Class 5 Activity
Medicaid policy options
Introduction: The asynchronous lecture focuses on the history of, eligibility for, and funding of Medicaid. The objectives of this activity are to 1) make sure students understand the pressure that Medicaid puts on state governments and 2) make sure the students understand the special problem of Medicaid enrollment during tough economic times for states 3) illustrate (again) the iron triangle from class 1(when you process the exercise).
You are the state health commissioner of State Nowhere. State Nowhere has a diverse economic portfolio, with much of its economy dependent on manufacturing (auto assembly is a major industry), agriculture, and tourism. The state is not particularly wealthy, with a median household income of $54,000 ($13,000 below the national average), and 15% of the population below the poverty line. 22% of the population is on Medicaid, and 50% of Medicaid dollars are spent on the elderly and people with disabilities (“dual eligible”). In 2019, 18% of the state budget was spent on Medicaid. Your colleague in the budget office has just told you that they are expecting that a coming recession will increase unemployment and that another 3% of the population are likely to enroll in Medicaid. At the same time, that recession is expected to reduce the revenue that the state has (because fewer people are paying income taxes since they are unemployed, or making less money) by 4%. Your colleague asks you to be ready to present the Governor with some ideas for addressing the problem. What options would you present at the meeting?

Essay Sample Content Preview:

Class Activities 4 and 5
Name of the Student
Institution
Course
Instructor’s Name
Date
Class Activities 4 and 5
Class Activity 4: Medicare
As a representative of the physician group of stakeholders, I would be against the policy proposal seeking nonpayment for care for beneficiaries whose hospitalization is below two days. The first point that would support this stand and persuade the rest of the stakeholders is that the policy goes against the need for value-based care. Care focusing on value calls for payers, hospitals, health systems, and other stakeholders to overcome challenges and biases in tapping the benefits of taking extra financial risks (Mamidi et al., 2020). In the proposed intervention, the financial risk seeks to benefit only individuals who spend a longer period in hospitals, hence introducing bias.
The second point is that the policy compromises the care outcomes of patients. In the U.S., experts acknowledge the need to transform healthcare systems into structures that reward hospitals and providers based on the value of offered services and not quantity (Mjåset et al., 2020). Even while the payers focus on reducing costs, they must not deviate from the valuable care process. The efforts to curb health care costs to sustainable levels must be ones acknowledging the significance of alignment of stakeholder incentives. As mentioned above, the proposal does not address the needs of all involved parties. For example, caregivers and their respective organizations need to acquire payment after delivering quality care that sees many patients leaving their hospital beds within 48 hours.
The third point against the policy proposal is the need for more modern care methods in skilled nursing. Given the reduced number of professional nurses in the country, caregivers may opt for a shortened hospitalization and then shift the patients to their homes, where the sick would receive adequate monitoring through telemedicine services. The limitation of a minimum of three days limits the utilization of such modern care tools.
Class Activity 5: Medicaid
Given the looming econ...
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