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550 CASE MOD 2. MEDICARE ELIGIBILITY AND FINANCING

Essay Instructions:


USE THESE HEADERS FOR THE ESSAY
Investigate the eligibility of the Medicare program; who can be covered?
How is the Medicare program financed? What specific operating rules must be followed to receive reimbursement funds?
How does the average Medicare reimbursement level specifically compare to the average reimbursement for private insurance? How can this difference affect the bottom line at your facility?


Module 2 - Case
MEDICARE ELIGIBILITY AND FINANCING
Assignment Overview
An awareness of the covered and noncovered services of Medicare is a criticalarea of understanding for health care managers. The program has grown andchanged over time, refining who and what is included vs. excluded. The Casepresents the opportunity to investigate these coverages, as well as the financingof Medicare. Specific reimbursement rules are in place that must be followed iffunds are to be received for providing services. The level of Medicarereimbursement differs from what would be received from private insurance – butby how much – and how can this affect your bottom line?
Case Assignment
Using the information in the required readings, as well as some additionalresearch in peer-reviewed sources, complete your Case assignment byanswering the following:
1. Investigate the eligibility of the Medicare program; who can be covered?
2. How is the Medicare program financed? What specific operating rules must befollowed to receive reimbursement funds?
3. How does the average Medicare reimbursement level specifically compare tothe average reimbursement for private insurance? How can this differenceaffect the bottom line at your facility?
Assignment Expectations
1. Conduct additional research to gather sufficient information to support youranalysis.
2. Provide a response of 3-5 pages, not including title page and references.Listen
4/22/20, 9(50 PMhttps://tlc.trident.edu/content/enforced/153691-MHA550-2020APR0…lSessionVal=aSEh3LAbbYuNZ833qyN2qqdSd&ou=153691&d2l_body_type=3 Page 2 of 2Privacy Policy | Contact3. There are multiple required items to be addressed herein; please usesubheadings to show where you are responding to each required item and toensure that none are omitted.4. Support your paper with peer-reviewed articles, with at least 3 references. Usethe following link for additional information on how to recognize peer-reviewedjournals:Angelo State University Library. (n.d.). Library Guides: How to recognize peerreviewed(refereed) journals. Retrieved fromhttps://www.angelo.edu/services/library/handouts/peerrev.php5. You may use the following source to assist in formatting your assignment:Purdue Online Writing Lab. (n.d.). General APA guidelines. Retrieved fromhttps://owl.english.purdue.edu/owl/resource/560/01/.6. For additional information on reliability of sources, review the following source:Georgetown University Library. (n.d.). Evaluating internet resources. Retrievedfrom https://www.library.georgetown.edu/tutorials/research-guides/evaluatinginternet-content

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Assignment 
Name 
Institution  
Medicare Program
Eligibility of the Medicare ProgramMedicare is a comprehensive health care program provided by the federal government. The health insurance covers people of over 65 years, the disabled people in society, their dependents, as well as those people who are suffering from chronic diseases such as kidney failures. More than 95 percent of the older adults in the US are covered under the Medicare program. By the year 2000, the program had covered around 39 million of the American population (Schwartz, 2019).
Medicare has a range of insurance benefits that eligible people can choose. The first one is Medicare Original, which is a traditional service directly offered by the federal government. The Medicare Original pact is made up of Part A, Part B, Part C, and Part D. The first one, Part A covers inpatient services, which include hospital care, some extended facility care, as well as some home care. Part B provides for outpatient services and includes general medical coverage, such as physician expenses. Part A and Part B are straightforward pacts that cover Medicare beneficiaries automatically. Part C was established in 1997 and had more coverage options. The eligible beneficiaries under Part C can take part in HMOs, PPOs, and PSOs, among other similar programs. Part D gives the eligible beneficiaries to choose Medicare Private Drug Plan (PDP) (Moon, 2016). The second Medicare plan is Medicare Advantage Plus. This type of insurance is privately offered by companies under agreement with the federal government.
Medicare Financing and Operating Rules
Financing Medicare program
Medicare program is primarily financed by general revenues, taxes from payrolls, and also from beneficiaries’ paid premiums. Other funding is sourced from benefits from social security, interests, as well as payment from the different states. The funding, however, can be broken down into the different Medicare plans available. Part A, which deals with outpatient services, is financed by a payroll tax and is shared equally by the employees and employers. These taxes added up to 88 percent, out of the $251 billion of the total Part A funds in 2013 (Atkins et al., 2017). Part B, which is the Supplementary Medical Insurance (SMI), gets its funds from combined effort of the overall revenue, the beneficiaries’ paid premiums, as well as the interests, among other sources of finance. Premiums cover up to 25 percent of the total aggregate of funds as the revenue cover around 73 percent. A larger share of the spending comes from the beneficiari...
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