Review of a Healthcare Based Organization

Table of Contents

Introduction3

Discussion4

Background4

Important Medicaid Changes From 1965 Till 20104

Medicaid Eligibility6

Services Offered to the Families7

Issues Accessing Medicaid7

Beneficiaries of Medicare8

Configuration, Benefits, and Financing9

Conclusions10

References11

Review of a Healthcare Based Organization

Introduction

Medicare is basically a social insurance program based in the U.S. that provides the coverage of health to seniors and disabled persons without a test of need. Medicare is run by the CMS or the Centers for Medicare & Medicaid Services, an organization affiliated with the Department of Human and Health Services. Medicaid, created in 1965 by the federal legislation provides easy access to healthcare to families with low earnings, the elderly, and persons with disabilities in the United States. Medicaid is the biggest public source of the health insurance of children in the U.S. More than 28 million children are enrolled, representing 37% of U.S. children, according to the CMS. Medicaid is an important safety net for families who do not possess health insurance provided by the employer or private insurance. CMS estimates that without this program, more than 40 million persons would not have had access to health care in 2007 (Boards of Trustees of the Federal Hospital Insurance, 2010). Another 16 million persons are expected to be served by Medicaid when all the provisions of the 2010 Patient Affordable and Protection Care Act are completely put into practice in 2019, although most will be served beginning in 2014.

Discussion

Background

Medicare was created in 1965 to provide coverage for hospital and physician services to individuals' age sixty five and above who are eligible for Social Security. Benefits began on July 1, 1966. In 1972, coverage was extended to individuals below the age of sixty five who have acquired the benefits of Social Security Disability Insurance for no less than two years and to those with renal disease on end-stage (Engel, 2006). In 2001, the program was extended to address individuals with Lou Gehrig's disease. Prescription drug coverage was enacted in 2003 and became effective in January 2006. The 2010 health reform legislation improves Medicare's coverage of prescription drugs and preventive services.

Important Medicaid Changes From 1965 Till 2010

Medicaid was marked into ruling on July 30th, 1965 by U.S. President Lyndon Johnson. Medicaid, component of the War on Poverty legislation and policy, was created to reduce the wide disparities among states in health care available to low-income individuals and families. Medicaid was originally administered at the federal level contained by the U.S. Department of Health, Education, and Welfare. Today, it is run by the CMS within the U.S. Department of Health and Human Services.

Medicaid has changed in each succeeding presidential administration: There has been both expansion and contraction of the program in the past 45 years. In 1967, for example, President Nixon expanded Medicaid through the creation of the EPSDT or Early and Periodic Screening, Diagnostic and Treatment Program to ensure adequate health care for children. During this time, there was significant growth of the nursing home industry as the elderly were supported in nursing homes with reimbursement provided by ...