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Medicare and Medicaid-Revised

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Medicare and Medicaid
Student’s Name:
Institution Affiliation:
Medicare and Medicaid
Why do healthcare organizations have to understand Medicare and Medicaid?
The first thing that organizations need to understand in Medicare and Medicaid is the process of eligibility and enrolment. These are federal programs that were established in 1965 to allow sharing of the financial burden amongst the healthy and sick individuals. Their primary purpose was to address the healthcare needs to the elderly and lower-income earners who could not afford to buy private health insurance covers (Billioux et al., 2017). The service providers and healthcare organizations ought to be knowledgeable on who qualifies for each program. They need to be aware that the services rendered to non-qualifiers are never reimbursed. Also, healthcare organizations also need to understand the programs to ensure full compliance with the legislation governing them.
Past legislative attempts to control Medicare and Medicaid costs
Some of the efforts to control Medicare and Medicaid costs include the Balanced Budget Act (BBA) of 1999; Modernization Act and many others (Billioux et al., 2017). BBA was meant to address the complains raised on Medicare and Medicaid programs on increasing budget deficits due to exaggerated charges from the private healthcare organizations. The legislative incorporated a cost-saving measures for these programs. Also, the Modernization Act of 2003 was created to ensure incorporation of those with disabilities on the Medicare program.

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Success/failure of the attempts
The past legislative efforts were not successful since the intended vision was not realized. Medicare and Medicaid did not achieve quality and affordable healthcare as it was required initially since the prices rebounded much quickly. The programs increased the running cost and hence making them less feasible. Most of the healthcare organizations utilized the loopholes with the past legislative to maximize profit for the selfish gain. The cost of running the programs became much higher compared to their benefits. In my opinion, competent execution of today’s legislation such as the Affordable Care Act (ACA) or Obamacare would help to achieve high quality and standardized healthcare services at a fair cost to all. Advances in medical technology have also played a significant role in increasing efficiency in the sector.

References
Billioux, A., Verlander, K., Anthony, S., & Alley, D. (2017). Standardized Screening for Health-Related Social Needs in Clinical Settings: The Accountable Health Communities Screening Tool. NAM Perspectives, 7(5), 56-75. doi: 10.31478/201705b

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