Download Medicare (Health and Medical Issues Today) by Jennie Jacobs Kronenfeld PDF

By Jennie Jacobs Kronenfeld

Medicare is a crucial resource of health-care insurance for the majority americans elderly sixty five and over. it might even be some of the most complicated topics with which voters needs to contend. one of the first books to envision the effect of the 2010 health-care reforms at the software, Medicare studies Medicare's historical past, explores its present coverages and difficulties, and takes a glance at its possible future.Readers will find out about makes an attempt to cross Medicare laws, in addition to approximately a number of the very important alterations that experience happened seeing that 1965. they are going to examine carrying on with price matters through the years and approximately transformations in either health center and health care professional fee techniques. severely for modern-day readers, the e-book examines present matters, equivalent to drug assurance, HMO/managed care strategies, long-term-care assurance, the demographic-based investment hindrance, Medicaid, and the influence of contemporary health-care reforms. The aim all through is to aid shoppers comprehend Medicare so that you can insure that this system is still robust.

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Sample text

The DRG change resulted in converting Medicare payments to hospitals to a prospective per case system based on the diagnosis of the patient which included more than 460 different diagnostic-related payment categories. The model was based on a program in New Jersey that had experimented with DRGs as a way to pay hospitals. It was adopted by the Reagan administration as a way to hold down rising hospital costs. Under the new system, instead of a hospital charging Medicare a set fee per day plus specific charges for supplies and other facilities used in the care of a patient, the hospital care of a Medicare patient was paid with one fee set in advance, based upon the expected average length of stay and the services typically used for that diagnosis.

Also, some technical adjustments occurred in how DRG payments were calculated for outlier (or extremely expensive) cases.

Fears about the possible overcrowding of hospitals, however, did not occur. While some physicians did not cooperate with the program, the cooperation of physicians was high overall. The President of the American Medical Association at the time, James Appel, was helpful in urging physicians to cooperate (at one time there had been talk of a physician boycott) and the organization provided consultations about how to participate, leading to high rates of utilization from physicians. There is a certain irony about the ways that Medicare benefitted physicians after its passage.

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