Medicare at 30: preparing for the future

Article Abstract:

Medicare is a beneficial health care program for the elderly and disabled, which can be improved but should not be discontinued. Payment reductions and policy changes proposed by Congress to balance the federal budget could jeopardize the 30-year-old program. The greater rise in total Medicare spending compared to private insurance spending can be attributed to the advanced age of Medicare beneficiaries and their more serious illnesses and surgeries. Medicare also funds graduate medical education programs that serve the disabled and elderly. Medicare administrative expenses account for only 2% of program spending compared to about 17% for private insurance. Medicare spending per enrollee has grown more slowly than spending for private insurance per enrollee from 1983 to 1991. Better payment plans, reviews and expanded choice could improve the effectiveness of Medicare. Managed care options cannot be built into the program currently because of problems in Medicare's payment apparatus.

Health aspects, Aged, Elderly, Medicare

---

Medicare, Medicaid fraud and abuse

Article Abstract:

Physicians and other health care providers can help the Health Care Financing Administration (HCFA) in its efforts to identify and reduce Medicare and Medicaid fraud. The HCFA is implementing new measures to stem such abuse. These include stricter regulations regarding claims processing, better data analysis to detect fraudulent patterns and closer relations with law enforcement agencies to investigate and prosecute offenders. Physicians must be alert for potential deceitful practices by suppliers and others. They should protect their provider numbers, pay close attention to prescriptions for equipment and services reimbursable by Medicare or Medicaid, and carefully monitor billing by outside services. Physicians may also help by informing HCFA of policies vulnerable to exploitation, and by working with medical societies and licensing boards to stifle the activities of defrauders.

Investigations, Prevention, Medicaid fraud, Medicare fraud, United States. Centers for Medicare and Medicaid Services

---

A profile of the Medicaid program

Article Abstract:

As Congress considers turning Medicaid over to the states it is important to remember the role the government program has played in the health of the public. In 1995, 36 million Americans were covered by Medicaid, including poor women and children, the elderly and disabled, and those requiring long-term care. The expansion of Medicaid during the late 1980s has resulted in better prenatal care to poor women. In addition, poor children covered by Medicaid receive basic services such as immunization and physical exams to the same extent as children who are privately insured. Medicaid can supplement Medicare coverage among the elderly, and it has helped stabilize the growth of the uninsured population. Medicaid covers almost 70% of all nursing home residents and also provides substantial revenue to many public hospitals.

Poor, Medicaid, Insurance

Similar abstracts:

• Abstracts: Mechanisms of muscle wasting: the role of the ubiquitin-proteasome pathway. Treating diabetic nephropathy--are there only economic issues?
• Abstracts: Wait-and-see prescription for the treatment of acute otitis media: A randomized controlled trial. Impact of the Mexican program for education, health, and nutrition (Progresa) on rates of growth and anemia in infants and young children
• Abstracts: Adolescent pregnancy - another look. Association of young maternal age with adverse reproductive outcomes. Treatment of periodontal disease and the risk of preterm birth
• Abstracts: Incidence of and treatment for ductal carcinoma in situ of the breast. Efficacy of screening mammography: a meta-analysis
• Abstracts: Breathing easier. A hard Pill to swallow. A sensitive issue

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.