Medicare and Medicaid

Medicare and Medicaid

Steven R. Siepel

I appreciate the opportunity to be here today to address the board of trustee’s on how the new reimbursement structure of the new Health Care Reform will impact our organization’s revenue structure.

Medicaid and Medicare are two of the most common types of health care available in the United States. Because of these two programs, the federal government has become a primary payer of benefits for these two programs. There are numerous rules and regulations that must be followed in order for a hospital, physician or individual to receive benefits from these programs. In 1997, the Health Care Financing Administration was created to manage Medicaid and Medicare. The name of this organization was later changed to The Center for Medicare and Medicaid Services, commonly referred to as CMS. CMS became more involved in the reimbursement component of health care by creating a rate of payment based on the average cost to deliver care to a patient who had a particular disease. CMS has been able to work with both the public and private sector in establishing a new rules and regulations that puts American consumers in control of their health care. CMS is also able to work with partners in the private sector to improve care coordination, increase patient safety, offer beneficiaries more information and more control over their care, and achieve better outcomes. The involvement of CMS in the funding process of Medicare and Medicaid has impacted the entire health care industry.

According to Aronovitz, L. G(2002), “CMS provides operational direction and policy guidance for the nationwide administration of the Medicare program.” (p. 4). In order to make sure that our organization is meeting the policies and procedures that have been established by the CMS, we have determined that the following tools should be implemented:

* Establish written policies and procedures, which include a corporate code of conduct.

* Establish the...