Thursday, August 29, 2019
The Cost and Reimburstements of Medicare Research Paper
The Cost and Reimburstements of Medicare - Research Paper Example This study focuses on cost and reimbursement of Medicare as well as challenges facing the program. Medicare services can be provided to the beneficiaries either through traditional fee-for-service (FFS) program or private health plans such as Medicare Advantage (Kaiser Family Foundation, 2008). Whereas clients can be served in any hospital and by any doctor under FFS those using Medicare Advantage should be treated by providers in a network or pay extra charges for treatments received from out-of network providers (Mason et al., 2013). The program is available in four parts namely Part A, B, C and D. "Medicare covers Hospital Insurance (part A), Medical Insurance (part B), Prescription Drugs (part C) and Medicare Advantage" (part D) (Kaiser Family Foundation, 2008). Clients who apply for part C receives various benefits offered in other parts. Currently, some people prefer Medicare Advantage because it offers extra services in addition to those provided under FFS. Part A of the Medicare is financed through payroll tax charged on employees and the employers whereby each contributes 1.45% to make a total of 2.9% while for self employed persons they contribute full 2.9% since they are both employees and employers (Mason et al., 2013). Part C and D are financed by premiums contributed by enrollees of the Medicare and revenue from the general fund. Medicare in partnership with local insurance companies pay compensation to claims presented each year by the Medicare beneficiaries (Kaiser Family Foundation, 2008). The Medicare uses various methods to compensate the medical service providers for the services they offer to their clients covered by health insurance. For example, Center for Medicare and Medicaid Services introduced Accounting Care Organization model to harmonize medical service delivery among the service providers by enabling them to coordinate their service delivery to reduce expenses, improve quality and outcome of the
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