Question

You are an assistant administrator in a nonprofit hospital that receives Medicare and Medicaid funding. Your boss has asked you to make a presentation to other leadership about one of the above policies. She would like for you to provide an overview of the policy, the implications for your organization for non-compliance, as well as recommendations about what you should be doing to ensure compliance.

• The requirement to reduce hospital readmissions

Answer 1

Medicare funding

Overview:

Medicare funds is paid by a federal agency named The Centre for Medicare & Medicaid Services. Medicare trust funds are paid through two accounts, The Hospital Insurance Trust Fund and Supplimentry Medical Insurance Trust Fund.

The Hospital Insurance Trust Fund is funded mainly by income taxes paid by employees, employers and people and by interest earned by investments of the trust fund. It pays for Hospital stays, nursing care, home health care etc.

Supplimentry Medical Insurance Trust fund is funded mainly by premiums from people enrolled in medical insurance and medicare prescription drug coverage. Some part of it also comes from the interest earned from investments of the fund itself. This fund pays for doctors expenses, outpatient care expenses and costs of drugs which are prescribed by the doctor.

Medicaid Funding

Overview:

Medicaid is publically funded and governed by both state and federal governments. Both governments have equel say in controlling the funds. Medicaid is a major insurance fund for non-profit health organisations. Medicaid fund are paid in hospital fees, administrative charges, skilled nursing care, etc.

Reducing Hospital Readmissions:

Various steps can be considered to reduce re-admissions, for example:

1. A great home based care

2. A smooth transition from hospital health care to home health care

3. Advising the patients to visit on a scheduled follow up.

4. Advising the patients to take their medicines properly and on time on a daily basis

5. Monitoring of the condition of the patient for estimation of improvement or worsening.

6. Supporting the patient whichever means he/she needs, psychologically, emotionally etc.