Question

Should people have affordable access to “designer drugs” or experimental treatments through their commercial insurance? If your answer is yes then what is your position for those on Medicare or Medicaid where it is not covered? How would you address that patient need?

Answer 1

My answer is yes, people have affordable acess to designer drugs or experimental treatment through their commercial insurance.

The position for nuses on Medicare or medicaid policy is that, we are the professional caregivers provide the short term and long term care in the home depending on a person's need. Medicaid claims and eligibility data particularly when linked to other sources of patient level and contexual information represent powerful for health service research on the use and outcomes of prescription drugs.

Medicaid is predominent payer for low income people and is crucial for people with disablity. This is also for person with mental illness.

Medicare from paying for items or services that are not “reasonable and necessary.” “Reasonable and necessary” services, in turn, are defined as those that are “safe and effective, not experimental, and appropriate.”

Home care enables safety, securty and inceresed independence and also avoid un necessary hospitalization .when they need part time skilled nursing care or therapy medicare will pay for home.

The affordable care act include programs how led by the centers for medicare and medicaid services aiming to improve quality and control cost.

Greater coordination of care—across providers and across settings—will improve quality care, improve outcomes, and reduce spending, especially attributed to unnecessary hospitalization, unnecessary emergency department utilization, repeated diagnostic testing, repeated medical histories, multiple prescriptions, and adverse drug interactions. As a nation, we have taken incremental steps toward achieving better quality and lower costs for decades.

There are transformative changes occurring in healthcare for which nurses, because of their role, their education, and the respect they have earned, are well positioned to contribute to and lead. To be a major player in shaping these changes, nurses must understand the factors driving the change, the mandates for practice change, and the competencies (knowledge, skills, and attitudes) that will be needed for personal and systemwide success.

The patient need can adress by caring in their home like personal care and companionship services, private duty nursing care, and home health care.

Personal care and companionship can be paid by directly or through long term care insurance or Medicaid.

Medicaid an insurance program for low income persons, pays for non-medical home care, home health care, and other in-home supports to help individuals remain living in their homes.

When you need part-time skilled nursing care or therapy, Medicare will pay for home health care visits. Progressive health care professionals often encourage people to get out of hospitals and nursing facilities and into their own or family members' homes while recovering from injury or illness.

Medicare doesn't payfor an in-home care givers whencustodial care services like housekeeping and personal care are all you need. Medicare may pay for some short-term custodial care if it's medically necessary and your doctor certifies that you're homebound.

The Eligible persons

• You must be under the care of a doctor, and you must be getting services under a plan of care created and reviewed regularly by a doctor.
• You must need, and a doctor must certify that you need, one or more of these: ...
• You must be homebound, and a doctor must certify that you're homebound.

Another way nurses canhelp orinfluence organization costs is by advocating against unnecessary treatments or medications. ...nurses are a valuable asset to health care organizations as they not only provide direct patient care, but also insight into cost saving measures to reduce waste.

To be covered, the services must be ordered by a doctor, and one of the more than 11,000 home health agencies nationwide that Medicare has certified must provide the care. Under these circumstances, Medicare can pay the full cost of home health care for up to 60 days t a time.Medicare pays in full for an aide if you require skilled care (skilled nursing or therapy services). ... Medicare will not pay for an aide if you only require personal care and donot need skilled care

While Medicare covers a wide range of care, not everything is Covered . Most dental care, eye exams, hearing aids, acupuncture, and any cosmetic surgeries are not coverd by original Medicare .Medicare does not cover long-term care.

portion of medicare coverage, partA, is free for most Americans who worked in the U.S. and thus paid payroll taxes for many years. partA is called “hospital insurance.” If you qualify for Social Security, you will qualify for part A. partB, referred to as medical insurance, is not free .

so that now days transformative changes that are occuring in case of nursing roles. People are affordable to access designer drugs or experimental treatment by using their commercial insurances. And also there are more helpin authority for helpin persons as an insurance policy like that .Medicare and medicaid helping the nurses also.