Conditions to Benefit from Medicare or Medicaid

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Conditions to Benefit from Medicare or Medicaid

This paper focuses on Medicare and Medicaid. Consider how people qualify to receive Medicare and/or Medicaid write a paper that addresses the bullets below:

Consider how people qualify to receive Medicare and/or Medicaid

Firstly, Consider how people qualify to receive Medicare and/or Medicaid. Write a paper that addresses the bullets below:

Secondly, Describe the Quality Improvement Organization (QIO) and explain how the QIO improves policies and healthcare for Medicare beneficiaries.

Thirdly, Briefly define the qualifications for Medicare and Medicaid benefits.

Fourthly, How can qualifications be modified to serve more people who are considered a vulnerable population?

Further, Discuss the impact (including at least two positive and two negative aspects) that the ACA has had on benefits and coverage for Medicare and Medicaid recipients.

Also, Describe your role(s) as a healthcare leader as it applies to the practice of advocating for cost effective care for vulnerable populations.

 

More details;

How do you qualify for both Medicare and Medicaid?
Dual eligibility

If you have Medicare and full Medicaid coverage, most of your health care costs are likely covered. You can get your Medicare coverage through Original Medicare or a Medicare Advantage Plan (Part C). If you have Medicare and full Medicaid, you’ll get your Part D prescription drugs.

What does Medicaid cover?
Medicaid provides comprehensive inpatient and outpatient health care coverage, including many services and costs Medicare does not cover, most notably, prescription drugs, diagnostic and preventive care, and eyeglasses.

What is the function of the quality improvement organization?

QIO Program Mission
The mission of the CMS Quality Improvement Organization program is to improve the effectiveness and quality of services delivered to Medicare beneficiaries. The program strives to do this in several ways, including pay for performance, disease management, and accountability measures.
What does a peer review organization quality improvement organization primarily do?
Quality Improvement Organizations (QIOs), formerly called Peer Review Organizations (PROs), are the primary means by which the Centers for Medicare and Medicaid Services (CMS) promote quality of care for Medicare’s 40 million beneficiaries.
What is the role of the beneficiary and family centered care?
Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIOs) help people who have Medicare exercise their right to high-quality health care by: Managing all complaints and quality of care reviews to ensure consistency in the review process. Also, Providing Health Care Navigation services.
Lastly, What makes a good healthcare leader?
Successful healthcare leaders need clinical skills, business competencies, and interpersonal or soft skills to guide their organizations to success. … Becker’s Hospital Review cites listening, vision, integrity, empathy, and optimism as core skills for medical leaders.