Unit 2: Writing Assignment Answer the following questions and submit as a Word file or a spreadsheet.What does Medicare cover? How is it financed?What is a DRG? Why were they established?Who is eligi

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Introduction:

Medicare and Medicaid are crucial government-sponsored health insurance programs in the United States, which cater to the healthcare needs of different sections of the population. The following assignment discusses the details of these programs and their financing. Additionally, the roles and functions of CMS and Joint Commission Accreditation, and the importance of continuous quality improvement in healthcare are also addressed. Lastly, the assignment explains how Christian healthcare administrators differ from non-Christian healthcare workers.

1. What does Medicare cover? How is it financed?

Medicare is a federal health insurance program that covers people aged 65 years and above, people with disabilities, and those who suffer from chronic kidney disease. It covers most medical services, including inpatient hospital care, outpatient care, prescription drugs, preventive services, and medical equipment. The program does not cover everything, and individuals may have to pay some costs, such as copayments, deductibles, and coinsurance.

Medicare is financed through a combination of payroll taxes, premiums, and general government revenue. Workers and their employers pay a percentage of their earnings to the Medicare trust fund through payroll taxes. Beneficiaries of the program pay premiums for coverage of certain medical services, such as drugs, outpatient care, and medical equipment.

2. What is a DRG? Why were they established?

A DRG or Diagnosis-Related Group is a system of categorizing hospital cases into groups based on patient characteristics, medical diagnosis, and treatments undergone. The system was established in the 1980s to standardize hospital reimbursements to Medicare insurance providers by focusing on the severity of the diagnosis and treatments.

DRGs help Medicare and Medicaid to achieve more proportionate reimbursement levels for hospitals and prevent unnecessary hospitalizations, thereby reducing the overall program costs.

3. Who is eligible for Medicaid? What does it cover? How is it financed?

Medicaid is a jointly funded federal and state program that provides health insurance coverage for low-income individuals, families, and children. Eligibility is determined based on one’s income and family size.

Medicaid covers a range of healthcare services, including inpatient and outpatient hospital care, laboratory tests, nursing facility care, and transportation to medical appointments. Long-term care facilities and some prescription medications are also covered, although coverage varies by state.

Financing for Medicaid comes from both state and federal sources, with the federal government matching a percentage of the money states spend on the program.

4. What is CMS? What does it do?

CMS, or the Centers for Medicare & Medicaid Services, is a federal agency under the U.S Department of Health and Human Services, responsible for overseeing the administration and regulation of Medicare, Medicaid, and other federal healthcare programs. CMS safeguards the health, safety, and well-being of program beneficiaries by ensuring that appropriate standards of care are met by healthcare providers. Its functions also include investigating fraud and abuse, promoting health equity, and reducing the costs of healthcare.

5. Why is Joint Commission accreditation important for healthcare organizations?

Joint Commission Accreditation is a voluntary process by which healthcare organizations are evaluated and certified as meeting quality standards for patient care and safety. It is important for healthcare organizations as it:

– It standardizes care processes and enhances patient safety and quality of care.
– It improves staff engagement and training, resulting in better outcomes for patients.
– It enhances the organization’s reputation among patients, payers, and the public at large.
– It helps organizations to identify weaknesses in their care delivery processes and recommend areas for improvement which aids in increased efficiency and effectiveness.

6. Why should quality improvement be continuous?

Quality improvement is essential in healthcare organizations as it helps to optimize the quality of care provided to patients. Continuous quality improvement is an ongoing process of identifying, measuring, and improving the organization’s performance and delivery of care. It provides several benefits, such as:

– Reducing medical errors and adverse medical events, thus increasing patient safety and satisfaction.
– Improving the organization’s efficiency by saving time, money, and resources.
– Enhancing staff engagement and collaboration, leading to better morale and job satisfaction.
– Facilitating compliance with regulatory requirements and demonstrating the organization’s commitment to patient care.

7. How does a Christian healthcare administrator or worker differ from a non-Christian working in healthcare?

A Christian healthcare administrator or worker differs from a non-Christian working in healthcare in several ways. A Christian’s beliefs and worldview significantly shape their approach to healthcare. They are motivated by the love of God to serve and care for those who are in need. This love is the foundation of compassion, empathy, and kindness that Christian healthcare workers exhibit towards their patients.

Christians also believe that every human being is created in the image of God and deserves dignity, respect, and equal treatment, regardless of their race, religion, ethnicity, or social status. These beliefs shape the way Christian healthcare workers interact with their patients and colleagues, resulting in a culture of trust, transparency, and accountability.

Additionally, Christian healthcare workers often integrate prayer, spiritual support, and faith-based counseling into their healthcare delivery to provide holistic care to their patients. This approach alleviates patients’ physical, emotional, and spiritual burdens, leading to better health outcomes and overall well-being.