When a physician is fully certified by the ABNM, that physician have fulfilled all the requirements needed for training and is allowed to practice nuclear medicine since his competency is not in doubt. The certification process involves rigorous writing of examination tests ranging from medical uses of radioactive materials and related physical sciences to demonstrate the required excellence for the practice of nuclear medicine (SNM,2011)
Evolution of Medicare and Medicaid BOON or BANE? The concept of a national insurance was a preoccupation from 1900 to 1965 (Berkowitz 2005)
But the biggest contributor was a small increase in older and disabled Medicaid recipients in their share of the spending (Sherman). Conclusion The findings of a study published in the January-February issue of Health Affairs said that the rate of growth of Medicare and Medicaid costs had decelerated in 2003 as compared with those of previous years (Edwards 2005)
Health Care Spending Rises Steeply Statistics showed a record-high level of healthcare spending and growth at $1.6 trillion in 2002, which topped the rest of the economy in the fourth straight year (Sherman 2004)
By then, it had undergone major transformations, particularly in the aspects of consumer choice and the basic program design (Berkowitz). Eligibility for Medicaid coverage requires thorough documentation of income and assets and medical condition (Shumaker 2001)
The center of gravity along any value chain is defined as "the part of the chain that is most important to the company and the point where its greatest expertise and core competencies lie" (Wheelen & Hunger, 2009). Speaking of the medical field specifically, an example of a value chain can be found in the Wharton School's Study of the Health Care Value Chain, which examined "three major players at various stages of the value chain: producers (product manufacturers), purchasers (group purchasing organizations, or GPOs, and wholesalers/distributors), and health care providers (hospital systems and integrated delivery networks, or IDNs)" (Burns, et al
¶ … Medicaid and Medicare Value-Based Purchasing A value chain is defined as "a linked set of value creating activities that begin with basic raw materials coming from suppliers, moving on to a series of value-added activities involved in producing and marking a product or service, and ending with distributors getting the final goods into the hands of the ultimate consumer" (Wheelen & Hunger, 2009)
" This is showing how the system is designed to encourage a greater emphasis on quality and services. (Hewitt, 2012) The best way to ensure that it remains viable is to expand the categories and what is offered under the program
Every state has a Medicaid budget, which the federal government 'matches' based upon a formula, despite the fact that Medicaid is considered an entitlement, implying that enrollees are entitled to benefits regardless of where they live. Because federal funding is 'matched' that means that states that spend more on Medicaid -- usually wealthier states -- tend to receive more federal funds (Villarreal 2006)
Medicaid Participation by Elderly Residents The importance of Medicaid in elderly disadvantaged populations is critical to maintaining health and well being. For elderly persons who meet financial criteria, Medicaid will cover certain services in which Medicare does not participate, including dental services, prescription drugs, home care services, and long-term care nursing home visits (Ettner 238)
Moreover, different policies exist within different regions and states of the country, so it would be extremely difficult to combine these differences into one widespread benefit plan. Finally, more and more doctors are refusing to accept Medicare patients because they cannot afford to absorb skyrocketing operating costs, and many Health Maintainence Organizations (HMOs) are eliminating Medicare business because of inadequate payments (Korcok 1322)
Furthermore, it is important to diagnose their problems as well as to determine possible mechanisms for reform in order to maximize their benefits for the elderly population. Brief History of Medicare in the United States Medicare is managed by the Health Care Financing Administration and is composed of two primary areas: Part A and Part B (Vladeck 50)
This is the other undoing of the CMS plan since the private companies are required to cover all of the services while receiving only fixed monthly due from CMS, not taking into account the cost of care that was received by the patient. The effect of this is that the HMO may sound cheaper for the clients but it provides leaner options with most people going only for the primary care, hence effectively remaining not sufficiently covered (Steven J. Lonchyna, 2011)
The Medicare includes involves the federal health insurance for the seniors while the Medicaid basically deals with the needs-based programs. The CMS is also charged with overseeing the Health Insurance Portability and Accountability Act otherwise known as (HIPAA) the Children's Health Insurance Program also known as (CHIP) as well as the Clinical Laboratory Improvement Amendments (CLIA) as the main areas of concentration among several other areas of commitments (Techtarget, 2011)
Explanation of Proposed Solution The proposed solution for preventing 30 days readmission of Medicare and Medicaid patients is a process or procedure that focuses on post-discharge care through follow-up phone calls after discharge and follow-up appointments with primary care physicians. Generally, follow-up phone calls by nurses after patient discharge have widely been adopted as a means of enhancing patient satisfaction and outcome while ensuring continuity of care (D'Amore et al
Therefore, reducing the rates of readmissions to hospital of Medicare and Medicaid patients requires developing and implementing a new or enhanced plan for patients' follow-up after discharge. According to the findings of a recent survey, 22% of patients admitted to hospitals are either re-hospitalized or visit an emergency department within the first month after discharge (Harrison et al
The interventions help in achieving this through increasing visits to physicians' office, which implies that these patients seek help from physicians resulting in avoidance of re-hospitalization. The case for this proposed solution is also supported by vital evidence in literature that non-medical risk factors play a major role in early readmission of Medicare and Medicaid patients to hospitals (Iloabuchi et al
Moreover, the skills of the staff will be rejuvenated after a considerable period. For instance, the staff members will be taken through different seminarian proceedings and engagement that aid them to improve service delivery, while taking up progress records that will beckon further improvement (Cisneros, 2015)
Initiating programs of assessment and evaluation to access feedback for every change initiated The changes initiated will be monitored regarding their contributions, their certain changes they will result from the results of the services offered, and the general reaction of the patients and the staff upon these new things in place. The programs will involve regular placement of the changes and the contributions made by the changes (In Mason et al