HEALTHCARE REFORM

Healthcare Reform and its affects on Medicare and Medicaid Reimbursement Program

Acknowledgement

Iwould take this opening to express gratitude my research supervisor, family and associates for their support and guidance without which this study would not have been possible.

Abstract

This paper highlights the importance of healthcare reform in the United States of America. This paper also covers the impacts of healthcare reform on reimbursement mechanisms of Medicare and Medicaid programs based on long-term care. The first chapter provides a brief introduction to the topic, followed by relevant literature review. The methodology is covered in the third chapter, while the findings and discussion on the results is presented in the fourth chapter. The recommendations and implications of this study for future research are also included in the fifth chapter.



Table of Contents

ACKNOWLEDGEMENT2

ABSTRACT3

CHAPTER 1: INTRODUCTION5

Background of the Study5

Purpose of the Study6

Problem Statement6

Hypothesis7

Objectives of the Study7

Significance of the Study7

CHAPTER 2: LITERATURE REVIEW8

Recent history of primary care funding8

Government Sponsored Program10

Medicare11

Medicaid14

Government Regulation of Long-Term Care16

Management Issues In Long-Term Care17

Rehabilitation in Occupational Therapy19

Rehabilitation in Physical Therapy19

Rehabilitation for Speech Therapy21

Reimbursement for Hospice22

Physician's Reimbursement: Private Insurers23

Training and Staffing for Healthcare Professionals25

Support for Formal Caregivers26

Support for Informal Caregivers28

End-of-Life Care and Rehabilitation31

Summary34

CHAPTER 3: METHODOLOGY38

Research Method38

Measures38

CHAPTER 4: ANALYSIS AND DISCUSSION40

Analyses40

Results40

Characteristics of sample40

Access41

Satisfaction42

Utilization42

Discussion42

The current picture43

CHAPTER 5: CONCLUSION45

Implications of the Study46

Recommendations47

Conclusions48

REFERENCES48

APPENDIX A: TABLES52

APPENDIX B: SURVEY QUESTIONNAIRE57

Healthcare Reform and its effects on Medicare and Medicaid Reimbursement Program

Chapter 1: Introduction

Background of the Study

Long-term care services for an extended period of time that are not set on a certain level of functionality should be made available to the people across the board. Additionally, long-term care assistance is necessary for people to cope with, and sometimes, to survive, if affecting the physical and mental disabilities the ability to perform activities of daily routine such as eating, bathing and toilet to perform. In contrast to the provision of services to the general health of acute medical problems are oriented, long-term care should be a continuous process and therefore more expensive (Barbui, 2006).

Long-term care needs a diverse set of people who should receive help from a wide range of services thus reducing the ability of the older people, who are the main beneficiary of long-term care. Meanwhile, younger people with physical or mental disabilities tend to require these services in some cases. Primary providers of long-term care in the USA are family members and friends (Chen, 2005). Formal providers include nursing homes, board and care homes, health facilities, assisted living facilities, promote adult education and day care homes and continuing care retirement communities. For these different formal providers, there are different types of payers to complete and from their own pocket, public and private insurance. Since consumers often believe on the lack of information about the quality of services provided, there is a huge amount of state regulation in the long-term care industry (Conner, 2005).

It is important to address the health care management problems arising due to failure in provision and delivery of long-term care. A fragmented system of providers and payers, the dependence on human resources, relations with the acute ...