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UNFORMATTED ATTACHMENT PREVIEW

Due Sep 27, 2021 Revised Outline, Cover Page & Reference List Refer to the materials that you compiled for Weeks 1 and 2 intended for completion of the final paper. Make any corrections to your cover page and/or annotated bibliography based on instructor feedback. Determine which resources that you will use for your final paper (remove from or add more to your reference list). Remove summary annotations from your annotated bibliography once it is complete and create an APA formatted reference page as demonstrated in your APA Manual, 6th ed. Create an outline of your paper. You may choose to include annotations (adding information, explanations, sentences that you have composed to start each section, etc.) Submit revised cover page, outline of paper, and reference list with annotations removed. Modification to Medicare Policies Anita Reeves Ramaiya HUM8105: Applied Human Services Policy (RBB137DS) Dr. Philip Atkins September 13, 2021 Medicare is a national health insurance program in the United States, begun in 1965 under the Social Security Administration and now administered by the Centers for Medicare and Medicaid Services. When you have Medicare and other types of coverage, Medicare works with your other insurance to coordinate who pays first. The primary payer is the insurance that pays for your medical bills first, up to the coverage limits, and then sends the remaining balance to the secondary payer. Why is it necessary to reform Medicare? Medicare can lead a revolution in health care delivery that will give all Americans better health care at sustainable cost. It is believed that, if enacted together, these reforms will improve health care quality for patients and families and lower overall spending growth across the entire health care system. What’s right with Medicare? If left to fend for themselves, far too many elders could not obtain health-insurance coverage, and eventually would be impoverished by out-of-pocket costs or possibly even left without care. The Medicare guarantee changed that. Terminating that guarantee is unthinkable. The care that our elderly get from Medicare could be a lot better. The rising cost of Medicare is the primary driver of our long-term budget problem. A deal to fix the long-term problem is both unthinkable and impossible without reform of Medicare. And based on possibly misleading information, many have come to think that we can ignore the program’s rising costs though procrastination might come back to haunt us later. So, what’s wrong with Medicare? For many years, the cost of treating each individual Medicare beneficiary has been growing faster than has our gross domestic product. That cannot continue indefinitely. But the problem is compounded because the Medicare beneficiary population is growing faster than the population at large and is likely to continue to do so for the foreseeable future and at a rapid rate for the next quarter century or so. Most experts identify the problem as Medicare’s fee-forservice the more services, the more fees. Under that basic approach, physicians and facilities have an incentive to do anything that can be justified as beneficial for each patient by sending a bill to the U.S. taxpayer every time. One extreme story I experienced was having a physician who visited the room of my unconscious, dying elderly aunt to express his concern to the attending relatives and each time billing Medicare for a doctor’s visit. This doctor was not aware that after my aunt passes away, we will be carrying her body to Liberia, West Africa for interment but he made frequent visits and he bill every time he was in the room. We were unaware of that billing at that time but when we saw the bill, we were shocked. What if she had survived? She would have had no money to live on. After she passed, we carried her body to Africa for burial which we felt was better. So what should we do? Well, In summary, we believe that Medicare should offer each beneficiary a choice among competing plans, including traditional Medicare, along with a grant that would buy the secondleast-expensive alternative in his or her geographic area. If a beneficiary wants a moreexpensive plan, he or she can have it, but must pay the incremental cost above the grant to do so. If any beneficiary finds that his or her plan provides care that is not worth the cost, he or she can switch at the next open season. Plans will have to shape up or ship out. The easiest way to get there would be to build on the existing Medicare Advantage plan. References Colby, I. C., Dulmus, C. N., & Sowers, K. M. (2013). Connecting social welfare policy to fields of practice. Hoboken, NJ: John Wiley & Sons eText: ISBN-10 1118419286, ISBN-13 9781118419281; Print: ISBN-10 1118177002, ISBN-13 9781118177006. Minarik, Joseph (2012) IN THE NATION’S INTEREST What’s Right, What’s Wrong with Medicare Running Head: MODIFICATION TO MEDICARE POLICIES Annotated Bibliography- Modification to Medicare Policies HUM8105: Applied Human Services Policy (RBB137DS) September, 20, 2021 1 MODIFICATION TO MEDICARE POLICIES 2 Butler, S. M. (2020, July). Medicare Advantage for all, perhaps? In JAMA Health Forum (Vol. 1, No. 7, pp. e200967-e200967). American Medical Association. Butler (2020) notes that the COVID-19 pandemic has led to the questioning of the US health system. The has led to the suggestion that Medicare should become the chassis of the whole health care system. However, there have been concerns about Medicare for all. First is the increase in federal expenditure. Second is that even though the Medicare benefit package is comprehensive, traditional Medicare comprise of significant out of pocket-costs for all. There is also the concept of disruption, especially for the individuals with other health coverages since that means having multiple systems. This research is important in understanding modifications to Medicare. It is also relevant and up to date. Carvalho, N., Petrie, D., Chen, L., Salomon, J. A., & Clarke, P. (2019). The impact of Medicare part D on income-related inequality in pharmaceutical expenditure. International journal for equity in health, 18(1), 1-11. Carvalho et al. (2019) details the impact of Medicare Part D. The purpose of Medicare prescription drug benefit plan was to allow the beneficiaries have access to subsidized outpatient and subscription drug coverage which was offered through stand-alone prescription drug plans. The implementation of Medicare Part D was resulted in an increase in public drug expenditure, compared to the out-of-pocket and private spending. Public-drug expenditures only favoured the poor. Particularly, the comprehension of income-related inequality measures is crucial in describing how they are driving factors in the unequal distribution of health and health access. MODIFICATION TO MEDICARE POLICIES 3 Therefore, this research is important in understanding some of the introductions in Medicare program and how such modifications have had an effect on the overall US health system. Garrett, B., Banthin, J., Gangopadhyaya, A., Buettgens, M., Shartzer, A., Holahan, J., & Arnos, D. (2020). The Effects of Medicare Buy-In Policies for Older Adults on Health Insurance Coverage and Health Care Spending. According to Garret et al. (2020), the introduction of Medicare buy-in program allows qualifying people to purchase Medicare-like health insurance plan. The program required individuals aged 50 and 64 to enroll, which means that the only individuals above 50 would be beneficiaries. The research is important in understanding the effect of the buy-in program as well as the effect of modernizing the Medicare benefit. This research article is also up to date. Huffman, K. F., & Upchurch, G. (2018). The health of older Americans: a primer on Medicare and a local perspective. Journal of the American Geriatrics Society, 66(1), 25-32. Huffman and Upchurch (2018) detail the overview of Medicare and the insurance choices for Medicare beneficiaries. The authors also provide insights on the effect of Medicare on income and race. Thus, it is important to understand how Medicare works so as to be able to get the maximum benefits out of it. The research is important in the understanding of how Medicare has changed over the years. The research resource is also updated. Hussey, P. S., Liu, J. L., & White, C. (2017). The Medicare Access and CHIP Reauthorization Act: effects on Medicare payment policy and spending. Health Affairs, 36(4), 697-705. MODIFICATION TO MEDICARE POLICIES 4 Hussey et al. (2017) notes that the Medicare Access and CHIP Reauthorization ACT, which was enacted in 2015, resulted in the repealing of the Sustainable Growth Rate (SGR) formula. It also led to the expansion of the role of value-based payment in Medicare. Therefore, the modification to Medicare led to an increase in the utilization of payment models that were associated to health care quality. Health care providers were also awarded for decreasing spending growth. This research is important in understanding how MACRA impacts the overall health care system. Lissenden, B., & Yao, N. A. (2017). Affordable Care Act changes to Medicare led to increased diagnoses of early-stage colorectal cancer among seniors. Health Affairs, 36(1), 101-107. Lissenden and Yao (2017) note ACA changes to Medicare. ACA resulted in increasing the affordability as well as the accessibility of the preventive services in the US. ACA necessitated health insurers to increase the coverage of diseases such as breast cancer and colorectal cancer screening tests without any involvement in patient cost sharing. This, therefore, led to an increase in the early detection of the two types of cancers. This research is important in detailed how modifications to Medicare have had an impact in the coverage of health

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