Proposal for long term healthcare payment options

Long-term Care with Medicare/Medicaid

LaTonia Pleasant, Student Article

January 29, 2018

Medicare in most cases will not pay for the monthly housing cost for someone in a long-term care facility, but they will help with the cost of the individuals daily living activities. If a patient decides to choose a more advance plan such as Medicare Advantage Plan- Part C than you may possibly have additional coverage to help with nursing home care if they have some type of contract with that insurance. On the other hand, Medicaid, will cover long-term healthcare facilities for low-income groups of people as well as people that are 65 years and older, and those with disabilities. Now state and governments share the financial responsibility of the Medicaid plan.

After reviewing the current information my proposed change for long term care should be to allow Medicaid to pay the entire long-term care with the state, being allowed to cross-subsidized for the items that may need more attention than others. Reach out to the top 10 long-term facilities in the local area and find out the mediations that are used amongst the patients and reach out to the pharmaceutical companies in order to negotiate a huge discount for those patients that reside in those facilities. This proposal will save Medicaid billions of dollars annually with high medication coverage. I propose that long term facilities work with insurance companies that willing to pay for the most amount of coverage for the patient that don’t qualify for Medicaid.

It is more cost effective to have a facility for those whom require 24-hour care than to have that patients constantly spending days at a time in hospitals, which cost thousands of dollars a day and that organization is being uncompensated for. The traditional fee for the service should be reevaluated and allow private insurance carriers an opportunity to let the governments and states know how much they would be willing to accept for those with Medicare.

Some of the proposals I have recommended could possible hurt the providers reimbursement but the population that is benefiting from Medicaid and Medicare are the ones hurting, by having many of their healthcare services eliminated. The goal should be taking care of our populations of elderly and disabled in need.

References

Congressional Budget Office, Updated Budget Projections: 2016 to

2026 (March 2016), www.cbo.gov/publication/51384


Joint Committee on Taxation, Estimates of Federal Tax Expenditures

for Fiscal Years 2015–2019, JCX-141R-15 (December 2015),http://go.usa.gov/xkSeb.

https://www.medicare.gov/what-medicare-covers/part-a/health-care-and-drug-coverage-in-nursing-home.html

http://www.healthcarefinancenews.com/news/billions-proposed-budget-cuts-medicare-medicaid-threaten-provider-compensation