Health Care Drivers for Increased Medicaid Funding Research Paper

Pages: 10 (3735 words)  ·  Bibliography Sources: 1+  ·  File: .docx  ·  Level: Master's  ·  Topic: Healthcare

Buy full Download Microsoft Word File paper
for $19.77

Health Care Drivers for increased Medicaid funding: A study in the United States.

The Per capita health care spending has increased to about 2,814 in 1990 to more than $7,000 today. With such increased amounts, it is obvious that everyone in America would not be able to afford such so much. This led to the creation and the need for a program like Medicaid. Medicaid is basically a national health insurance program for people with low income. In the year 2000, about 42.7 million people received Medicaid. (Einhorn 25) This shows that Medicaid itself was a program that was a crucial factor in the medical necessities of a lot of people. The demand for health care is still expected to increase thus making an even larger part of the national economy. (Hall and Jones) Data from the National Health Interview Survey from 1997

About Medicaid

Medicaid was itself established in 1965 originally to assist states to provide medical assistance on their own choice. Thus this program was reserved for families who are either old, disable or blind. It also targeted persons whose income was low and resources weren't sufficient to meet costs of the medical bills. This was the program was initially about. Both Medicaid and Medicare were effective in mid-1966. Even though Medicare was the one that was supported fully by the government, Medicaid however wasn't. Thus, Medicaid and Kerr-Mills basically became an extension of the coverage

Eligibility

The eligibility criteria for Medicaid have always been a controversial topic since long. Currently, there are about 60 million people in the United States that receive Medicaid funded services. First, the boldest criteria's will be mentioned. A major criterion for the Medicaid services is that the person should be in a medical necessity. In other words, general physician checks ups are not necessarily funded by Medicaid. Another big criterion is that the Medicaid is the last resort for the patients who require assistance in paying their bills. Thus, they will only be eligible if other financial sources or routes will not pay for the medical bills. The participants should have freedom of choice of the provider and the services that are usually there, they are available statewide.

The Medicaid and the CHIP program cover children, pregnant women, seniors, parents and individuals with disabilities. The government requires certain criteria for an individual to be available to attain Medicaid care. It should be seen that the States set the individual eligibility criteria concerning what the federal poverty level for that region is. A lot of states have increased their coverage thus making more and more people eligible. In 2011, the FPL for a family of four was $22,350 per anum. (Medicaid) This is altered every year thus altering the requirements and the eligibility almost every year.

This topic is of primary concern now because of the reforms that have been carried out in America after the passing of the Affordable Care Act of 2010. The basic aim for this reform is so that more and more people would be insured somehow. This act basically sets a minimum eligibility of 133% of the federal poverty level for all the Americans under the age of 64. This is set to get into effect in 2014 but considering the economic situation of the country, it might be effective before as well.

Even though it appears that Medicaid is quite lenient in providing services, it should be noted that many states have very restrictive Medicaid eligibility requirements. A research carried out in the Brigham and Women's Hospital states that due to restrictive Medicaid Policies, a lot of patients are delaying medical care. (Clark) These are basically states and countries where the individuals need to be far off from the FPL in order to qualify in these programs. Clark states that even though the causes could be many, they are the main reason health care access are hindered in these areas. This is a problem because the patients are delaying the medical care that is quite urgent and is needed. A major way through way the health care access can be enhanced is by increasing the number of primary care providers. (Clark)

Major research question.

It is seen that over the years, the amount of money that the state and the government has to allocate for Medicaid has increased quite a lot. The major research question is what are the main drivers behind increased Medicaid funding in the United States? This research will collectively look at the Medicaid programs in the entire country. It will especially look at the reforms made in the program and why these reforms were necessary. Surely, there had to be some problems or hindrances in the program that caused in to alter its main goals. Furthermore, the statistics from the entire Medicaid history will be looked at. Special emphasis will be given to how Medicaid is planning to evolve subsequent to the passing of the Adorable Care Act of 2010.

The Basics of Medicaid

Before we get into why the need for funding has raised, it should be reviewed how the program actually functions. As mentioned earlier, Medicaid was initially made such that every state functioned on its own. In other words, the state basically chose itself how much it wants to fund or how much it wants to allocate its budge. One thing however is clear that every state has to function under the Medicaid State plan. The federal government basically devices the Medicaid services and states have to argue and basically chose the sort of coverage that they provide. The State also chooses which persons are eligible, the services it will prove, payment levels and providers. It should be noted that the State basically goes on to share the cost of Medicaid with the Federal government share known as FMAP.

Theory

In the research carried out the dependent variable is the change in expenditure or funding of Medicaid. What we are basically looking at is that which factors caused the changes in expenditure. Therefore, these factors would be the independent variable.

Reasons for funds

The most commonly used Medicaid services are prescribed drugs and physician services. (Grannemann and Pauly 7) the hospital out care facilities are used by about 44% of the recipients. This especially goes for those persons who have access to very large care units. About 73% of the Medicaid Payments goes to look after institutions such as hospitals, mental hospitals, nursing homes and intermediate care facilities. (Grannemann and Pauly 8) Nursing home services do not require that much contribution by Medicaid. This is because most of the elderly have some amount of money, thus they are able to pay for themselves. This basically gives an idea of what most of the funds are spent on. However, later we will see that the expenditure of Medicaid is not directly related to the number of cases enrolled alone. Other causes like dynamic policies and economic changes play a crucial role as well.

Problems in Medicaid

In 2010, the average health expenditure in the United States was 2.6trillion in 2010. This was about 8,402 per person or 17.9% of the GDP. (CMS) Out of all this expenditure, Medicaid had provided about 401.3 billion dollars. This is about 15% of all the health care expenditures of the same year. As mentioned before, the eligibility criteria are responsible for the creation of many problems. Since Medicaid is based entirely on blind, disable, age or families who have dependent children. However, many people who are residing below the poverty line, they are not eligible for Medicaid. Thus, a lot of families who are very much deserving and are in need for funded medical care do not receive the benefits of Medicaid.

Data Sources

The data that has been collected has been an amalgamation of newspaper articles and journals on the spending patterns of Medicaid. Furthermore, specific tables and charts have been incorporated from Kaiser foundation web pages and other pages with tabulated expenditures of the program.

Findings

Category

Medicaid & CHIP

Subcategory

Medicaid Spending

Growth in Medicaid Spending, FY90-FY10

Full Title

Average Annual Growth in Medicaid Spending, FY1990 - FY2010

Data Type

Percent

FY 1990-2001

FY 2001-2004

FY 2004-2007

FY2007-2010

Alabama

0.1238

0.0809

0.039655

0.049

Alaska

0.129

0.1524

0.023355

0.082

Arizona

0.1537

0.2277

0.10259

0.123

Arkansas

0.1116

0.1066

0.049142

0.084

California

0.1062

0.0851

0.050631

0.054

Colorado

0.1339

0.0695

0.035946

0.114

Connecticut

0.0941

0.0625

0.028911

0.097

Delaware

0.1513

0.1018

0.076806

0.092

District of

Hampshire

0.1319

0.0958

0.000583

0.046

New Jersey

0.1055

0.0379

0.036914

0.047

New Mexico

0.1573

0.1475

0.058765

0.093

New York

0.0919

0.0911

0.021233

0.055

North Carolina

0.1397

0.098

0.055272

0.035

North Dakota

0.0675

0.0623

0.011742

0.106

Ohio

0.0915

0.1105

0.03725

0.053

Oklahoma

0.1018

0.0723

0.091835

0.069

Oregon

0.1575

-0.0065

0.032613

0.114

Pennsylvania

0.1241

0.0892

0.0392

0.056

Puerto Rico

NA

NA

NA

Residence Unknown

NA

NA

NA

Rhode Island

0.0939

0.1159

0.013021

0.037

South Carolina

0.1238

0.0877

0.01503

0.075

South Dakota

0.0968

0.0648

0.028943

0.082

Tennessee

0.1298

0.0862

0.003154

0.061

Texas

0.1291

0.1159

0.081075… [END OF PREVIEW]

Two Ordering Options:

?
Which Option Should I Choose?
1.  Buy full paper (10 pages)Download Microsoft Word File

Download the perfectly formatted MS Word file!

- or -

2.  Write a NEW paper for me!✍🏻

We'll follow your exact instructions, guaranteed!
Chat with the writer 24/7.

Implementation of Electronic Medical Records in Healthcare Case Study


Health Care Organization Case Study


Health Care Reform in the US Term Paper


U.S. Health Care Delivery System and Drivers for Change Research Paper


Varying Differences of Universal Health Care Capstone Project


View 48 other related papers  >>

Cite This Research Paper:

APA Format

Health Care Drivers for Increased Medicaid Funding.  (2013, March 28).  Retrieved December 13, 2019, from https://www.essaytown.com/subjects/paper/health-care-drivers-increased-medicaid/4376650

MLA Format

"Health Care Drivers for Increased Medicaid Funding."  28 March 2013.  Web.  13 December 2019. <https://www.essaytown.com/subjects/paper/health-care-drivers-increased-medicaid/4376650>.

Chicago Format

"Health Care Drivers for Increased Medicaid Funding."  Essaytown.com.  March 28, 2013.  Accessed December 13, 2019.
https://www.essaytown.com/subjects/paper/health-care-drivers-increased-medicaid/4376650.