6202 Final (correct answers)

Since its inception, Medicaid (also called Title 19 of the Social Security Act) was originally designed to finance health care services for the indigent, and therefore it has been almost entirely a tax-payer funded program. From the very beginning, Medicaid has been what we call a means-tested program. What does that mean? correct answers -Eligibility depends on financial resources -Each state administers their own Medicaid program under -Federal guidelines, and Medicaid is jointly financed by both state and Federal governments -Federal government provides matching funds to each of the states based upon that state's per capita income What are the three main categories of people who are automatically eligible for Medicaid? correct answers 1.Families with children receiving support under the Temporary Assistant for Needy Families (TANF) program 2.People receiving Supplement Security Income (SSI), which includes the elderly, blind, and disabled with low income 3.Children and pregnant women whose family income is at or below 133% of the Federal Poverty Level About 9 million people are called dual-eligible beneficiaries. What does that mean? correct answers -They are eligible for both Medicaid and Medicare. -Dual-eligibility beneficiaries have extensive health care needs because of chronic conditions, one or more disabilities, or a need for long-term care -Example - low-income elderly and disabled young adults who are entitled to Medicare, but also become eligible for some level of assistance under Medicaid If you are in the C-suite of a large hospital system, what would you expect to happen, and what would you therefore have to plan for, if your state expanded Medicaid coverage, based upon observation and research findings? correct answers -increased in the use of hospital emergency departments -increased use of Eds, even over a number of years. -In the post-affordable Care Act era, Medicaid-paid use of Eds increased by 27%. - Look at how you are staffing your ED. There are a couple of perplexing and ongoing problems with the Medicaid program, and it would affect just about any healthcare organization within which you might work. What are those and explain? correct answers -#1 problem: comparatively poor reimbursement for providers, and the result of this is that many physicians and some other providers do not serve Medicaid-covered patients **Medicare, Medicaid reimburses providers only a fraction of what Medicare pays providers for the same or similar level of services