An awareness of the covered and noncovered services of Medicare is a critical area of understanding for health care managers. The program has grown and changed over time, refining who and what is included vs. excluded. The Case presents the opportunity to investigate these coverages, as well as the financing of Medicare. Specific reimbursement rules are in place that must be followed if funds are to be received for providing services. The level of Medicare reimbursement differs from what would be received from private insurance – but by how much – and how can this affect your bottom line?
Using the information in the required readings, as well as some additional research in peer-reviewed sources, complete your Case assignment by answering the following:
- Investigate the eligibility of the Medicare program; who can be covered?
- How is the Medicare program financed? What specific operating rules must be followed to receive reimbursement funds?
- How does the average Medicare reimbursement level specifically compare to the average reimbursement for private insurance? How can this difference affect the bottom line at your facility?
- Conduct additional research to gather sufficient information to support your analysis.
- Provide a response of 3-5 pages, not including title page and references.
- There are multiple required items to be addressed herein; please use subheadings to show where you are responding to each required item and to ensure that none are omitted.
- Support your paper with peer-reviewed articles, with at least 3 references. Use the following link for additional information on how to recognize peer-reviewed journals:
Angelo State University Library. (n.d.). Library Guides: How to recognize peer-reviewed (refereed) journals. Retrieved from https://www.angelo.edu/services/library/handouts/peerrev.php
- You may use the following source to assist in formatting your assignment:
Purdue Online Writing Lab. (n.d.). General APA guidelines. Retrieved from https://owl.english.purdue.edu/owl/resource/560/01/.
- For additional information on reliability of sources, review the following source:
Georgetown University Library. (n.d.). Evaluating internet resources. Retrieved from https://www.library.georgetown.edu/tutorials/research-guides/evaluating-internet-content
Kaiser Family Foundation. (2019). An overview of Medicare. Available at
Centers for Medicare and Medicaid Services. (2019). Medicare program: General information. Available at https://www.cms.gov/Medicare/Medicare-General-Information/MedicareGenInfo/index.html
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