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Hardships of Medicaid in Healthcare Organizations

The Blackberry Center healthcare organization is a Patient-Centered Medical Home. Patients’ treatment is coordinated through their primary care physician to ensure they receive the necessary care where and when they need it. The organization focuses on birthing a partnership between patients and their physicians.

Medicaid has led to various cuts in recent years, and if they are not addressed, they might cause some long-term effects, such as poorer health and economic impacts for low-income families in the future. Medicaid has led to financial constraints in various states. The program uses millions of dollars, and this ends up affecting the state’s economic status negatively. States executing the plan of expanding the Medic aid programs have complained that the initiative forces the states to cut spending in other parts of their Medicaid programs (Betler, 2017). The initiative allows the state to cut spending outside of Medicaid on state-funded health services for the uninsured. Lastly, the expansion increases the state revenues following the taxes imposed on Medicaid expansion or taxes imposed on the increased financial activity it causes (Antonisse et al., 2018). The expansion of Medicaid has led to increased wait outcomes for appointments.

Medicaid coverage has caused several hardships in our organization. First, sometimes the program pays the organization fewer profits for earlier unpaid care. The reduced revenues received by the organization consequently affect the organization negatively. The organizations need more funds to run their operations and carry out development projects such as purchases of new and modern medical equipment and machines.

The organization needs to benefit from the changes in base payment rates. The changes in state reimbursement rates for healthcare organizations harm Medicaid hospital financing. The increase in base rates has delayed increases in costs during economic declines because states regularly reduce provider rates.

The Blackberry Center Organization receive Medicaid payments that are less than the regular payments. The fewer payments emanate from the many poor people the government wants to cater to. The conditions in the organization end up worsening due to inadequate funds to operate and develop the organization.

Our organization has suffered from the changes in Medicaid DSH funding. According to the current law, DSH expenditure is restricted by annual federal allocations and individual hospital limits. Organizations cannot receive DSH payments above uncompensated care costs.

Healthcare providers in the organization face a huge workload because many low-income people and the elderly come for treatment. Low-income people and the elderly are more susceptible to contracting diseases and sicknesses due to poor living standards. The increased rate of contraction leaves physicians with a heavy workload with little payment.

One positive impact of federal healthcare policies on consumers’ costs is the expansion of Health Savings Accounts (HSAs). HSAs such as the U.S. Department of Health and Human Services and the U.S. Department of Labor allow customers to have further regulation over their healthcare expenditure by permitting pre-tax money to be set aside for upcoming healthcare costs. Secondly, the Health Insurance Marketplaces have advanced. Consumers can now shop for their healthcare, look at available alternatives, and make deliberate decisions.

The negative impacts include a reduction in some competition in the insurance marketplace leading to an increase in premiums for middle-class consumers. When the government lowers its supplies to hospitals or insurance companies, the premiums of the consumer increase automatically (Frean, 2017). The lesser money from the government, the higher the payment for the consumer.

Changes that I recommend to help decrease the deficit in our organization include increasing our profitability chances, merging related services, and establishing blueprints for episodes of care. To increase our profitability opportunities, the organization should use data analytics to develop a pathway to higher profitability. The organization should look for opportunities to reduce the patients’ costs.

Secondly, I recommend that the organization curb spending on corporate services. Corporate service costs such as data systems, digital technology, IT security, and human resources increase faster than the rate of revenue growth. Rather than paying for such services independently, the organization should merge them and assign the responsibility to a single person depending on the scope of the work. Thirdly, I recommend blueprint episodes of care. The difference in the efficiency of physicians in treating a similar medical condition gives rise to Medicaid losses.

References

Antonisse, L., Garfield, R., Rudowitz, R., & Artiga, S. (2018). The effects of Medicaid expansion under the ACA: updated findings from a literature review. Published March.

Bitler, M. P., & Zavodny, M. (2017). Medicaid. In The law and economics of federalism (pp. 183–213). Edward Elgar Publishing.

Frean, M., Gruber, J., & Sommers, B. D. (2017). Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act. Journal of health economics53, 72-86.

 

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