Medicaid Benefits and Eligibility and Financing
MEDICAID ELIGIBILITY AND FINANCING
Assignment Overview
Over 72 million Americans are currently covered by Medicaid (along with coverage by the SCHIP programs), which makes Medicaid the single-largest source of health insurance coverage in the United States. Depending on income, children, pregnant women, parents, senior citizens, and individuals with certain disabilities are able to access the health care system for needed services. In this Case Assignment, benefits, eligibility, financing, and reimbursement levels will be examined – including how the Patient Protection and Affordable Care Act impacted the program. How do the economics of Medicare reimbursement levels vs. private insurance reimbursement levels affect health care systems and providers?
Case Assignment
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:
Examine the benefits and eligibility of the Medicaid program. Who can be covered, and what are the specific income restrictions when qualifying via financial status? How did the Patient Protection and Affordable Care Act change the income determination methodology?
Describe how the Medicaid program is financed. How much do the individual states (including your home state) contribute?
Determine how the average Medicaid reimbursement level specifically compares to the average reimbursement for private insurance. How can these reimbursement levels affect the bottom line at your facility?
Assignment Expectations
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.
You may use the following source to assist in formatting your assignment:
Purdue Online Writing Lab. (n.d.). General APA guidelines.
For additional information on reliability of sources, review the following source:
Georgetown University Library. (n.d.). Evaluating internet resources.
Module 3
Required Reading/Viewing
Dillender, M. (2017). Medicaid, family spending, and the financial implications of crowd-out. Journal of Health Economics. Vol. 53, 1-16.
Kaiser Family Foundation. (2019). Ten things to know about Medicaid: Setting the facts straight.
Perez, K. (2017). The fiscal realities of a single-payer healthcare system. Healthcare Financial Management, 71(11), 108-109.
Petrou, P., Samoutis, G., & Lionis, C. (2018). Single-payer or a multipayer system: A systematic literature review. Public Health, Vol. 163, 141-152.
Robert Wood Johnson Foundation. (2019). Medicaid: The basics.
MHA 550 Module 3 (Case) Medicaid Eligibility and Financing
Student's Name
College/University
Course Code and Name
Professor's Name
Due Date
Medicaid provides essential healthcare to nearly 72 million Americans, including children, pregnant women, parents, elders, and people with disabilities. Its comprehensive benefits cover preventive and long-term care, ensuring access to vital healthcare. Income requirements vary by category for program eligibility. The Affordable Care Act (ACA) changed Medicaid income calculations, making it more inclusive and correcting previous inequities. However, Medicaid's federal-state funding issues and opportunities affect state budgets and healthcare delivery. This paper addresses Medicaid's vital role in US healthcare and its economic effects compared to private insurance as it investigates its complex financing and reimbursement dynamics. Healthcare providers face considerable hurdles due to the economic discrepancies between Medicaid reimbursement rates and private insurance, which could undermine their sustainability and Medicaid patients' access to excellent care.
Medicaid Eligibility and Benefits
Covered People and Benefits
Over 72 million Americans depend on Medicaid, the most extensive health insurance program in the US, for crucial healthcare. The