LEARN MORE...

MHA 505 UOPX A Systems Thinking Approach to Medicare Buy In Paper

Content type

User Generated

Subject

Health & Medical

School

University of Phoenix

Course

MHA 505

Type

Discussion

Uploaded By

fwbetrpnzcbf

Pages

Showing Page:

1/5

A Systems Thinking Approach to Medicare Buy-In

Medicare is a government program that provides lower provider payments and

administrative costs than private payors. The structure of Medicare was built in a way to provide

more choices in healthcare options for eligible consumers, which would have a significantly

positive outcome in areas where private payors are not in the market. It can reduce costs for

young adults, as well as high-risk older adults. At a glance, the Medicare program seems

beneficial, helpful, and easy to access. Having a healthcare insurance program for all

socioeconomic groups that provides a broad base of coverage with multiple provider choices is a

systems thinking approach. The scope of the program is to serve a larger base of consumers,

while meeting, but not exceeding, the healthcare costs. However, the lower reimbursement rates

that the Medicare program offers are becoming more unsettling to healthcare providers.

…true…reimbursement is about 80%

Medicare Buy-In

In the American Action Forum, Holt (2019) states that the Medicare Buy-In and Health

Care Stabilization Act of 2019 allows consumers between the ages of 50 to 64 to buy into

Medicare “using the Affordable Care Act tax credits and cost-sharing reduction subsidies”, while

also providing funding for reinsurance. This bill creates adjustments to the ACA, as well. The

major change to the ACA includes the establishment of a reinsurance program to protect insurers

who sell insurance plans to the ACA market against high-cost consumers and reigniting and

increasing cost-sharing payments to payors (Holt, 2019).

Strategy and Concepts of the Medicare Buy-in

Currently, in the United States, there have been great strides made to bridge the gap of

insurance coverage and availability for affordable healthcare. The cost of affordable healthcare

Showing Page:

2/5

and life expectancy has raised concerns for the healthcare systems in today’s market. For this

reason, there is currently a healthcare crisis in this country. There is a push for Medicare for all,

this is not thought to be going to pass for many reasons. There is another option that has a better

chance to pass, and that is a Medicare buy-in program that would be available to consumers,

starting at the age of 55. The reason this has a better chance of passing is that it would allow

more people to have affordable coverage.

Medicare has one of the best success rates as it has a long and sustainable history, having

been in operation since the 1960s, providing coverage to those over 65 and the disabled. It has

opened the door to allow for better services that lower-income, disabled, or retired consumers

could afford. Accessibility to care for the older population, disabled, or lower socioeconomic

patients is what the country needs to help improve access to care. The thought process behind

opening the buy-in option to those who are 55 and older is that it would then allow more

affordable care as well as promoting consumers under the age of 55 to gain more affordable

coverage through private insurance. The private insurance would be more affordable to younger

people, as there is a gap in access to many healthcare services compared to the access that is

available for the older generations.

It is no secret that something is needed and there is a lot of push and pull from

government branches concerning what should happen. Each option comes with its pros and cons,

it Comma Splice does appear in the research that the buy-in option could work to get a large

majority of people covered. Those over 65, as well as the disabled, have access to good care, so

by using this model it makes sense that it would work. The key to making anything work is

going to be the cost and not just the cost of coverage, but the cost that is paid to the providers

Showing Page:

3/5

End of Preview - Want to read all 5 pages?

Access Now

Unformatted Attachment Preview

A Systems Thinking Approach to Medicare Buy-In Medicare is a government program that provides lower provider payments and administrative costs than private payors. The structure of Medicare was built in a way to provide more choices in healthcare options for eligible consumers, which would have a significantly positive outcome in areas where private payors are not in the market. It can reduce costs for young adults, as well as high-risk older adults. At a glance, the Medicare program seems beneficial, helpful, and easy to access. Having a healthcare insurance program for all socioeconomic groups that provides a broad base of coverage with multiple provider choices is a systems thinking approach. The scope of the program is to serve a larger base of consumers, while meeting, but not exceeding, the healthcare costs. However, the lower reimbursement rates that the Medicare program offers are becoming more unsettling to healthcare providers. …true…reimbursement is about 80% Medicare Buy-In In the American Action Forum, Holt (2019) states that the Medicare Buy-In and Health Care Stabilization Act of 2019 allows consumers between the ages of 50 to 64 to buy into Medicare “using the Affordable Care Act tax credits and cost-sharing reduction subsidies”, while also providing funding for reinsurance. This bill creates adjustments to the ACA, as well. The major change to the ACA includes the establishment of a reinsurance program to protect insurers who sell insurance plans to t ...
Purchase document to see full attachment

Tags: government program lower provider payments administrative costs Medicare Program Medicare Buy In