...Elaine Bobo Budgetary Analysis The Medicaid program is one of the largest sources of health insurance in this country in addition to employer-based health insurance and Medicare. Medicaid delivers crucial medical related services to the most at risk populations in society. The importance of Medicaid's part in providing health insurance cannot be exaggerated; “the Medicaid program covers millions of low-income women, children, elderly people and individuals with disabilities” (U.S Department of Health and Human Services, 2000). Funding for Medicaid is limited through various federal policies, leaving much of the program’s budget burdened on the individual states to make necessary spending cuts in order to provide the funds needed for the demand of the program. Budgetary decisions need to be thoroughly reviewed before any immediate action is taken as these decisions can create a domino effect on other programs and their participants as sections of this paper will describe. Medicaid Overview Medicaid is a cooperative federal and state program with a common goal to provide a vital service for the general public. “Medicaid is the largest source of federal revenue for states. Medicaid funds support health care providers, jobs and state economies overall” (Kaiser Family Foundation, 2013). Every state institutes its own eligibility criteria, benefits platform, payment rates and program organization under the broad federal recommendations. Medicaid provides three types of vital health...
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...December 16, 2013 The health care industry have been impacted by the economy across the country. The patients who used Medicaid services have been affected by budget cuts. The Clark County Clinic has gone through budget cuts too. Each department that services to Medicaid clients has received a 15% budget cut. The managers of Clark County Clinic have to make a decision if they have to cut certain services or what they can do to still provide services to those that has Medicaid. Effective decision-making is a key component in managing an organization. Managers make important decisions daily that affect the operations and quality of their organization. Every manager has their own perspectives, some are natural at decision-making and some are not. Manager’s still uses tools such as the Informed Decisions Toolbox (IDT) by Rundall et al, it helps managers with their decision-making. Clark County Clinic has gone through budget cuts, a 15% budget cut. The organization has a number of decisions such has how to achieve the goal and still maintain the best quality care for their Medicaid clients. There is an article that have been written in 2007 by Rundall et al that describes the decision-making process and has a set of tools that may help this clinic make the most informed and effective choices determine which services should be changed to meet their budget needs (Rundall et al., 2007). The managers of Clark County Clinic will determine their decision-making based on an Informed...
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...that are consistent. The economy has its ups and downs and continues to change as well. As the economy changes, healthcare cost rises which can have an impact on many organizations. The many organizations either had to move, down sized, lay off staff or close. The Piedmont County Clinic has been struggling to stay in operation. Due to budget cuts the clinic has been affected tremendously. The Piedmont county clinic budget has been cut by 15%. The population that is mainly affected by the budget cuts are the Medicaid recipients. Medicaid recipients are affected in two ways, benefits are reduced and the services they receive at the clinic are reduced as well. The administration at Piedmont County Clinic are being forced to reduce or eliminate services that are provided to Medicaid recipients. In order for Piedmont County Clinic to continue to provide quality health care the administration has to address the budget cuts by either reducing or eliminating services that will unfortunately affect many Medicaid recipients. The Piedmont County Clinic has appointed a team of managers to plan and make decision in regards to addressing the recent budget cuts. To be able to decide what is best for the clinic and the clients, the team of managers will use the informed decision tool box. The team would have to know pertinent information which would be needed in order to make a sound decisions in regards to services that are provided. The team of managers would need specific questions...
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...Medicaid 1 Medicaid and Stakeholders On July 30th 1965 the Medicaid program was created to address the poor and elderly uninsured population in the United State. This voluntary program is administered on a State level but regulated on a Federal level. The Center for Medicare and Medicaid Services (CMS) is the organization that over sees the delivery, quality, funding, and eligibility of the program. Each individual State can choose how to operate the Medicaid itself. The program is design to help people with low income, children, parent of those children, pregnant women, disabled and elderly people in need of a nursing facility. Medicaid is a complex system because it is not a single program and runs differently in each State. It is a very costly system because its serves the poorer population and the long term patients. Currently Medicaid is experiencing changes on all levels. The rise in unemployment has caused an increase in applicants who qualify thus driving up the costs associated. With the passage of the Patient Protection and Affordability Care Act (ACA) the general consensus is that the Medicaid has some current issues to address before more people fall under their umbrella of services. Currently there are more than 59 million people enrolled the Medicaid system for health care. The system is expected to add nearly 16 million more people by 2019. With State governments facing a budget crisis many are looking to cut the Medicaid program. The Federal government...
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...County Clinic is struggling to keep the doors open. Buduget cuts have affected the clinic tremendously. The El Paso County Clinic’s budget has been cut by 15%. The population affected by the budget cuts are Medicaid recepients. Medicaid recepients have a two-fold problem; reduction of benefits, and the reduction of services at the clinic. El Paso County Clinic’s recent budget cuts will force the administration to reduce and eliminate services. The El Paso County Clinic must address the current budget cuts by reducing, and or eliminating services, and continue to provide quality health care. The El Paso County Clinic has appointed a team to address the budget cut issues. The team will use the Informed Decision Toolbox to decide what is best for the clinic and the clients. The first step is to frame the question. The team will gather necessary information and frame questions regarding which services to eliminate, and which services to reduce. In framing these questions the specifics must be stated. What are the most utilized services in the clinic? How will service cuts and elimination affect the clients? What services can be outsourced to other facilities that accept Medicaid? Can lab test, and or raidology be outsourced? Are there any jobs that can be combined without affecting quality services to the clients? Specific questions pertaining to nonessential personnel. Can the custodial personel be downsized? Do the Medicaid recipients of the clinic have...
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...National Health Reform - Decreased Cost in Medicare and Medicaid: How Does it Impacts Nursing Home Care in New York State by Vina Aileen Bonner HCA 621 Utica College Fixing medical care and health insurance in the United States has been a public policy concern for about a century. Presidents such as Theodore Roosevelt, Harry S. Truman, John F. Kennedy, Richard Nixon, Jimmy Carter and Bill Clinton focused on the National Health Reform, but only President Barack Obama achieved the health care reform. Health care costs are increasing while the access to health care is declining. The occupationally based health insurance system is greatly stressed. Medicare and Medicaid are consuming more of the federal budget. According to the White House’s budget for U.S. Department of Health and Human Services (HHS), President Obama’s proposal would save nearly $360 billion in Medicare and Medicaid over the next 10 years: $56 billion would come through Medicaid reforms. Medicare is a federal health insurance program providing health care benefits to all Americans age 65 and over. Medicare is a significant part of the reason the national debt is soaring out of control. It is an open-ended program for provided for millions of senior citizens and people with disabilities. Medicare is growing faster than Social Security and more expensive in the next 25 years. Nationally, health care experts believe that as much as third of all health care spending – about $800 billion in...
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...risen. The present state of the economy has had a major effect on health care across the nation. Individuals and families who receive Medicaid services have been especially affected in the health care system with budget cuts and reduced services. Gardner County Clinic has about seven offices located in Northern, California which provides services to low income communities and Medicaid recipients. The clinic provides primary health care and behavioral services which include prevention and education, early intervention and treatment, mental health, advocacy services and is committed to improving the health condition of children, adults and elderly. The Gardner County Clinic is not different when it comes to budgets cuts. The clinic’s budget has been reduced by 15% and this budgets cut have affected the clinic significantly. With the current budget constraint, decisions have to be made in regards to what clinical services should be eliminated or introduced or what changes could best address the situation to help benefit both the clinic and Medicaid recipients, and continue to provide quality services. Budget preparation and administration are important and are major duties for a manager. Before dealing with the actual calculations, the manager must understand the basic concepts of and principles of budgeting (Liebler & McConell, 2008). Medicaid...
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...Decision-Making Case Study Decision-Making Case Study It has been my pleasure to be your manager of Ramon County clinic. There has been plenty of speculation about the future of Ramon County clinic, more important your positions. Our economy has taken a serious decline and presents several challenges. With that being said, the time has come where I have to make the decision to deal with a 15% cut of my departmental budget. Conversely, the good news is that these cuts will not present a risk to your job here at Ramon County clinic. Our most important goal is to continue to ensure quality health care to all of our patients, including those under Medicaid. “Each state operates a Medicaid program that provides health coverage for lower-income people, families and children, the elderly, and people with disabilities” ("Medicaid", 2013.) Instead of cutting positions I have decided to place you all on an administrative furlough status. An administrative furlough status simply means “the placing of an employee in a temporary non-duty, non-pay status because of lack of work or funds, or other non-disciplinary reasons” (United States Offices of Personnel Management, 2013).After much thought and evaluation using the Informed Decision Toolbox of this seemed to be the best option for our staff and our patient here at Ramon county clinic. These administrative furlough days will allow us to retain all employees, however will eliminate one day of work, overtime, and will reduce patient...
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...that are consistent. The economy has its ups and downs and continues to change as well. As the economy changes, healthcare cost rises which can have an impact on many organizations. The many organizations either had to move, down sized, lay off staff or close. The Piedmont County Clinic has been struggling to stay in operation. Due to budget cuts the clinic has been affected tremendously. The Piedmont county clinic budget has been cut by 15%. The population that is mainly affected by the budget cuts are the Medicaid recipients. Medicaid recipients are affected in two ways, benefits are reduced and the services they receive at the clinic are reduced as well. The administration at Piedmont County Clinic are being forced to reduce or eliminate services that are provided to Medicaid recipients. In order for Piedmont County Clinic to continue to provide quality health care the administration has to address the budget cuts by either reducing or eliminating services that will unfortunately affect many Medicaid recipients. The Piedmont County Clinic has appointed a team of managers to plan and make decision in regards to addressing the recent budget cuts. To be able to decide what is best for the clinic and the clients, the team of managers will use the informed decision tool box. The team would have to know pertinent information which would be needed in order to make a sound decisions in regards to services that are provided. The team of managers would need specific questions...
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...care rules and regulations a patient’s ability to cover the costs of living and health care is a battle. Unneeded budget spending is the tops reason for the high costs associated with health care. Medicare and Medicaid are the two most overly expended health care programs within the United States. If these programs and budgets are not controlled and corrected, there will be no coverage availability for the younger aging generations. How can this conflict be change for future needs and what is the government doing about this? Current Expenditures The United States measure the amount of spending on a yearly basis to track and control costs associated with needs, each year these estimates are changed to reflect the needs of the measures. In the 1960s the NHEA began to measure the annual U.S. expenditures for health care which includes; goods and services, public health activities, government administration, the net cost of health insurance, and investment related to health care. In 2013 the annual health care expenditures reached $2.9 trillion dollars or an estimated $9,255 per person. ("Cms.gov", 2014). According to "Forbes" (2014), “smaller rate of healthcare spending growth (3.7% is “slowest growth rate on record”).” If the health care expenditures continue to increase by 2040 there will be no funding for the aged population. Changes must be made to the budgets and current health care programs in afford funding for the future elderly generations. Spending Spending in...
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...adequate operations in the economic climate we live in. Budget cuts have hit all organizations in corporate America as well as the healthcare industry. Staying afloat in these economic times requires the implementation of difficult decisions, often including reduction of services. This has never been more prevalent than in the health care industry. Healthcare organizations are being hit hard. Hospitals and outpatient clinics are operating with budget deficits. Many organizations are now required to cut or eliminate clinical services in order to remain operational. Determining which clinical services should be cut requires managerial staff to make the difficult decision. Managers require tools that enable them to best make that difficult decision to best address the health care needs of the community served. The New York State Medicaid program is the largest single payer of healthcare in the state of NY to the tune of about $47 billion dollars (“Advocates,” 2008). New York has the nation’s highest total and per-patient Medicaid spending and must link spending to healthcare priorities. The number of uninsured patients has steadily increased over the past few years. Funding losses and projected increased operating expenses have left many healthcare organizations with budget shortfalls. In New York State alone various facilities face losses of up to $300 million in Medicaid funding based on proposed state budget cuts (NYCHHC, 2009). I am employed as a manager in a county...
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...providers. Budget cuts are not just a speculation but are a reality. Decision-making to provide quality patient care with less money is a challenge at best. The Informed Decisions Toolbox can assist administrators and managers with evidence-based decisions that will allow patients to receive the quality care they deserve while reducing expenses. The Informed Decisions Toolbox The Informed Decisions Toolbox (IDT) is the result of a research study to aid managers with making evidence-based decisions that improve organizational performance. The IDT has an approach of six steps to decision-making (Rundell, et al, 2007): (1) framing the management question, (2) finding sources of information, (3) assessing the accuracy of the information, (4) assessing the applicability of the information, (5) assessing the actionability of the evidence, and (6) determining if the information is adequate (p. 325). As a facilitator for the use of evidence-based research in decision-making, the IDT assists decision-makers with estimating how operational and strategic decisions will have an effect on the organization. Evidence-based decision-making is not new to the health care industry. Clinicians have incorporated evidence-based research for years when making patient treatment determination. The use of evidence-based research for decision-making in other realms of healthcare is only logical. Case Study Example A manager of a Denton County, Texas, clinic that provides care to Medicaid clients...
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...Effective Decision Making Every health care facility makes complex decisions to run the organization affectively. In health care organizations, management is usually in charge of making the decisions and uses certain strategies to come up with a plan that will improve and benefit the facility. When there are budget cuts within an organization, management must accommodate to meet the new standards and make a decision whether to eliminate or introduce health care needs better to suit the population. “Decision making is choosing from among alternatives to determine the course of action” (Liebler & McConnell, 2008, p. 147). In terms of the Medicaid program receiving a 15% budget cut, the organization must eliminate a health care need that will accommodate for the budget cut but also make a small impact on the wellbeing of the consumers. “The state Medicaid program will no longer pay for preventative or routine dental care for adults other than those with developmental disabilities” (Washington State Health Care Authority, 2013, para. 2). There is a set of decision-making tools used to determine this decision. The informed decisions toolbox helps managers over come barriers such as time pressures, preveived threats to evidence base, and determining the quality of the information (Rundall, Martelli, Arroyo, & McCurdy, 2007). This paper describes how using the toolbox affects accountability, a questioning organization, and knowledge transfer. The Toolbox To make...
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...Medicaid Expansion: Dichotomous Philosophy Threatens the Economy and Health of Millions Medicaid is a federally funded program that insures disabled, elderly and low-income Americans. While all 50 states have yet to opt-in to its expansion per the Affordable Care Act (ACA), which would add 21 million people to its rolls, or half of the nation’s uninsured, many states chose to opt in following the June 2012 U.S. Supreme Court decision which deemed the Patient Protection and Accountable Care Act (PPACA) constitutional (AAFP)(Mears) Despite the ruling of the Supreme Court, the decision to accept Medicaid remains a divisive and heavily debated issue in many states. Indeed partisan bickering, already strained budgets and questions of uncertain monetary futures all weigh heavily upon those relegated to make the final decision of acceptance or refusal. There is also a question as to whether refusal to accept is ultimately meritorious, as acceptance necessarily requires states to agree to some future percentage of the bill while refusal renders them ineligible for millions in federal funding every year. Thus, in a way, the ACA, perhaps much like many governmental policies, could well be considered a gamble either way. Accept it now and don’t miss out on federal funding or decline it, miss out on the funding but don’t put your state on the hook for unknown quantities of money that have to come from somewhere. The option of acceptance or refusal is indeed a very loaded choice;...
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...Budgetary Analysis Medicaid counts as one of the largest sources of public health insurance in the United States, and also in the whole world. It provides essential medical cover to vulnerable population within the United States. This population includes elderly individuals, expectant mothers, children, low income families and individuals with different physical disabilities and the disadvantaged in the American society. In 1965 President Johnson signed into law under the Social Security Act to improve the health care of the elderly with Medicare. Medicaid would provide improved health care for the poor, unwed mothers, children, and the disabled. The program involves a joint initiative between the states government and the federal government hence the two governments jointly fund the program and ensuring its success through putting up laws to guide its implementation. President Obama’s legacy will be protecting the health of the individual American. The health care policy rules, regulations, and legislations are the consequence of the policy procedure which involves legislators, all the decision-making branch leaders, and public also. The budget for Illinois starts when the Governor submits a bill each January to the House of Representatives. After the bill has been submitted by the Governor then the house is responsible for ways and means review then they budget and develop their own recommendations. The next step is that the budget is then debated as well as...
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