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Medicare is a state and federal government program that is designed to provide medical cover for low-income earners and the disabled population. This program has made it possible for this unfortunate group to meet their healthcare needs at a cost friendly price. The federal government and the state are charged with providing funds for this program.
Restricting Medicare benefit design
The reorientation of Medicare is supposed to raise the health cost of most beneficiaries in Medicare and Medicaid while at the same time reducing spending for the sickest. Changes in out of pocket spending are greatly dictated by the health needs of the beneficiaries and the provisions for supplement insurance health cover.
There are two proposed variations in this plan whereby the first approach focus is on a high or low out of pocket spending where the higher limit would increase beneficiary costs while decreasing Medicare expenses and the lower limit will do the contrary. The second proposition assesses the impact of combining the alternative benefit plan with the restriction imposed on Medicare cover in the attempt to cut Medicare expenses (Kaiser Family Foundation, 2012).
Medicare role for dual eligible beneficiaries
More than 9 million low income and disabled people are covered by the Medicare and Medicaid programs. Medicare is the main provider of healthcare insurance cover while Medicaid helps to provide supplemental services that are not covered in the Medicare program (Kaiser Family Foundation, 2011).
Lawmakers in both the federal and state levels have proposed to develop an initiative for dual eligible whose mission is to ensure proper coordination of care for the duals at the same time cut Medicare and Medicaid expenses. Currently, Medicare beneficiaries receive their medical benefits under free for service program or a Medicare advantage schemes that enable them to get subsidized payments from the federal government to cater for their health needs (Kaiser Family Foundation, 2011).
Fiscal challenges face Medicare and Medicaid program and have interfered with their efficiency to care for the population, therefore formulating effective strategies will guide to coordinate care for the dual eligible and promise financial sustainability for the Medicare and Medicaid services for now and many years to come (Kaiser Family Foundation, 2012).
- Kaiser Family Foundation. (2011). Restructuring Medicare’s Benefit Design: Implications for Beneficiaries and Spending. Retrieved November 17, 2017, from https://www.kff.org/medicare/report/restructuring-medicares-benefit-design/
- Kaiser Family Foundation. (2012, April 5). Medicare’s Role for Dual Eligible Beneficiaries. Retrieved November 17, 2017, from https://www.kff.org/medicare/issue-brief/medicares-role-for-dual-eligible-beneficiaries/