- Imagine that you are the CEO of Kind Heart Hospital, which is located in a low-income area and has spent millions of dollars over the years on charity care patients. Unfortunately, this practice has placed your hospital in a tough financial position, as the Medicare and Medicaid programs continue to reduce reimbursement for their patients and your mix of commercial insurance patients (or patients who pay more than your cost) continues to decline.
– Discuss what you can do to continue to provide care to the needy but reduce the amount of the loss.
– Will national health reform laws help your reimbursement or hinder it?
- How would you describe the history of Medicare, emphasizing the increasing cost of the program? What was the purpose of offering Medicare Advantage to Medicare beneficiaries? Why is the year 2011 important in terms of Medicare viability?
- Identify a recent example of recent Medicare or Medicaid fraud and abuse cases. What are the details of the case and what were the repercussions or penalties, if any?