Respond to two of your classmates, contrasting and comparing the benefits and challenges.

Peers response attached. My response (2-1) is attached to be able to compare against peers

Medicare, Medicaid, and the Health Insurance Portability and Accountability Act (HIPAA) have had significant impacts on the healthcare industry. Consider the most significant benefits that Medicare, Medicaid, and (HIPAA) have brought to the healthcare industry and the most significant challenges they have presented to decision making in the industry.

Research Medicare, Medicaid and HIPAA. Identify two benefits as well as two challenges.

Peer Response 1:

Erika Corbett posted

CONS

Disclosure to relatives. This means that hospitals will not reveal information over the phone to relatives of admitted patients (U.S. Department of Health & Human services, n.d.). I do agree with this, however in cases where a patient may be out of state and is injured, unable to speak on their behalf, families are left to wonder where they are and what has happened to them. I agree that everyone has a right to privacy but if you look at it from a standpoint of an injured loved one and no way to contact them and find out what has happened, this can be a bad part of HIPAA laws in my opinion.

Victims of abuse, neglect, or domestic violence.  While this section of the HIPAA privacy rule is good, it could also be bad. If the allegation does not look to be in the favor of the person it was meant to protect, the worry of retaliation is of great concern to the patient. If CPS or Police do not have enough to deem neglect or abuse the child or person being abused may fear retaliation from their abuser. This puts them in a difficult position.

PROS

Right to access your PHI. I think this is great because it allows patients to review their conditions, labs, imaging, and treatment plans. It can help keep them on track with caring for themselves and participate fully in the provider’s care. Patients can also request that their records be transferred to someone else that is caring for them, keeping with continuity of care.

Victims of abuse, neglect, or domestic violence.  The HIPAA privacy rule allows providers to disclose PHI to authorities regarding victims. By having this in place, it helps protect children of neglect and abuse as well as domestic violence victims who are unable to speak out for themselves. By allowing us to share healthcare information that can help get them to a safe place and/or protect them from their abuser.

PROS

Medicare/Medicaid: These health plans are regulated by the Government; therefore, certain standards of care must be met by the providers in order to be reimbursed. I think this is good for the patients because if they receive poor care, hospitals/Doctors are fined, and it makes them want to improve their standards. An example of this is hospital-acquired infection rates. If a patient is admitted and develops a bed sore, or pneumonia, that is the hospital’s cost not

Running head: MEDICARE, MEDICAID AND HIPAA 1

MEDICARE, MEDICAID AND HIPAA 2

MEDICARE, MEDICAID AND HIPAA 3

Medicare refers to a federal health insurance program that covers people who are 65 years and above, young people who have disabilities and also people with end-stage renal disease (ESRD) i.e. kidney failure that requires transplant or dialysis. There are three parts of Medicare service covers including Medicare part A, which is hospice insurance covering inpatient services, hospice care, and home healthcare. Medicare part B is medical insurance covering outpatient services, preventive services, medical supplies, and other doctor services. Medicare part D, which covers adds drug prescriptions. Medicare provides coverage to low-class people, elderly and people living with a disability (Nanof, 2016).

It services are affordable due to its low costs and offers additional Medicare advantage plus with more benefits like a free visual and dental checkup. Medicare has led to drug prescription innovation thus creating a business opportunity for drug companies. This has led to increased quality of drugs to international standards so that the companies can compete with the market. However, Medicare has faced challenges it costly to the administration, which could have been used to fund other valuable programs like education and social justice. People who are sick, elderly are entitled to high charges that the healthy people thus there is a lack of equality those who stay long in hospitals also are charge highly.

Medicaid is a health program funded by state and federal government that covers. It covers many American including children, pregnant women, elderly adults, adults, and those with disabilities. Medicaid is governed by federals that only entitled to the low-income people who are below cut off levels. These make sure that only those who are really in need are covered. Medicaid supports the local economies and offers financial protection to the people since medical expenses are covered (Sommers et al, 2013).

It provides insurance coverage to the unemployed people who do not receive insurance cover since they are not employed. Medicaid ensures that there are no cost-shifting issues as it provides momentary coverage for less fortunate people. Medicaid challenges include delayed medical attention with appointments of over 30 days since a lot of people need it. Some doctors do not accept patients under the Medicaid program due to the delayed and low compensation from the state. They opt to treat patients with private insurance since they make more mone