During my research this week on these 3 insurance "foundations," I
ended up traveling down a few unexpected rabbit holes while chasing
information. It seems that the amount of information on this week's
topic is endless, so it was difficult to narrow down the reference
material.
Medicaid was signed into law in 1965 by President Lyndon B.
Johnson to help Americans obtain and maintain medical care. Low-
income, disabled, and elderly persons have been able to get care
thanks in large part to this program making it possible. Medicaid
removed racial segregation from the healthcare, ensured access to
care, and children grow into healthier adults. The challenges brought
about by Medicaid were limited networks, the continually evolving
payment models. and legislation changes often bring about
re4quirement changes. It's a lot to keep up with from the financial
aspect of the program (Leonard, 2015).
Medicare hit the scene and ensured medical coverage for the
elderly/retired/disabled population. It includes a wide range of
services for patients for no- to moderate costs to the consumer, and
it also helped to pave the way for transparency in patient care. The
challenges brought about by this program is limited network
availability, coverage/legislation changes, cost fluctuations occur for
both the healthcare organization and the consumer, and it sometimes
it falls short on transitional care services. There are also providers
who don't accept Medicare as insurance, which creates a limited
network for recipients (Leonard, 2015).
HIPAA made it possible to port insurance between jobs, but it also
targets fraud prevention and data security. EHR systems were
required for compliance purposes as well as for the ease of access to
PHI across a vast network of providers. HIPAA also eliminated pre-
existing conditions clauses to assist workers with obtaining medical
insurance (HIPAA Journal, 2021). However, along with the uptick in
the use of technology, there has been a proportionate increase in the
number of "business associates" in the healthcare industry, based on
the legal definition of the term (Charles, 2021). As technology
continues to grow in this industry, so too will the need for third-party
vendors, increased security measures, frequent audits, and staff
training. In order to meet the challenges presented, budget
considerations will have to become more fluid rather than the set-in-
stone allowances that have thus far been typical when allocating
monetary resources across an organization.
References
Charles, F. (2021). HIPAA Challenges of 2021: 6 Ways the Healthcare
Sector is Responding. Charles IT blog. March 31, 2021.
https://blog.charlesit.com/hipaa-challenges-of-2021-6-ways-the-
healthcare-sector-is-responding
Leonard, K. (2015). America's Health Care Elixir. US News. July 30,
2015. https://www.usnews.com/news/the-
report/articles/2015/07/30/medicare-changed-health-care-in-
america-for-the-better
HIPAA Journal (2021). Why is HIPAA Important? Posted on October
12, 2021. https://www.hipaajournal.com/why-is-hipaa-important/
