Many lives have been improved using Medicaid, Medicare, and HIPAA. Medicaid is
funded by both the government and states providing medical care to those who
otherwise cannot afford it. Medicaid provides coverage for individuals and families
who demonstrate need and will assist those in getting preventative, dental, and
chronic illness care needs met. As of January 2022, 79,982,228 were enrolled in
Medicaid in the States that reported enrollment data for 2022 (Medicaid.gov,
2022). Medicare is health coverage for those over 65 or with disabilities and with
end-stage renal failure. Medicare is funded by the government, payroll taxes, and
premiums and provides benefits to patients to help cover expenses for hospital
stays, prescription drugs, and outpatient and chronic care for a small monthly
premium. Medicare provides coverage for items and services for over 55 million
beneficiaries (CMS, 2022). The Health Insurance Portability and Accountability
Act of 1996 is a government program that establishes and improves the
availability of health insurance to working families and children. HIPAA also gives
the patient's more power over their own health information with more accessibility
and the ability to make corrections and allow authorized users of their information.
Challenges that come with Medicaid are the changes needed to make to cover
the millions more needing coverage due to the Covid-19 pandemic. Medicaid is
expected to absorb many of the millions of newly unemployed, with States
projecting higher spending and enrollment continuing into 2021 (Zhu, 2020). This
is causing providers to receive lower payments for services, and make budget
cuts to staff and supplies. The challenges of Medicare are also controlling costs.
Despite attempts to control costs through legislation, increased beneficiary
shares, HHS projects that the Medicare trust fund will go bankrupt by
2026(Nowicki, 2022). HIPAA comes with the challenge of adequately protecting
patient information whether in paper form or most likely today via electronic health
record systems. HIPAA Security Rule states :
164;306 Security Rules Standards
General requirements. Covered entities and business associates must do the following:
(1) Ensure the confidentiality, integrity, and availability of all electronic protected health
information the covered entity or business associate creates, receives, maintains, or transmits.
(2) Protect against any reasonably anticipated threats or hazards to the security or integrity
of such information.
(3) Protect against any reasonably anticipated uses or disclosures of such information that
are not permitted or required under subpart E of this part.
(4) Ensure compliance with this subpart by its workforce. (National Achives, 2022).
Compliance issues continue to be a problem, as facilities find ways to improve on
protecting patient information. In 2018, Anthem agreed to pay a record settlement
after a series of cyberattacks led to the largest health data breach in history
affecting 79 million people (Nowicki, 2022).
References
Centers for Medicare and Medicaid Services. (2022, March 3). Medicare Coverage- General
Information. Retrieved from CMS.gov:
https://www.cms.gov/medicare/coverage/coveragegeninfo
Medicaid.Gov. (2022, January). January 2022 Medicaid & CHIP Enrollment Data Highlights.
Retrieved from Medicaid.Gov: https://www.medicaid.gov/medicaid/program-
information/medicaid-and-chip-enrollment-data/report-highlights/index.html
National Archives. (2022, May 9). Code of Federal Regulations. Retrieved from National
Archives: https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-
164/subpart-C
Nowicki, M. (2021). Introduction to the Financial Management of Healthcare Organizations.
Chicago: Gateway to Healthcare Management.
