Medicaid Basics

Medicaid is a state-operated program funded in part by federal funds and in part by state funds.

On the basis of your understanding of the statement, answer the following questions:

· Why was Medicaid but not Medicare designed to be state operated?

· What factors prove that Medicaid program is being operated by the state?

· Conduct an analysis of the Medicaid program of your state and another state from a different region of the country.

· What are the main similarities and differences between the two programs?

· Are there enough differences to prove that the state and not the federal government operate Medicaid? Discuss.

As a government program, Medicaid has recently been subject to cuts and last minute increases in funding.

Note: Present your answers in the context of Medicaid payment and reimbursement policies.

· Why is Medicaid subject to seemingly constant cutbacks?

· Are these cutbacks due to the relationships between the state and federal governments and the populations being served, or just the rising cost of healthcare in general? Discuss.

Medicaid is an entitlement program that provides healthcare coverage to a variety of low income individuals.

· Identify three beneficiary groups receiving care through Medicaid.

· Analyze the federal eligibility requirements for each group.

· Discuss the coverage provisions for each group.

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Combine all three parts of the QI plan into one document, making sure to include instructor feedback. Organize the plan as you would present it to the organization’s board of directors for approval. Use the QI Plan Template as a guide. (950-word)

 

In the QI Plan Template, complete the following:

• Evaluate various data collection and display tools used in performance measurement.
• Evaluate tools used to measure and report data.
• Analyze various improvement methodologies for integrating quality improvement strategies into performance measurements.
• Analyze the impact of information technology applications on performance measures.
• Analyze the use of internal and external benchmarking and milestones in managing the utilization of quality indicators.
• Evaluate criteria and tasks for developing quality improvement plans.
• Analyze how performance and quality measures are aligned to the organizations mission, vision, strategic and operational plans.
• Evaluate strategies for meeting regulatory and accreditation standards within health care organizations.
• Evaluate measures used to monitor and revise quality program implementation.
• Evaluate barriers that can interfere with the implementation of quality measures.
• Evaluate strategies to ensure successful implementation of quality measures.

Write a 600-word executive summary related to your QI plan which includes an evaluation of the  following:

• Evaluate the current state of QI at the organization, its organizational and operational QI structure, authority, mission, methodology, and tools used.
• Recommend how the organization will achieve its objectives over the long term.
• Evaluate challenges that may impact the future of health care quality improvement.
• Evaluate effect of health care quality improvement on operational and financial performance.

Format your paper according to APA guidelines.

 

Cite 6 peer-reviewed, scholarly, or similar references to support your paper.

 

Due date: 8/21/16 (Sunday) at 10 am – California time (PST)

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