HCM 500 CT 2
doc
keyboard_arrow_up
School
Colorado State University, Global Campus *
*We aren’t endorsed by this school
Course
500
Subject
Finance
Date
Jan 9, 2024
Type
doc
Pages
5
Uploaded by jncook25
MEDICARE SOLVENCY
Medicare Solvency
Jessica Cook
Colorado State University Global
HCM 500: The U.S. Healthcare System
Dr. Jennifer Davis July 30, 2023
1
MEDICARE SOLVENCY
2
Medicare Solvency
The United States offers medical insurance coverage to residents that are aged 65 years and older, or those that have been diagnosed with certain disabilities. The insurance helps pay for
several healthcare costs such as doctor visits, medication, hospital stays, and home health. Though funding for the insurance will need to be added to the accounts each year. The research will review what the Medicare Trust Fund is, while investigating where the accounts stand in the current state. In addition, reviewing what future challenges may present that affect the Medicare Trust Fund. Medicare Trust Fund Medicare provides insurance coverage to nearly 65 million residents in the United States who meets its requirements. The trust provides two aids in two separate funds which are known as hospital insurance, also known as Part A, which provides coverage for hospital stays and skilled nursing, hospice services, and a limited number of services in home health (
Status of the Medicate Trust Funds, 2022). The second fund called supplemental medical insurance, also known as Part B and Part D, which gives coverage for doctor visits, medications, limited number
of home health, and outpatient services (
Status of the Medicare Trust Funds, 2022). The is also one more area of coverage for qualified residents, called Part C, which also gains funding from both the hospital insurance and supplemental insurance funds. Funding comes from employer payroll taxes that both employer and employee pay towards under Part A. For the supplemental fund are bsased on revenue from general taxation and premiums that the members will pay. Current State of the Fund
Each year the funds are evaluated to compare the amount of spending to how much funds
in being placed into the two separate funds. If spending surpasses the amount of funds available,
MEDICARE SOLVENCY
3
then Medicare will begin to deplete the necessary funds to provides services (Cubanski & Neuman, 2022). Projections for the current year of 2023 estimate around 172 billion dollars in available funds, however the amount of spending for this year is projected to be around 3 billion dollars. Leaving the remaining year end funds to be estimated around 169 billion dollars (Cubanski & Neuman, 2022). Still appears that there is a large amount of funding still available for recipients to utilize. In the 1990’s Congress stepped in and established ways to decrease Medicare spending to prevent the funds from depleting. With the prediction of spending the Board of Medical Trustees did find that the year 2022 did perform slightly better than planned to push back further decreased predictions (
Status of the Medicare Trust Funds, 2022). Future Challenges
Previously, it was mentioned that the spending from 2023 would still leave enough funds available for use, however it is predicted to only last for an estimated amount of time. While the 2022 spending year performed slightly better than predicted, the Medicare Trust Funds are predicted to deplete by the year 2028 (
Status of the Medicare Trust Funds, 2022). Patterns show that spending is increasing fast each year and contributions aren’t filling the funds as fast. One major cause for the increased spending is the baby boomer generation is approaching the age of eligibility, as well as an increase in health care costs (
Status of the Medicare Trust Funds, 2022). One key factor about the depletion, however, is that funds will empty from the hospital insurance
primarily. The supplemental insurance will not experience this drastic measure as the funds will be replenished by the U.S. Treasury. Another great impact to the funding is Senators proposing that Medicare be given to all U.S. residents, causing a drastic increase to increase which will lead
to faster depletion (
Status of the Medicare Trust Funds, 2022).
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
MEDICARE SOLVENCY
4
There is more than legislation affecting the spending levels but there are a few other factors that will affect the future of Medicare Trust Funds either in a positive or negative way. A growing economy will increase revenue that is collected from payroll taxes. A growing economy
led to an increase in employment numbers, though a decline in the economy could cause a decrease in revenue from payroll taxes (Cubanski & Neuman, 2023). Healthcare is constantly advancing, with advancements comes an increase in health care costs, and then leads to an increase in spending. Previously mentioned above that the baby boomer generation is about to reach eligibility age for Medicare, which increases spending, though the one loss is the decline in
payroll taxes to fund Medicare Part A (Cubanski & Neuman, 2023). Conclusion
There is a lot to consider when understanding the funding aspect of the Medicare Trust Fund. Now with the baby boomers entering the age for Medicare, it is time for the government to
evaluate the spending limits. If the funds are depleted, the question remains on how to rebuild such a vast amount of funding to assure residents have the medical coverage. Some areas that are
being considered are rebates for medication, that will lead to lower prices (Cubanski & Neuman, 2023). While there are ongoing talks about increasing spending to improve care, yet further considerations that will need to be discussed to increase revenue into the account. While the funds have an estimated five years before it reaches insolvency, this is a projection and there is still time to alter the estimates and improve solvency.
MEDICARE SOLVENCY
5
References
Cubanski, J., & Neuman, T. (2022, June 17).
FAQs on Medicare financing and trust fund solvency
. KFF. https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-
and-trust-fund-solvency/
Cubanski, J., & Neuman, T. (2023, January 19).
What to Know about Medicare Spending and Financing
. KFF. https://www.kff.org/medicare/issue-brief/what-to-know-about-
medicare-spending-and-financing/
Status of the Medicare trust funds
. (n.d.). https://www.rpc.senate.gov/policy-papers/status-of-the-
medicare-trust-funds#:~:text=The%20Medicare%20trustees%20estimate%20that%20the
%20Part%20A,the%20program%E2%80%99s%20ability%20to%20provide
%20beneficiaries%E2%80%99%20health%20benefits.
Related Documents
Related Questions
“Financing Health Care in a Time of Insurance Restructuring” Please respond to the following:Analyze the impact of financing the present U.S. health care system and the consequential ramifications for citizens. Rationalize the use of dwindling funds to support the burgeoning U.S. health difficulties in a time of other competitive national interests.Evaluate the levels of affordability and accessibility of different health services protocols that apply to working Americans and senior citizens under the U.S. health insurance umbrella. Rationalize the use of taxpayers funding for uninsured and economically challenged individuals.
arrow_forward
W4
Private health insurance
In the US, about 2/3 of individuals are covered by private health insurance, and most of the private insurance is provided through the large firms. Usually in this big firms, workers are offered with the same kind of health insurance. People pay for health insurance through reduced wages. Discuss the potential redistribution effects (progressive or regressive?) and efficiency effects of this system.
arrow_forward
To enroll in Medicare Part C, an individual must
A. also enroll in Medicare Part D
B. have an annual income under $15, 000
C. already be enrolled in Medicare Part A only
D. already be enrolled in both Medicare Parts A and B.
arrow_forward
Help get answer
arrow_forward
QUESTION 10
With a DRG, Medicare pays for a hospitalization based on _____.
how long the patient was hospitalized
the diagnosis the patient was hospitalized to treat
how much the hospital did to treat the patient
how much the hospital spent caring for the patient.
arrow_forward
Which of the following statements is not correct about Medicaid?
Multiple Choice
The Social Security Act created Medicaid in 1965.
Medicaid is a program of medical assistance to certain low-income individuals and families.
Medicaid is administered by each state within certain federal guidelines.
Medicaid is financed by both state and federal funds.
Medicaid is provided to wealthy individuals.
arrow_forward
V3
arrow_forward
What government programs are available to cover long-term care expenditures in the United States? How do the government programs affect the demand for private long-term care insurance by families who are currently ineligible for government-financed long-term care insurance?
arrow_forward
Indicate whether the statement is true or false, and justify your answer.In the 2010 American health reform law, one primary mechanism for financing the expansion of health insurance to the uninsured involves reducing planned Medicare expenditures.
arrow_forward
Mary Elizabeth has Medicare Part B. Medicare requires a yearly deductible of$110.00. After the deductible has been met, Medicare's coinsurance is80/20. Mary Elizabeth has paid only$72.50toward her deductible. Today's bill is$115.00. How much will Mary Elizabeth be responsible for?
arrow_forward
Domestic
arrow_forward
9. Define out of pocket maximum.
a. A flat-rate fee you must pay when receiving any kind of health care service.
b. The maximum amount of money your insurance will cover of a certain health care
service.
c. The maximum amount you will have to pay out of pocket in one year for the
benefits your insurance covers.
d. The maximum amount of money the insured party will pay toward prescription
medications.
arrow_forward
J. Explanation of Benefits
XYZ Insurance Company Explanation of Benefits
Walden-Martin Family Medical Clinic
1234 Anystreet
Anytown, AK 12345-1234
Patient Treatment CPT
Name
Dates
Code
Yan, Tai 01/06/20XX (99205
01/06/20XX
01/06/20XX
Totals
Gomez, 01/07/20XX
Pedro
Totals
82947
86580
99212
*
Amount
Charge Reason Covered Deductible Co-Pay
Code Amount Amount Amount Paid At
132.28
03
15.00
11.34
158.62
28.55
28.55
70.92
01/04/20XX 71020
Totals
Green, 01/04/20XX 99203
Jana
40.97
111.89
Reason Code: 03 Allowed amount per insurance contract
03
03
125.00
15.00
11.34
151.34
28.55
28.55
69.23
34.95
104.18
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Copyright © 2020, Elsevier Inc. All Rights Reserved.
80%
80%
80%
0.00 80%
0.00 80%
0.00 80%
01/20/20XX
Payment
Amount
100.00
12.00
9.07
121.07
22.84
22.84
55.38
27.96
83.34
Check No: 56390 $227.25
Using the explanation above answer the following questions:
1. For Tai Yan's office visit, 99205, there is a difference between the Charge Amount and…
arrow_forward
K and L
BuCross BlueShield of Illinois announced two new low-cost, cost-sharing
Medicare supplement plans for Illinois seniors, Plans K and L These plans aim to
help individuals seeking assistance with the portion of doctor and hospital bills that
Medicare does not cover, Business Wire, Inc. reports.
Plans Kand Lare options for seniors seeking lower premiums for their
uoplemental insurance. They provide coverage comparable to other Medicare
clement products but have lower monthly premiums in exchangr for higher
cost-sharing by the member.
Members with Plan K pay half of the cost-sharing for covered services (such as the
fist day deductible for hospital care). Members with Plan L pay 25 percent for these
wrvices. Once members reach an out-of-pocket limit (54.000 for Plan K and $2.000
ke Plan L). 100 percent of their Medicare copayments and coinsurances are covered
for the rest of the calendar year.
- Yolanda Younes-Garcia of Decatur, IL, has decided to purchase BCBS Plan K.
She has a…
arrow_forward
Describe the relationships that are eligible for the Canada Care giver amount of $7348 for 2022.
arrow_forward
Sh15
arrow_forward
SEE MORE QUESTIONS
Recommended textbooks for you

PFIN (with PFIN Online, 1 term (6 months) Printed...
Finance
ISBN:9781337117005
Author:Randall Billingsley, Lawrence J. Gitman, Michael D. Joehnk
Publisher:Cengage Learning

Individual Income Taxes
Accounting
ISBN:9780357109731
Author:Hoffman
Publisher:CENGAGE LEARNING - CONSIGNMENT
Related Questions
- “Financing Health Care in a Time of Insurance Restructuring” Please respond to the following:Analyze the impact of financing the present U.S. health care system and the consequential ramifications for citizens. Rationalize the use of dwindling funds to support the burgeoning U.S. health difficulties in a time of other competitive national interests.Evaluate the levels of affordability and accessibility of different health services protocols that apply to working Americans and senior citizens under the U.S. health insurance umbrella. Rationalize the use of taxpayers funding for uninsured and economically challenged individuals.arrow_forwardW4 Private health insurance In the US, about 2/3 of individuals are covered by private health insurance, and most of the private insurance is provided through the large firms. Usually in this big firms, workers are offered with the same kind of health insurance. People pay for health insurance through reduced wages. Discuss the potential redistribution effects (progressive or regressive?) and efficiency effects of this system.arrow_forwardTo enroll in Medicare Part C, an individual must A. also enroll in Medicare Part D B. have an annual income under $15, 000 C. already be enrolled in Medicare Part A only D. already be enrolled in both Medicare Parts A and B.arrow_forward
- Help get answerarrow_forwardQUESTION 10 With a DRG, Medicare pays for a hospitalization based on _____. how long the patient was hospitalized the diagnosis the patient was hospitalized to treat how much the hospital did to treat the patient how much the hospital spent caring for the patient.arrow_forwardWhich of the following statements is not correct about Medicaid? Multiple Choice The Social Security Act created Medicaid in 1965. Medicaid is a program of medical assistance to certain low-income individuals and families. Medicaid is administered by each state within certain federal guidelines. Medicaid is financed by both state and federal funds. Medicaid is provided to wealthy individuals.arrow_forward
- V3arrow_forwardWhat government programs are available to cover long-term care expenditures in the United States? How do the government programs affect the demand for private long-term care insurance by families who are currently ineligible for government-financed long-term care insurance?arrow_forwardIndicate whether the statement is true or false, and justify your answer.In the 2010 American health reform law, one primary mechanism for financing the expansion of health insurance to the uninsured involves reducing planned Medicare expenditures.arrow_forward
- Mary Elizabeth has Medicare Part B. Medicare requires a yearly deductible of$110.00. After the deductible has been met, Medicare's coinsurance is80/20. Mary Elizabeth has paid only$72.50toward her deductible. Today's bill is$115.00. How much will Mary Elizabeth be responsible for?arrow_forwardDomesticarrow_forward9. Define out of pocket maximum. a. A flat-rate fee you must pay when receiving any kind of health care service. b. The maximum amount of money your insurance will cover of a certain health care service. c. The maximum amount you will have to pay out of pocket in one year for the benefits your insurance covers. d. The maximum amount of money the insured party will pay toward prescription medications.arrow_forward
arrow_back_ios
SEE MORE QUESTIONS
arrow_forward_ios
Recommended textbooks for you
- PFIN (with PFIN Online, 1 term (6 months) Printed...FinanceISBN:9781337117005Author:Randall Billingsley, Lawrence J. Gitman, Michael D. JoehnkPublisher:Cengage LearningIndividual Income TaxesAccountingISBN:9780357109731Author:HoffmanPublisher:CENGAGE LEARNING - CONSIGNMENT

PFIN (with PFIN Online, 1 term (6 months) Printed...
Finance
ISBN:9781337117005
Author:Randall Billingsley, Lawrence J. Gitman, Michael D. Joehnk
Publisher:Cengage Learning

Individual Income Taxes
Accounting
ISBN:9780357109731
Author:Hoffman
Publisher:CENGAGE LEARNING - CONSIGNMENT