Medicare

In: Health Care Issues, Costs and Access

Abstract

Intro -- MEDICARE ELEMENTS AND ECONOMICS -- MEDICARE ELEMENTS AND ECONOMICS -- Contents -- Preface -- Chapter 1 Medicare Primer* -- Summary -- Introduction -- Medicare History -- Eligibility and Enrollment -- Benefits and Payments -- Part A -- Inpatient Hospital Services -- Skilled Nursing Facility (SNF) Services -- Home Health Services -- Hospice Care -- Part A Services for End-Stage Renal Disease (ESRD) -- Part B -- Physicians and Non-physician Practitioner Services -- Therapy Services -- Preventive Services -- Clinical Lab and other Diagnostic Tests -- Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) -- Part B Drugs and Biologics31 -- Hospital Outpatient Department Services -- Ambulatory Surgical Center Services -- Ambulance -- Rural Health Clinics and Federally Qualified Health Centers -- Part B Services for End-Stage Renal Disease -- Part C, Medicare Advantage -- Part D -- Administration -- Financing -- Part A Financing -- Part B Financing -- Part C Financing -- Part D Financing -- Additional Insurance Coverage -- Medicare Issues -- End Notes -- Chapter 2 Addressing Medicare Hospital Readmissions -- Summary -- Introduction -- Factors that Influence Hospital Readmissions -- Medicare's Readmission Measures -- Medicare's Existing Payment Incentives and Conditions of Participation (COP) for Discharge Planning -- Current Medicare Care Transition Initiatives -- Community-Based Care Transitions Program (CCTP) for High-Risk Medicare Beneficiaries -- Forthcoming Medicare Payment Initiatives to Address Readmissions -- The Hospital Readmissions Reduction Program (HRRP) -- National Pilot Program of Payment Bundling -- Bundled Payment for Care Improvement Initiative -- Conclusion -- Appendix A. Hospital Actions That May Mitigate against Readmissions -- Improving Hospital Discharge Procedures