The Medicaid Programme

The Medicaid Programme

Introduction

There are several healthcare programs and organizations in the United States. These programs depict the efforts we have made as a country is solving the various health care challenges we have been facing over the past many years.  One such program is the Medicaid Programs that has transformed the healthcare sector. Medicaid program is a united state federal as well as state program that significantly assists in covering medical costs for population groups with low-income levels.  Besides, the program provides other benefits such as nursing home care and personal care healthcare services   not provided by their counterparts, Medicare program (Jones, 2010).  Medicaid program is also classified as a government healthcare insurance program for people across all ages with the inability to access insurance coverage due to their low socio-economic status (Jones, 2010).  Hence clearly, this organization helps in funding the medical costs of the community across all states in the USA nation. Thus, this research paper seeks to analyses how the funding of human services is done based on successful budget planning using the case study if the United States’ Medicaid program.

Vision and Mission of Medicaid Programme

Budget planning is an essential ingredient in the management of any large or small corporate programs. Likewise, every organization, regardless of which sector it operates within, needs to have a vision and a mission. This is also similar to the Medicaid program, which is one the largest of the six major healthcare programs (Miller, 2011).  The Medicaid program shares the same vision and mission. However, their scale of operation varies. There are certain health services that Medicaid program provides while the Medicare program does not offer. This was mentioned earlier in the introduction of an overview of the Medicaid program.  However, they operate on a similar purpose of ensuring the health care costs of United States citizens, mainly low-income populations groups.

The mission of the Medicaid program states that; The Medicaid program is meant to ensure that the healthcare grievances of the populations are present. This is done so while at the same time implementing, developing as well as evaluating its operational policies and programs. The vision of the Medicaid program is based on ensuring that all CMS members have attained their health services at the best and highest level. Besides, the Medicaid Program is purposed to eliminate the available healthcare disparities affecting quality health care services provision (Musumeci, Garfield & Rudowitz, 2018).

The mission and vision of the Medicaid program play a significant role in the healthcare program in successful budget planning. Simply, we can say that it provides a financial direction of where the healthcare program should follow. In detail, there several important ways through Medicaid vision and mission that have shown its importance in the budget planning of the program healthcare funds for the benefit of the low-income citizens of the United States.  The purpose and vision of the Medicaid program, for instance, contain the program’s core values, goals, and strategies won which funding should be directed towards.  These components play an essential role in the annual budgeting or quarterly budgeting of the Medicaid program. The Medicaid program has a fiscal year recorded in terms of quarterly. The mission and vision of the Medicaid program are directed towards serving the community from a low socio-economic class. Hence a high proportion of the Medicaid program funds are directed towards fulfilling this mission. Therefore the program uses these funds to cater to insurance coverage of this population group in the united states. As stated earlier, money requires direction on where to be spent. The mission and vision of the Medicaid program fulfill that statement by ensuring that people from low socioeconomic class do not lack access to healthcare services.

Financial budgeting of the Medicaid program is also guided by the strategy depicted in the program’s mission and vision. The Medicaid program focuses on developing, implementing, and evaluating its programs and policies. With such specific areas to focus on, funds of the program are directed towards this are to enhance the provision of healthcare insurance coverage services to the needy section of the population. Besides, the united states healthcare sector is faced with unmeasurable healthcare disparities. Medicaid program administration and government funding are aware of this, hence allocating more fiscal resources for fighting healthcare disparities.

Influence of Short and Long Term Goals on the Budget Planning process and Practices in The Medicaid Programme

The Medicaid program deals with the provision of services to a diverse group of people. To ensure quality and success in their mission and vision, there is always the need to have short and long term goals.  Likewise, the Medicaid program, through its initiators, has short and long term goals. The short term goal is paying for peoples’ health services.   The Medicaid program has several long term goals.  The main long term goal is to reduce healthcare disparities among the low socio-economic class of people. To ensure health care services are of the best quality.  Reducing health disparities is a long time goal that requires the integration of various factors together (Musumeci, Garfield, & Rudowitz, 2018).  The program’s anther long term is laying out a well-structured plan for paying people healthcare services for a long time.

These goals have typically helped Medicaid Programme to layout a successful budgeting strategy. For the short term goals, the Medicaid program has allocated the available funds to cater to the current insurance issues such as regular payment of patient’s insurance coverage.  The Medicaid program depends on funding from the federal government to carry outs its insurance coverage activities on the community in each state. With such a dependence on the national government, short term and long term goals have helped in the budgeting of the necessary activities to be undertaken to enhance community service (Verschuere, & De Corte, 2012).

Besides, through short and long term goals, the Medicaid program has been able to predict where it might be soon in terms of insurance coverage and other health services. The program was also able to shape its budget and evaluate some of the healthcare benefits it can offer instead of others. With Long term goals, one of the goals is to expand the program magnitude of coverage by increasing the number of beneficiaries and funds needed to implement this strategy. The population of the united states is growing and still required to be involved in Medicaid insurance coverage. It is having  Having a budget that has enabled the Medicaid program to realize this direction and develop a plan on how to finance this area soon.  Health care issues are challenging for many people in the united states. The main problem is in terms of financial capability. Paying medical coverage for a large proportion of the population is not an easy task. Setting short and long term goals for the Medicaid program has indeed of significant help in ensuring they budget well to face the long term goals and even the short ones (Musumeci, Garfield, & Rudowitz, 2018).

Changes in Political policies influence the Budget Planning Process and Activities of the Medicaid Program

The budgeting of the Medicaid program funds has been influenced both positively by the united state’s various political systems.  One of the political policies that affected the Medicaid program was the policy changes made to the patient protection and Affordable Care Act (PPACA). The policy was changed to provide room for expansion of the Medicaid program eligibility and federal funding (Jones, 2010). This was a positive step in the political aspect of the United States healthcare sector. It significantly increased the amount of funds to be given by the federal state to the Medicaid program to enhance its budgeting process. Hence more money was available to cater to the program budgeting planning practices.  The Medicaid program was now able to increase its beneficiaries to all united states citizens, and the people who had an income level of maximum to 133% of the program set the poverty line.  Budgeting for beneficiaries was also able to include adults without dependent children.  In this case, the federal government will take the responsibility of paying 100% of the medical eligibility costs expansion process.

The Medicaid Drug Rebate and The Health Premium program (HIPP) were established by the Omnibus Budget Reconciliation Act of 1990. These act assisted the Medicaid to avoid incurring expensive costs that the programs were catering for the outpatient’s medications in their discontinued costs. Besides, there are other policies that were brought into senate to influence the Medicaid program yet they did not pass. A good example is the American Health Care Act (AHCA) that was meant to change the reduction of funding to the Medicaid program from the federal state (Rosenbaum, 2017). If it could pass, the budgeting process of the Medicaid program would be significantly affected. The program will have to cut down some costs to squeeze the budget and fit all sections of the population.  However, the political motion did not pass, and the Medicaid program survived this challenge.

Recently, there were attempts to enact the ACA repeal bill during this current Trump Administration. The Medicaid retrenchment was disguised as a few changes in the funding strategy of the program. This was another federal attempt to reduce funding of the Programme (Rosenbaum, 2017). Historically, many regimes guided by republicans have attempted to influence a reduction of the financing of the Medicaid Programme by the federal government.  The democrats, on the other hand, have effortlessly helped in ensuring Medicaid program funding is not affected. This shows some of the political influence on the Medicaid program that has also shaken the budgeting process and activities of the program.

Motivations, Incentives and Expectations

Motivations, incentives and expectations factors have indeed helped in shaping the budgeting process and practices of the Medicaid Programme.  Incentives and expectations have played their part in the budgeting of Medicaid programs. For instance, several incentives have been established in the Medicaid program. Excellent and well known Medicaid incentives are the Electronic Health Record (EHR) incentives and the Medicaid incentives for the prevention of chronic diseases program. Incentives have their allocation in the budgeting of the Medicaid program’s financial budget and financial statements.  The MIPCD program, for instance, was allocated approximately $ 85 million to work on ten states in five years (Rosenbaum, 2017).  The main aim of this funding was to test the effectiveness of this program in the provision of incentives to the program beneficiaries who are involved in prevention programs. They change their health risk as well as impact through embracing healthy behaviors. The performance of these incentives programs has been questionable. Many research studies have proved that they are infective. This has posed a challenge on the Medicaid program being in a dilemma of allocating another amount of money or avoid due to the mixture of results it has displayed.  The Idaho incentive program is encouraging in terms of performance hence bringing the challenge of allocating more money to this incentive program from the budget.

Reimbursement is one of the motivational factors that is posing a challenge to the Medicaid program’s financial strength. There has been a high rate of reimbursement requests. This has led to the incurring of more money from the budget to cover reimbursement costs.  Although they are ignored literally, they are affecting budgeting. The Medicaid program’s budgeting plans have to be structured in a way to accommodate the allocation of funds to cater to reimbursement issues.  Besides, other reimbursement costs are overburdening the budget plan of the Medicaid program.  This is the reimbursement of the home care and other medical expenses incurred.  This is only possible because medical coverage can take up approximately three months (Berenson & Rice, 2015).

According to the terms and policies of operation of Medicaid program, it is possible for a medical applicant or a close family member who incurred the medical expenses for the medical applicant to refunded the money spent during the three months of applying for a Medicaid health insurance coverage (Berenson & Rice, 2015). From my point of view, this brings the use of funds on an applicant who has not yet completed the process of being a full member and beneficiary of the Medicaid insurance program.   There is a need to ensure a person’s insurance coverage in the Medicaid program starts to be active immediately. One has completed the process of joining the Medicaid program.   This challenge brings miscellaneous factors to be incurred that are affecting budgeting.

Expectations is another aspect that has helped in shaping the Medicaid program budgeting plans and process specifically for the future arising needs.  The forecasting of how demand for Medicaid program insurance coverage has helped the program to plan strategies to use in the budgeting process to accommodate the growing aspect of the program.  Besides, the Medicaid program management projects growth of the program spending, which will strain the federal financial power. Hence their program has been financially prepared to deal with this expansion.

Conclusion

In conclusion, the Medicaid program has indeed survived various challenges that have shaken its financial power through interfering with its budgeting plans and activities. However, the presence of well structure mission, vision, and goals of the program have guided the budgeting planning of the program. The Mission of the program is to ensure that the healthcare grievances of the populations are present. The vision of the program is to base on ensuring that all CMS members have attained their health services at the best and highest level. Some of the political policies and legislation that have influenced budgeting of the Programme are the Omnibus Budget Reconciliation Act of 1990, the American Health Care Act (AHCA), the patient protection and Affordable Care Act (PPACA) among other acts. Incentives programs, motivational factors, and expectations have helped in shaping the budgeting process and activities of the Medicaid program. In summary, they have helped in assisting the Medicaid program to offer health services to communities by shaping the budgeting plans of the program either positively or negatively.

References

Miller, G. (2011). Government Budgeting and Financial Management in Practice.

Verschuere, B., & De Corte, J. (2012). The Impact of Public Resource Dependence on the Autonomy of NPOs in Their Strategic Decision Making (pp. 293-313).

Jones, W. (2010). MEDICAID 101: HISTORY, CHALLENGES, AND OPPORTUNITIES.

Musumeci, M., Garfield, R., & Rudowitz, R. (2018). Medicaid and work requirements: New guidance, state waiver details, and critical issues. San Francisco, CA: Henry J. Kaiser Family Foundation.

Rosenbaum, S. (2017). The Trump administration re-imagines section 1115 Medicaid demonstrations–and Medicaid. Health Affairs Blog [blog on the Internet].

Berenson, R. A., & Rice, T. (2015). Beyond measurement and reward: methods of motivating quality improvement and accountability. Health services research, 50, 2155-2186.