Modern Healthcare has documented every Medicare and Medicaid milestone and challenge since Crain Communications purchased the magazine in 1976. This section commemorates the programs' 50th anniversary by providing some history and an overview of their challenges.
Medicare and Medicaid evolved in dramatically different ways. Medicare, which provided health coverage for seniors, became the third rail of American politics. Medicaid, a state-based program that provided health coverage for the poor, existed in a political netherworld. All that is about to change.
Medicare and Medicaid have precipitated the vast expansion—and even the creation—of many profitable industry sectors including hospitals, physician groups, managed-care insurers, home health, drug manufacturers, devicemakers and others.
Douglas Holtz-Eakin, president of the American Action Forum and a former Congressional Budget Office director, writes that Medicare and Medicaid have an obligation to provide high-quality care to America's seniors and low-income beneficiaries, and they must be made financially sustainable.
Georgetown University professor and former HHS official Judy Feder writes that the 50th anniversary of Medicare and Medicaid enactment calls for a celebration. Medicare provides health insurance protection to virtually all older Americans and many workers who become disabled.
While politicians debate the future of Medicare and Medicaid, few question that those programs are here to stay. It's easy to forget how controversial the idea of government healthcare programs was for most of the 20th century, and how many decades it took to enact the programs.
Before Medicaid was established, low-income Americans had limited access to healthcare, relying heavily on charity care and public hospitals. "To be old and poor and sick was to suffer and to die prematurely,” said Trish Riley of the National Academy for State Health Policy.
As high-deductible plans proliferate and regulators step up scrutiny of hospital collection practices, some providers are investing in tools to make the process less confusing and easier to navigate and using sophisticated algorithms to predict who is most likely to pay.
It's a tough challenge to engage academic physicians in managing the health of an enrolled patient population.
Connecting monitoring devices and EHRs is likely to become a growth business over the next decade. Once they do start communicating, together they could also help clinicians improve care and raise hospital productivity.
The personalized medicine marketing wars are on. From national chains to regional powers, hospital systems are spending millions of dollars to claim leadership in this new field.
A growing number of hospitals have turned to healthcare consulting firms for help to streamline and improve their clinical operations. Increased financial pressures associated with declining inpatient volume, rate pressure from insurers, and Medicare performance-based rewards and penalties have...