MHA FPX 5006 Assessment 1 Attempt 1 Financial Basics
The “MHA FPX 5006 Assessment 1 Attempt 1 Financial Basics” course includes the Categories of Revenue Sources lecture for an introductory Health Care Finance course. This lecture provides a general overview of three different types of revenue sources, their function, how the organization is compensated, and their advantages. Healthcare professionals receive money in a variety of ways. For payment and achievement, it is essential to comprehend what they are and how they operate. Each initiative has its specifications, conditions, and payment methods. The processing of assertions must be done in a way that covers all bases to minimize the chance that they will be rejected if provider organizations are to profit from these payment systems. Medicaid, Medicare, and Managed Care coverage payments are the three primary sources of provider income. These three income streams are governed by laws, which determine how and when the services participants get paid for. This presentation’s goal is to talk about these three monetization strategies, their functions, and how each one’s particular reimbursement procedures operate.
Types of Health Finance
Medicaid
Medicaid It is a framework made by the American federal government. It is a joint federal-state initiative (Mehta et al., 2022). The major objective of the program is to help people. As a provision of the Social Security Act, Medicaid was established in 1965 to provide “poor” residents with high-quality health care. This comprises people with disabilities, kids, and senior individuals who need protracted care. Since its beginnings, the program has grown dramatically to the point that one in five Americans (68 million yearly as of 2018) are now covered by Medicaid, making it the main provider of protracted care services in the nation. The Medicaid program is regarded as a collaboration between the federal and state governments. This implies that each state has its own Medicaid program, although the federal government sets precise guidelines for them to go by, each state operates its program differently, resulting in variations in coverage among states.
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In the context of “MHA FPX 5006 Assessment 1 Attempt 1 Financial Basics,” the Categories of Revenue Sources lecture for an introductory Health Care Finance course delves into essential topics. When the Affordable Care Act was formed in 2014, it gave individual states the ability to increase individual coverage for those under 65 whose families earn less than 133 percent of the federally determined poverty line (Bosch et al., 2022). This development significantly impacts the landscape of healthcare financing, as it harmonizes the standards that govern enrollment and compensation management.
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The organization overseeing Medicaid is structured into seven distinct entities, each with its specific responsibilities, including the State Demonstrations Group, the Financial Management Group, the Operations Services Group, the State Health Programs Group, and the Innovation Accelerator Program. Medicaid’s payment system is uniquely designed to facilitate access to medical treatments for individuals who would otherwise be unable to afford them. However, understanding the intricacies of the reimbursement procedure for this program can be challenging, as it depends on the state offering the coverage and their unique requirements. Therefore, comprehensive knowledge of these financial basics, as explored in “MHA FPX 5006 Assessment 1,” is essential for healthcare professionals and financial managers in the field.
Medicare
For those who are 65 years of age or elderly and young person’s receiving Social Security disability payments, Medicare is a health insurance program. Although the program helps with medical costs, it does not pay all medical costs or the cost of the majority of long-term care. Three months before turning 65, you can first register for Medicare. If you have a handicap, you might be able to acquire Medicare sooner.
Managed Care
A considerably larger and most well-defined term is managed care. Although it often comprises systems that may not fulfil the precise regulatory standards of some governmental bodies, it is frequently used to include and occasionally to denote Health Maintenance Organization (HMO). Therefore, Medicare can enter into contracts with both HMOs and competitive medical plans (CMPs), which may adhere to various standar