Medicare Blog

how does medicare and medicaid support/hinder the health of our population?

by Eldon Feil Published 1 year ago Updated 1 year ago

Why are Medicaid recipients so poor?

Thus, the adult populations studied in most Medicaid research are extremely poor. Because of Medicaid’s eligibility criteria and the strong correlation between poverty and poor health and disability, Medicaid beneficiaries are poorer and have a poorer health profile compared with both the privately insured and the uninsured.

How does Medicaid coverage affect access to care?

Consistently, research indicates that people with Medicaid coverage fare much better than their uninsured counterparts on diverse measures of access to care, utilization, and unmet need.

Does Medicaid improve health care use?

Medicaid increased access to care and health care use, and improved self-reported health. One year out from the lottery, the adults who gained Medicaid were 70% more likely to have a regular place of care and 55% more likely to have a regular doctor than the adults who did not gain coverage.

How does Medicaid affect mental health?

Medicaid improved adults’ mental health markedly; Medicaid’s impact on physical health remains inconclusive. Objective clinical data collected on both groups of adults two years after the lottery show that, relative to being uninsured, having Medicaid led to a 30% reduction in the rate of positive screens for depression.

What impact did Medicare and Medicaid have on society?

Medicare and Medicaid have greatly reduced the number of uninsured Americans and have become the standard bearers for quality and innovation in American health care. Fifty years later, no other program has changed the lives of Americans more than Medicare and Medicaid.

How does Medicaid and Medicare affect the economy?

In short, Medicaid adds billions of dollars in economic activity. The federal government boosts this activity by matching state Medicaid spending at least dollar for dollar, bringing new money into states.

What are the disadvantages of Medicaid?

Disadvantages of Medicaid They will have a decreased financial ability to opt for elective treatments, and they may not be able to pay for top brand drugs or other medical aids. Another financial concern is that medical practices cannot charge a fee when Medicaid patients miss appointments.

How does Medicare impact the healthcare system?

Providing nearly universal health insurance to the elderly as well as many disabled, Medicare accounts for about 17 percent of U.S. health expenditures, one-eighth of the federal budget, and 2 percent of gross domestic production.

How does Medicare affect the economy?

In addition to financing crucial health care services for millions of Americans, Medicare benefits the broader economy. The funds disbursed by the program support the employment of millions of workers, and the salaries paid to those workers generate billions of dollars of tax revenue.

How does Medicare Effect economy?

Medicare for All could decrease inefficient “job lock” and boost small business creation and voluntary self-employment. Making health insurance universal and delinked from employment widens the range of economic options for workers and leads to better matches between workers' skills and interests and their jobs.

What are the cons of Medicare?

Cons of Medicare AdvantageRestrictive plans can limit covered services and medical providers.May have higher copays, deductibles and other out-of-pocket costs.Beneficiaries required to pay the Part B deductible.Costs of health care are not always apparent up front.Type of plan availability varies by region.More items...•

What is the difference between Medicare and Medicaid?

The difference between Medicaid and Medicare is that Medicaid is managed by states and is based on income. Medicare is managed by the federal government and is mainly based on age. But there are special circumstances, like certain disabilities, that may allow younger people to get Medicare.

How do you explain Medicare?

Medicare is the federal government program that provides health care coverage (health insurance) if you are 65+, under 65 and receiving Social Security Disability Insurance (SSDI) for a certain amount of time, or under 65 and with End-Stage Renal Disease (ESRD).

What were the purposes of Medicare and Medicaid?

Medicare provided health insurance to Americans age 65 or over and, eventually, to people with disabilities. For its part, Medicaid provided Federal matching funds so States could provide additional health insurance to many low-income elderly and people with disabilities.

How did Medicaid impact the United States?

Even before Medicaid expansion under the ACA, Medicaid coverage was associated with a range of positive health behaviors and outcomes, including increased access to care; improved self-reported health status; higher rates of preventive health screenings; lower likelihood of delaying care because of costs; decreased ...

What role does Medicare and Medicaid play in meeting the health care needs of the American public?

Medicare and Medicaid are two government programs that provide medical and other health-related services to specific individuals in the United States. Medicaid is a social welfare or social protection program, while Medicare is a social insurance program.

What Is The Purpose of Health Insurance?

The IOM articulated the purpose of health insurance in the first of its six reports: “For individuals and families, health insurance enhances acces...

Who Are Medicaid Beneficiaries?

Medicaid was designed to provide health coverage for low-income children and families who lack access to private health insurance because of their...

Finding #1: Having Medicaid Is Much Better Than Being uninsured.

Consistently, research indicates that people with Medicaid coverage fare much better than their uninsured counterparts on diverse measures of acces...

Finding #2: Medicaid Beneficiaries and The Privately Insured Have Comparable Access to Preventive and Primary Care.

Given the benefits that cascade as health insurance lowers financial barriers and opens the door to the health care system, and, in contrast, the d...

Finding #3: Specialists Are Less Willing to accept Medicaid Patients Than Privately Insured patients. However, Studies Comparing Access to Specialist Care Between Medicaid and Private Insurance Have Produced Mixed Findings – Likely A Reflection of The Difficulty of Adjusting For All The Factors That May Influence Access.

As distinct from access to primary care, access to specialty care has emerged in some research as a weakness in Medicaid relative to private insura...

Finding #4: Studies Examining The Causes of Higher Emergency Department (ED) Use by Medicaid Beneficiaries Compared to The Privately Insured Indicate That Most of The Difference Is Due to Higher Rates of Symptoms Determined by Ed Triage Staff to Need Urgent attention. Barriers to Access to Care Are Also A factor.

Compared with both privately insured people and the uninsured, Medicaid beneficiaries have much higher rates of ED use.43 However, a substantial bo...

Finding #5: New Evidence Is Emerging About The Quality of Care Provided to Medicaid beneficiaries.

Research investigating the quality of care received by Medicaid beneficiaries is limited, but two new analyses, one focused on health center care a...

Why is Medicaid important?

Medicaid was designed to provide health coverage for low-income children and families who lack access to private health insurance because of their limited finances, health status, and/or severe physical, mental health, intellectual, or developmental disabilities.

How much more likely are Medicaid patients to report good health?

Compared with the uninsured adults, the Medicaid adults were 25% more likely to report they were in good to excellent health (versus fair to poor health), 40% less likely to report health declines in the last six months, and 10% more likely to screen negative for depression.

What is a health center?

Health centers are a key source of preventive and primary care for medically underserved communities and populations , including millions of Medicaid beneficiaries. The ACA funded a major expansion of the health center program to help meet the expected increased demand for care as both Medicaid and private coverage expand. Given the role of health centers in providing care to Medicaid patients, evidence on the quality of care they deliver is important to an assessment of the Medicaid program itself. A recent study examined how health center performance on a set of three quality measures – diabetes control, blood pressure control, and receipt of a Pap test within the past three years – compares to the performance of Medicaid managed care organizations (MCOs), which also serve a low-income population. 50 The study defined the standard for “high performance” as the 75 th percentile of Medicaid MCO quality scores, and the standard for “lower performance” as the mean Medicaid MCO quality score. Because all Medicaid MCO enrollees are insured but a large share of health center patients are uninsured, MCO performance is a demanding benchmark to use for health centers.

What are the findings of the New England Journal of Medicine?

Two rounds of findings have been published in the New England Journal of Medicine, which can be summarized, in part, as follows: Medicaid increased access to care and health care use, and improved self-reported health.

How does health insurance help people?

Second, health insurance lowers financial barriers to access. It does this by reducing out-of-pocket costs for medical care, which disproportionately burden low-income people and people with extensive health care needs.

Does Medicaid have ED?

Compared with both privately insured people and the uninsured, Medicaid beneficiaries have much higher rates of ED use. 43 However, a substantial body of research investigating this disparity more closely indicates that poorer health and access challenges in Medicaid both play important roles in explaining Medicaid’s higher ED visit rates.

Is Medicaid effective?

In its totality, the research on Medicaid shows that the Medicaid program, while not perfect , is highly effective . A large body of studies over several decades provides consistent, strong evidence that Medicaid coverage lowers financial barriers to access for low-income uninsured people and increases their likelihood of having a usual source of care, translating into increased use of preventive, primary, and other care, and improvement in some measures of health. Furthermore, despite the poorer health and the socioeconomic disadvantages of the low-income population it serves, Medicaid has been shown to meet demanding benchmarks on important measures of access, utilization, and quality of care. This evidence provides a solid empirical foundation for the ACA expansion of Medicaid eligibility to millions of currently uninsured adults, and individuals and communities affected by the Medicaid expansion can be expected to benefit significantly. At the same time, the Medicaid program cannot overcome health care system-wide problems, like gaps in the supply and distribution of the health care workforce, or lack of access to transportation in low-income communities. Nor can Medicaid be expected to tackle many other barriers and issues that disproportionately affect low-income individuals and communities. These challenges require an additional set of policy responses beyond Medicaid’s ambit.

What is the most important thing about medicaid?

Medicaid has long been an essential source of health insurance coverage for low-income children, parents, elderly, and individuals with disabilities, improving health care access and health outcomes. With the Medicaid expansion under the Affordable Care Act (ACA), authorizing states to extend Medicaid eligibility levels for all adults with incomes up to 138 percent of the federal poverty level (FPL), it is the largest health insurer in the country, covering almost 66 million individuals. Accordingly, Medicaid spending comprises one-sixth of total health care expenditures in the United States, translating to over three percent of GDP.

What is the economic impact of Medicaid?

Medicaid is a fundamental component of states’ economies, because of the large role it plays in coverage and care and its design as a federal-state partnership. In all states but one (Wyoming), Medicaid is the largest source of federal grant money that states receive—comprising two-thirds of all federal grants to states, ...

What were the benefits of Medicaid before the ACA?

Even before Medicaid expansion under the ACA, Medicaid coverage was associated with a range of positive health behaviors and outcomes, including increased access to care; improved self-reported health status; higher rates of preventive health screenings; lower likelihood of delaying care because of costs; decreased hospital and emergency department utilization; and decreased infant, child, and adult mortality rates. Three states that expanded their adult Medicaid eligibility levels prior to the ACA—Arizona, Maine, and New York—thereafter experienced an aggregate 6 percent decrease in all-cause mortality rates for 20 to 64-year-olds, translating to 20 fewer deaths per 100,000 residents than compared to states without expanded Medicaid programs.

Is Medicaid good for poverty?

Of all types of health insurance, Medicaid is the most successful in reducing poverty rates. On a person-level basis, Medicaid coverage at different points during the lifespan has been tied to economic mobility across generations and higher educational attainment, income, and taxes paid as adults. Studies by states and independent researchers have ...

Does Medicaid help with personal finances?

Among enrollees, Medicaid coverage is associated with improved personal finances; for example, in Oregon, as compared to a control group, individuals who gained Medicaid coverage were 13 percentage points less likely to have medical debt and approximately 80 percent less likely to have experienced catastrophic medical expenses.

Does Medicaid replace prior state spending?

Expansion states have experienced budget savings, and in many cases, these savings offset at least some of the cost of the state share—as federal Medicaid dollars replace prior state spending—most notably with respect to behavioral health, public health services, and the criminal justice system.

What is the evidence that the introduction of Medicare was associated with faster adoption of then-new cardiac technologies?

Consistent with this, Finkelstein presents suggestive evidence that the introduction of Medicare was associated with faster adoption of then-new cardiac technologies. Such evidence of the considerable impact of Medicare on the health care sector naturally raises the question of what benefits Medicare produced for health care consumers.

Why is there a discrepancy in health insurance?

Finkelstein suggests that the reason for the apparent discrepancy is that market-wide changes in health insurance - such as the introduction of Medicare - may alter the nature and practice of medical care in ways that experiments affecting the health insurance of isolated individuals will not. As a result, the impact on health spending ...

How much does Medicare cost?

At an annual cost of $260 billion, Medicare is one of the largest health insurance programs in the world. Providing nearly universal health insurance to the elderly as well as many disabled, Medicare accounts for about 17 percent of U.S. health expenditures, one-eighth of the federal budget, and 2 percent of gross domestic production.

What was the spread of health insurance between 1950 and 1990?

Extrapolating from these estimates, Finkelstein speculates that the overall spread of health insurance between 1950 and 1990 may be able to explain at least 40 percent of that period's dramatic rise in real per capita health spending. This conclusion differs markedly from the conventional thinking among economists that the spread ...

When did Medicare start?

Medicare's introduction in 1965 was, and remains to date, the single largest change in health insurance coverage in U.S. history. Finkelstein estimates that the introduction of Medicare was associated with a 23 percent increase in total hospital expenditures (for all ages) between 1965 and 1970, with even larger effects if her analysis is extended ...

Does market wide change in health insurance increase market demand for health care?

For example, unlike an isolated individual's change in health insurance, market wide changes in health insurance may increase market demand for health care enough to make it worthwhile for hospitals to incur the fixed cost of adopting a new technology.

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