Question

1. Why are long term care providers subject to so much external control by government agencies?

2. Why are government programs such as Medicare and Medicaid so concerned with regulating cost?

3. What do we mean when we say that the long term care system is reimbursement driven?

4. Who is covered by Medicare? Medicaid?

5. What long term care services does Medicare cover and what restrictions are placed on receiving those services?

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Answer 1

1. Long term care providers are more controlled by governmental agencies because to increase the quality of care and controls of cost. The government regulates the cost of the providers through a prospective payment system.

2. Medicare and Medicaid concerned with the regulating cost of care in order to protect the consumer. It also regulates health insurance and health care coverages.

3. Reimbursement driven means that the care is delivered based on the reimbursement. The access to care, specific services, availability of services provided based on the type and amount of reimbursement.

4. Medicare is covered the people above 65 years of age who need special medical care. The coverage differs from state to state. Medicaid covers all adults with low-income, families, children, pregnant woman, and people with disabilities.

5. Long term care consist of a wide variety of services such as nursing home, assisted medical facility, home care, personal care. Medicare covers long term services for people who have special disabilities and diseases.