Medicare is a national health insurance program

Medicare is a national health insurance program

Medicare is a national health insurance program for younger people with disabilities, people above 65 years old, and people with end-stage renal disease. The Medicare plan covers specific services; hospital insurance, medical insurance, and prescription drugs coverage. The insurance plans are offered by approved insurance companies (Sultz et al., 2017).

However, in the recent past, there have been concerns about wastage and fraud of Medicare resources. Therefore, there is a need to come up with various strategies that will help curb wastage of Medicare resources and, at the same time, ensure quality healthcare services. One cause of wastage of Medicare resources is improper payments, which includes incorrect payments or payments that should not have been made (Sultz et al., 2017). To curb improper payments, there is a need to ensure integrity among the insurance companies licensed to provide Medicare services.

To ease the drain on Medicare resources, policies on Medicare Integrity Program and Medicare Abuse and Fraud should be reviewed. These policies are responsible for some of the waste of Medicare resources. The policy review can include a review of the activities of Medicare providers to ensure the integrity and supporting individual states’ efforts on combating abuse and fraud of Medicare resources by providers. Further, the authority and powers of various insurance providers approved to provide Medicare services should be reviewed in relation to the identification of fraud and abuse (McGee et al., 2018).

Utilization of technology can also help curb drain of Medicare resources. The federal government can utilize data mining techniques to determine patent health needs and thus predict the amount of resources needed for the Medicare program. Further, computer programs can detect inconsistencies in healthcare data leading to the identification of abuse and fraud, which will help curb drain of Medicare resources (Saminsky, 2010).

References

McGee, J., Sandridge, L., Treadway, C., Vance, K., & Coustasse, A. (2018). Strategies for Fighting Medicare Fraud. The health care manager, 37(2), 147-154.

Saminsky, A. (2010). Health Care Reform: Reducing Waste and Improving Efficiency in Today’s Medicare. Inquiries Journal, 2(2), 1.

Sultz, H. A., & Young, K. A. (2017). Health care USA: Understanding its organization and delivery (9th ed.). Boston: Jones & Bartlett.