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Full-Text Articles in Medicine and Health Sciences
Rising Cost Of Medicare And Its Effect On Recipients 65 And Older, Williesa Toomer
Rising Cost Of Medicare And Its Effect On Recipients 65 And Older, Williesa Toomer
Walden Dissertations and Doctoral Studies
The rising cost of Medicare is a growing concern for recipients. Beneficiaries are often forced to implement a host of strategies to meet rising out-of-pocket expenses. This qualitative study was conducted to address a research gap in methods used by senior citizens to manage rising Medicare coverage costs. Garmezy’s resilience theory was used to contextualize the rising costs of Medicare premiums and copays and strategies used to manage healthcare needs. The purposive sample of 12 socioeconomically diverse respondents included eight women and four men ranging in age between 65 and 77, for an average age of 70.2 years. Participants completed …
Impact Of Medicare Utilization On Mortality And Readmission Rates Of Heart Failure Patients 65 Years And Over, Joanna Alexander
Impact Of Medicare Utilization On Mortality And Readmission Rates Of Heart Failure Patients 65 Years And Over, Joanna Alexander
Walden Dissertations and Doctoral Studies
Roughly 25% of individuals 65 years and over hospitalized with heart failure are readmitted within 30 days after discharge. Elderly individuals identified with heart failure possess a 5-year mortality approaching 50%. The purpose of this study was to determine if there is a relationship between Medicare-covered services for care, mortality rates, and readmission rates for beneficiaries 65 years and over with heart failure. To address this topic, the chosen approach was retrospective and quantitative. The theoretical foundation was the Chronic Care Model. The research questions sought to determine if there is a relationship between the Medicare-covered services for care and …
Successful Billing Strategies In The Hospital Industry, Samirah Merritt
Successful Billing Strategies In The Hospital Industry, Samirah Merritt
Walden Dissertations and Doctoral Studies
Failure to collect reimbursement because of changing regulations negatively impacts hospital profitability. A multiple case study approach was used to explore the successful strategies billing managers employed to collect reimbursement for all legitimate Medicare claims. The target population for this study included 5 hospital billing managers from 3 organizations in the Northern New Jersey region. The complexity theory was used as a framework for assessing changing Medicare regulations and how the managers adapted to them. The data collection process for this study involved gathering data from participant interviews, documentation from the organizations of the participants, and government documented regulations and …
Reduction Of Centers For Medicare And Medicaid Services Reimbursement Penalty Risk, Christopher Douglas Poteet
Reduction Of Centers For Medicare And Medicaid Services Reimbursement Penalty Risk, Christopher Douglas Poteet
Walden Dissertations and Doctoral Studies
Healthcare centers face increasing revenue risk under the Medicare Access and Children's Health Insurance Program Reauthorization Act (MACRA). The purpose of this multiple case study was to explore strategies that successful leaders of healthcare centers use to mitigate the risk of reimbursement penalties under MACRA. The conceptual framework of this study was Generation 3 cultural-historical activity theory (CHAT-III), and the analysis process used was Yin's recursive and iterative phases. Participants of this study were 6 leaders of healthcare centers in the United States identified as having high quality and low cost via the Centers for Medicare and Medicaid public use …
Patient Experience And Readmissions Among Medicare Shared Savings Programs Accountable Care Organizations, Benjamin Michael Anderson
Patient Experience And Readmissions Among Medicare Shared Savings Programs Accountable Care Organizations, Benjamin Michael Anderson
Walden Dissertations and Doctoral Studies
In 2011, Medicare patients represented the largest share of total readmissions and health costs when compared to all other patient categories. Because patient-centered care drives the use of health services, the U.S. Patient Protection and Affordable Care Act outlined improving the patient experience to reduce readmission rates; however, the relationship between patient experience and readmissions is not well understood. Grounded in systems theory, the purpose of this correlational study was to determine if the relationship between patient experience and readmission rates in Medicare Shared Savings Program accountable care organizations. Data from the Consumer Assessment of Healthcare Providers and Systems survey …
Increasing The Value Of Medicare Annual Wellness Visits For Patients And Providers, Stephanie Hope Turner
Increasing The Value Of Medicare Annual Wellness Visits For Patients And Providers, Stephanie Hope Turner
Walden Dissertations and Doctoral Studies
The Medicare Annual Wellness Visit (AWV) has been available to Medicare beneficiaries since 2005; however, most eligible individuals have not taken advantage of this benefit. The literature supports that patients are willing to schedule and complete an AWV if urged to do so by their primary care provider; however, providers are reluctant to advise patients to pursue the AWV due to the lack of perceived value and overall health benefit. The integrative theory of health behavior change was used as the theoretical framework for the project. By increasing patient self-management skills through education, engagement, and support, the project was designed …
Initial Findings Of A Medicare Annual Wellness Visit Program, Hesper B. Nowatzki
Initial Findings Of A Medicare Annual Wellness Visit Program, Hesper B. Nowatzki
Walden Dissertations and Doctoral Studies
Despite the emphasis of benefits on preventive health, many older adults are not receiving the recommended age specific, evidence based screenings and vaccinations. The Medicare Annual Wellness Visit (AWV) is designed to address modifiable risk factors with aging adults and close gaps in care not captured in routine office visits. Although a free Medicare benefit to patients, and a reimbursable service to health care providers, participation in the AWV is low nationwide. The purpose of the project is to introduce an AWV program to a rural health clinic in Northwest Illinois that has a population consisting of over 25% of …