Medicaid Program Evaluation By SSA

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Medicaid Program Evaluation By SSA

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Medicaid Program Evaluation By SSA

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Discuss about the Medicaid Program Evaluation.

Medicaid Program was established in the year 1995. It was created by the Social Security Amendments (SSA), Title, “XIX” was added by the amendment to the Social Security Act (SSA). The Medicaid Program’s primary objective was to help the states with provision of the medical assistance to the citizens who could not pay for even basic medical costs. The Medicaid Program has improved the health coverage effectiveness amongst millions citizens in America. Moreover, Medicaid is regarded as a government insurance program for people of all ages with low income who cannot pay for medical cost.  The beneficiaries of the Medicaid Program   entails low-income adults, elderly adults as well as disabled individuals, pregnant females and children. Nevertheless, Medicaid Program funding that is via federal states and government is extremely puzzling.
The scope, duration, amount as well as type of the services to be delivered are determined independently by each state within federal vast guidelines. The biggest problem arises when the United States’ economy undergoes economic hard time like higher unemployment rate alongside big crises like Hurricane Katrina. Such situations make millions of families and individuals to be Medicaid-eligible sine these calamitous instants put more unwanted pressure on respective states to arrive at challenging budgetary decisions including forcing states to dollars from non-mandatory including school funding of K-12 into Medicaid Program. Thus leads to budget cuts and augmented taxes. The adverse effect ultimately becomes a loss to other key economic sectors.
Goal:  To establish an evaluation scheme that will help interrogate the effects of Medicaid Program budgetary changes on the community









To establish whether surplus and additional funding or deficit and cut is the best budgetary approach for Medicaid program  

Examining the effects of a deficit and cut on Medicaid Program on one hand and then analyze the effects of the surplus of additional funding on the other

Amount of cost associated with surplus or deficits


Adopting surplus or additional funding as the best budgetary approach


To analyze the feedbacks from the beneficiary both during the cut and deficit on one hand and then analyze the feedbacks of the surplus and additional funding on the  other

Amount of feedbacks and complaints from the beneficiaries

Count feedbacks and complaints

Increased uptake for Medicaid Program


To analyze the benefits of Medicaid Program through reduction in hospitalization cost reduction

Amount by which the cost have increased or reduced due to Medicaid Program

Estimating the amount of  costs reduction

Great reduction on medical costs



To enhance awareness among the policymakers on the effect of the budgetary changes on Medicaid Program

Arrange for a meeting with the policymakers and explain to them my findings about the budgetary changes effects on the Medicaid Program

Number of policymakers attending the meeting

Count the number and document

The Policymakers will have been exposed on the need to adopt surplus or additional funding budgetary approach


Write a detailed report and deliver to the policymakers with clear recommendations on the best approach

Number of reports delivered and the number of reports received and stamped as received

Count the number of the reports delivered and stamped as received

Policymakers exposed to the best budgetary approach for Medicaid Program



To increase awareness among the public on the benefits of the Medicaid Program

Advertise on many channels the benefits of the Medicaid Program

Quantity alongside types of the advertising materials generated and disseminated


Public exposed to program shall report a surged awareness of the benefits of the Medicaid Program

Survey the public exposed to the program

Community outreach and extension program to educate the people about the need to take up the Medicaid Program services

Number of locals attending the workshops or the outreach programs

Count the number of the locals attending the outreach

Locals exposed to the Medicaid Program


This evaluation remains timely and significance. Both adverse and positive and impacts of fluctuations in the budget have been acknowledged with respect to funding Medicaid Program in the course of the crises.  The common negative impacts of budgetary fluctuations encompass reduction in jobs or employment alongside service leading to arising from the surges in program enrolment. Those expenditure cuts adversely affect Medicaid Program payment alongside services besides associated sectors. Occasionally, the FMAP fails to avail extra funding thereby hampering provider reimbursement rates. This rate this face various hurdles as a result to incapability of the states to evade the cuts for the payment of surged Medicaid Program enrollment. The overall funding revenue deficit further contributes to encounters in the reimbursement rates by provider culminating in an enduring imbalance spending and the revenue collected (United States 2008).
This evaluation will hence remain increasingly useful amongst the states as it will inform efficient alterations in changes Medicaid Program funding thereby to containing the cost. These budgetary fluctuations hence impact the society because that states will have to freeze as well as reduce the payment to both physicians and providers. The removal and restrain of certain benefit that would otherwise accrued to community. The fluctuations in the budgets will force the states to use pre-emptive policies for controlling the drug prescription usage. The states might as well be compelled to upsurge the tax rates thereby making the community to face following upsurges commodity prices. The increases in the commodity prices shall lead to additional cost of living among the populace.
Either surged taxation or expenditure cuts or even a merger of the two concurrently are required to fund the budget deficits from the Medicaid Program. Both levels of the government are limited to federal funds and face challenges in case there cuts in in funding by the federal government. The two levels further agonize when the federal government makes a decision to boost its revenue via the higher tax. Albeit community and state are the indirect benefits’ beneficiary of the taxpayers via the federal tax credits and cuts like benefits shall stop where a tax surge is witnessed, it will culminate in a drop in the preference of tax spending.
The state and local governments always shift the tax burden in cases of in unattainable situations to community. Tax-raising alongside indirect cost-reduction measures based on federal law adversely impact the community in which homeowners will be compelled to increase price of houses. Thus there shall be a decreasing disturbance in real estate values that is the foundation for the local property taxation hence culminating in a decrease in rate of interest. Therefore, a federal government will greatly lose. The house-value use as the base for property taxa shall out-of-date thus locals will suffer a cost.
Both sales taxes and user charges employed in the improvement of federal revenues will lead to a loss in the community. Such strategies will lead to intensive and stiff competition for revenue between the two levels of government. The state will respond to such a mechanism by agonizing the surges due to an increase of thirty billion dollars marginal revenue for the federal government when the federal government increases its motor fuel tax for example,  by twenty-five cents to wards deficit budget funding. The states’ abilities to effect such increments in taxes shall be limited even in the face of a clear drop in revenue.
The scope of this evaluations was relevant in providing a detailed data that can help effectively understand the effects of the budgetary changes on the community. Thus by bringing both the policymakers and the beneficiaries of the Medicaid Program in this evaluation, primary data will be availed on a first-hand basis which will help really have an informed report to make the policymakers adopt the right budgetary approach that guarantees least adverse effect to the community (Iglehart and Sommers 2015).
The timing of this evaluation is right and comes at the best required time. Despite Medicaid Program a good policy that helps millions of people, it is undergoing serious challenges and the person that is mostly hurt is the community who were the very same group that Medicaid wanted to help (Schubart, Camacho and Leslie 2014). Thus this evaluation is imperative in helping inform the states to have the best budgetary approach to help salvage this fast-deteriorating state of affairs. Any delay would have greatly led to a worsened situation as many people fail to benefit from the program and yet they can still not afford even the basic healthcare. Thus this is the right time that the policymakers should take the budgetary changes more seriously to save the community from these apparent agony.
The stakeholders for this evaluation are justified. One hand, the policymakers and on the other the beneficiaries of the Medicaid Program are inexcusable stakeholders when it comes to this issue. This is because the actions taken by the policymakers will have an immediate and direct impact on the beneficiaries or the community at large. Thus, there is a need to bring both the policymakers and beneficiaries and listen to both sides before coming up with any effective plan. It must be understood that any error, unintentional or intentional made by these stakeholders will direct affect the community, very one that is sovereign and must always come first. Therefore, bringing the beneficiaries will help me get their views which will then be provided to the policymakers inform of report with particular recommendations. This will be effective because the Medicaid Program is aimed at the beneficiaries whose wellbeing reigns supreme than any other policy. This is effective since having the beneficiaries’ feedbacks and complaints as integral parts of the strategy to deal with the issues of budgetary changes to reduce their impacts on the community will greatly inform the best approach that should be adopted to enhance the Medicaid Program.
The choice of the persons to undertake the evaluation is also well informed. For example, evaluating the Medicaid Program will be overseen by competent policymaker working along a team of ten individuals with knowledge on how the Program works, its strength as well as weaknesses and the potential areas for improvement to meet the intended goals (Keast Thompson, Farmer, Smith, Nesser, and Harrison 2014).
The process, outcome and impact of this evaluation remains highly imperative. As seen in the table above, various outcomes have been showcased. It is expected that this evaluation will have the community a great deal (Centers for Medicare and Medicaid Services 2016). This is because adopting the best budgetary approach will ensure that the Program remains effective without hitches and that it help the beneficiaries in their times of need.  These questions will be effective in evaluating the Medicaid Program. By focusing on answering the question related to effects on the community caused by the hitches on the budgetary, it is will help point out to the relevant agencies and policymakers to improve Medicaid and reduce the adverse on the community.
Some of the ethical issues considered here will include asking for the consent from the stakeholders since I will be dealing with the human subjects. I will ensure that the information they give me is used for only the purpose which they have consented. I will ensure that their confidentiality and privacy.  The political issues relevant to Medicaid Program is that the decision to be taken is politically informed. Thus the changes will have to be subjected to certain form of politics before it is accepted. Thus the recommendations may never necessarily be implemented which can be detrimental to the community who suffer when Medicaid Program is intended to help the community (Garfield, Damico, Stephens and Rouhani 2016). 
There are a range of factors that will dictate the successful dissemination as well as utilization of the evaluation findings. The first factor regards to the political matters. The politics will play a fundamental role when it comes to the utilization of the evaluation report (Taubman, Allen, Wright, Baicker and Finkelstein 2014). This is because for the policymakers to utilize this evaluation findings, the government will have to have a say and hence the process will be lagged before full implementation (Thompson 2012).
Another issue that will impede dissemination is costs. Evaluating the program will consume much costs and time. Where the huge costs are required, it would be difficult to undertake evaluation and subsequently disseminate (Taubman, Allen, Wright, Baicker and Finkelstein 2014). Thus where the process of dissemination is hampered, there is a direct and automatic aspects as it will mean that many policymakers will not have access to the evaluation report.  The net effect of this is the inability to utilize the findings to better the community (Rowley and Schneider 2004).
Another issue that will determine the utilization of the evaluation report could be relevance of the findings. Only when the policymakers will be convinced that the information provided in the report meets the required standards for implementation will the evaluation be used (Baicker, Finkelstein, Song and Taubman 2014). Thus ensuring detailed and comprehensive report with convincing information will make the policymakers to adopt and use the recommendations presented (Barua, Greenwald, Grebely Dore, Swan and Taylor 2015).     
A surplus/additional funding is recommended for the Medicaid Program instead of deficit/ cut as the best approach for budgetary to finance Medicaid program. The rationale behind this suggestions is that state has continuously face challenges in attempts to escape the deficit. Therefore, a surplus alongside additional funding approach seams appealing. Furthermore, the cut and deficit adversely affect the society as highlighted since such a cut culminate to an incapability to offer quality services to the populace. Both additional funding and surplus remain recommendable due the fact they will buttress the community of programs creation thereby offering quality services to the beneficiaries of the Medicaid Program (Schick 2007). The cut and deficit funding will lead to poor performance of the economy which makes the state government to halt the provision of the essential needs for the public culminating into condensed living standards.  
The Program offers healthcare to many beneficiaries across America. Those states that have embraced the Medicaid program have made sure that their populace have effective access to quality healthcare even in the course of recession alongside calamitous events (Garfield, Damico, Stephens and Rouhani 2016). It remains clear from the above deliberation that both federal and state governments’ response to these crises account for severe loss the society via expenditure cuts and augmented taxation (Rowley and Schneider 2004).
Both federal and state government levels need to work in collaboration as well as undertake effective harmonization of the Medicaid Program operation in a way which discourages the budgetary cuts and deficits thereby ensuring that the Medicaid Program meets its envisioned goals amongst the recipients (Barua, Greenwald, Grebely, Dore, Swan and Taylor 2015). Both government must escape deficits as well as cut on their budgetary frameworks each time to speak to the underlying challenges deliberated overhead connected to budgetary fluctuations in the course of the crises. Both government levels must adopt the additional funding and surplus to effectively buttress programs to guarantee effectiveness of the Medicaid Program. 
Baicker, K., Finkelstein, A., Song, J. and Taubman, S., 2014. The impact of medicaid on labor market activity and program participation: Evidence from the oregon health insurance experiment. The American economic review, 104(5), pp.322-328.
Barua, S., Greenwald, R., Grebely, J., Dore, G.J., Swan, T. and Taylor, L.E., 2015. Restrictions for Medicaid Reimbursement of Sofosbuvir for the Treatment of Hepatitis C Virus Infection in the United StatesMedicaid Restrictions of Sofosbuvir for Hepatitis C. Annals of internal medicine, 163(3), pp.215-223.
Centers for Medicare and Medicaid Services, 2016. Medicare and Medicaid EHR incentive program basics.
Garfield, R., Damico, A., Stephens, J. and Rouhani, S., 2016. The coverage gap: uninsured poor adults in states that do not expand Medicaid–an update. Menlo Park, CA: Kaiser Family Foundation.
Iglehart, J.K. and Sommers, B.D., 2015. Medicaid at 50—from welfare program to nation’s largest health insurer.
Keast, S.L., Thompson, D., Farmer, K., Smith, M., Nesser, N. and Harrison, D., 2014. Impact of a prior authorization policy for montelukast on clinical outcomes for asthma and allergic rhinitis among children and adolescents in a state Medicaid program. Journal of Managed Care Pharmacy, 20(6), pp.612-621.
Ketler, S. R. 2008. Medicaid: Services, costs and future. New York: Nova Science.
Rowley, C. K., and Schneider, F. 2004. The encyclopedia of public choice. Dordrecht [etc.: Kluwer Academic Publishers.
Schick, A. 2007. The federal budget: Politics, policy, process. Washington, D.C: Brookings Institution Press.
Schubart, J.R., Camacho, F. and Leslie, D., 2014. Psychotropic medication trends among children and adolescents with autism spectrum disorder in the Medicaid program. Autism, 18(6), pp.631-637.
Taubman, S.L., Allen, H.L., Wright, B.J., Baicker, K. and Finkelstein, A.N., 2014. Medicaid increases emergency-department use: evidence from Oregon’s Health Insurance Experiment. Science, 343(6168), pp.263-268.
Taubman, S.L., Allen, H.L., Wright, B.J., Baicker, K. and Finkelstein, A.N., 2014. Medicaid increases emergency-department use: evidence from Oregon’s Health Insurance Experiment. Science, 343(6168), pp.263-268.
Thompson, F. J. 2012. Medicaid politics: Federalism, policy durability, and health reform. Washington, DC: Georgetown University Press.
United States. 2008. Transformation of the Medicaid program: Hearings before the Subcommittee on Health and Environment of the Committee on Commerce, House of Representatives, One Hundred Fourth Congress, first session. Washington: U.S. G.P.O.

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