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How Medicare/Medicaid Laid the Foundation for Advancing Population Health

On July 30th, 1965, the Medicare and Medicaid bill was signed into law by President Lyndon B. Johnson. These vital health insurance programs are critical for ensuring access and affordability to care across our nation. Currently over 135 million people are enrolled in Medicare or Medicaid.

Medicare is for people 65 and older as well as people who are under the age of 65 with disabilities. There are three essential components to Medicare:

  • Part A: Covers in-patient stays at hospitals, Critical Access Hospitals (CAH), Skilled Nursing Facilities (SNF), hospice, and home health care  
  • Part B: Covers medical visits and outpatient treatments as well as physical and occupational therapists
  • Part D: Prescription drug coverage

Medicaid is a public health insurance program that provides coverage to low-income adults, children through the Children’s Health Insurance Program (CHIP), pregnant women, elderly adults, and people with disabilities. This July 2022, the Biden administration announced a $49 million grant that is aimed to help provide insurance to the over “4 million uninsured children who quality for free coverage through Medicaid or CHIP.”

As we reflect on the anniversary of the launch of Medicare and Medicaid, here are two ways we can leverage the goals of our national insurance programs and help propel our nation’s Population Health efforts:

Identifying High-Risk Patients
Protecting the most vulnerable and underserved populations is a fundamental component of Medicare and Medicaid. Expanding healthcare accessibility, such as through the Affordable Care Act, is one example of how we are building on President Johnson’s vision of a national health insurance program.

Another crucial need is identifying patients at risk for chronic conditions, such as diabetes, obesity, heart disease, etc. Care teams must integrate Social Determinants of Health (SDoH) into their assessments as well as have the data at their fingertips to properly conduct risk stratification to identify and intervene with patients at risk of chronic conditions.

Advancing Patient Data Sharing Across the Continuum
The Centers for Medicare and Medicaid Services’ (CMS) National Quality Strategy identifies several ways to improve the quality, safety, and equity of care, including “embrace the digital age” and “incentivize innovation and technology.” We saw the great strides that the Meaningful Use program brought to our healthcare system, including the implementation and adoption of Electronic Health Records (EHRs).

We must continue to push forward with the digitization of healthcare records as well as ensuring clinicians have access to patient data, regardless of where in the continuum care has been received. Pharmacists, for example, are significantly lacking the clinical, administrative, and financial tools to maximize their potential as care givers. Arming pharmacists with the capability and technology to prescribe prescriptions and expand their clinical offerings is essential for improving the accessibility and affordability of care.

Related to this, I was extremely proud to see Michele Belcher, President, National Community Pharmacists Association, AssureCare customer, and owner of Grants Pass Pharmacy (Grants Pass, OR) share her thoughts on the recent Food and Drug Administration’s authorization for pharmacists to prescribe the COVID-19 medication, Paxlovid, to patients.

As we celebrate the anniversary of Medicare and Medicaid, we challenge our colleagues, customers, partners, and business associates to continue to work in unity to accelerate the fundamental goals of a national healthcare system through access and affordability of care as well as patient data sharing to improve the quality of human lives.

Interested in learning more about how AssureCare’s solutions support both Medicare and Medicaid populations? Click here.

Laura Porto

Director of Marketing