Government Payer Program

959 Words4 Pages
The Federal government Payer program “SCHIP” in my opinion is a beneficial program for many individuals needing healthcare coverage. The SCHIP program provides eligible children with healthcare benefits that cover doctor appointments, prescribe medication, co-pays, dental expenses, hospital visits, including other medical expenses. SCHIPS referred to as the “ State Children's Health Insurance Program” is a partnership between the Federal and State government that provides health coverage for uninsured children whose families income is over the suggested amount to qualify for Medicaid, but lower than the income threshold to afford private coverage (”Every state follows a certain protocol to determine the eligibility and requirements…show more content…
All HCOs Medicaid and Medicare providers are required to meet all the quality, safety, and health standards to obtain accreditation (” If the standards are not met, the HCOs are fined, even may result in losing their accreditation and or license’s to participate in Medicare or Medicaid programs. SCHIPS has impacted the healthcare organization, requiring the clinical staff to be licensed or certified from an accredited school to perform the clinical duties, to meet the standards required by…show more content…
The “Quality-Based Payment” system for Medicaid pays on performance for State Medicaid programs.” “Each state has a standard reimbursement for Medicaid covered services choosing fee-for-service or managed care rates (” The reimbursement for SCHIP is based on “managed care rates” which are based on capitulated reimbursement rate paid to the organizations (” SCHIP reimbursement rate also depends on health utilization and cost. The SCHIP program provides coverage for all beneficiaries to access healthcare organization to receive treatment. Since SCHIP contracts with different providers and hospitals to influence patient access to healthcare services; this gives patients more providers to choose from, also, lowering out of pocket expenses will influence patient access to healthcare services. The federal government, Medicaid, Medicare, JCAHO, has guidelines in which some if not all beneficiaries should be

More about Government Payer Program

Open Document