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Only 10 percent of physicians and 23 percent of specialists reside in rural areas. [8] Compared to their urban counterparts, rural residents have to travel much farther to receive treatment. [8] 23 percent of the rural population are Medicare beneficiaries while 45 percent of rural poor are covered by Medicaid. [8]
Medicaid consists of three different plans that are characterized to fit differing needs. [3] The principal plan for children is the Medicaid Basic Plan. “The Medicaid Basic Plan is for healthy low-income children and adults with eligible dependent children. This plan provides complete health, prevention, and wellness benefits for children ...
Introduced for Medicaid in 1989 and Medicare in 1990, this designation allowed HRSA-funded health centers to receive cost-based reimbursement rates. Covered services included those provided by physicians, physician assistants, nurse practitioners, certified nurse midwives, clinical psychologists, and clinical social workers.
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As of 2014, the Centers for Medicare and Medicaid Services (CMS) require patient navigators seeking to facilitate public enrollment in plans to disclose information that may result in a conflict of interest to exchanges and consumers. [11] Potential conflicts of interest include: Lines of insurance that a navigator intends to sell.
CMS begins using the Medicare fee schedule to give larger payments to physicians who provide high-quality care compared with cost. [127] The "Employer Mandate" (originally scheduled to take effect on January 1, 2014) goes into effect for employers with 100 or more employees. [116] [117]
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