Hospital Management: Benefits and Risks of Managing Medicare and Medicaid in US Healthcare

Over the next decade, Medicare is projected to grow more slowly than private health care spending on a per capita basis, but the retirement of the Baby Boom generation and rising health care costs are predicted to present fiscal challenges for the nation. How these challenges are addressed has important implications for many entities, the Federal budget, the nation’s health care system, health care providers, taxpayers, and individuals with Medicare.

This webinar training will enlighten you with a brief “back story” on Medicare and Medicaid programs and their evolution into today’s health care and the positive and challenging changes happening now and in near future. This is a valuable opportunity to take a “fresh” look at the current challenges your organization is having and plan strategically to be more successful within the models that have been created for US healthcare systems nationwide. This presentation will also include “live” examples of trends and challenges with managing the Federal programs in the hospital environment, just in case you think, “it can’t happen to you".

Medicare and Medicaid have significant influence over healthcare organizations in the United States. Medicare, which serves nearly 60 million seniors & ppl w/disabilities, accounted for 20% of national health spending in 2016. Total federal and state Medicaid spending was about $553 billion in FY 2016. Medicaid is the third-largest domestic program in the federal budget, after Social Security and Medicare, accounting for 9.6% of federal spending in FY 2016.

Webinar Jan 01 2026, Thursday 01:00 PM EDT 60 Minutes Intermediate Level Code: GRC0000333

  • Brief Introduction to Medicare and Medicare programs
  • Their impact on “how we do business in healthcare”
  • Positive changes in the patient population and care initiatives
  • Identify ways to improve profitability
  • What risks put hospitals in “harms’ way”
  • Identifying and monitoring the benefits and risks of Medicare/Medicaid programs
  • Live case scenarios from other organizations – learn from the experts
  • Planning for the future with Medicare and Medicaid challenges and trends
  • Creating a pathway for success with Medicare and Medicaid populations clinical care and reimbursements by mitigating risks and maximizing the benefits

  • Medical Practices/Organizations (small to large).
  • Medical Coding and Billing Organizations
  • Compliance Officers, CEO, CFO
  • Medical Practice Managers/Administrators
  • Physicians, Compliance Committees
  • Revenue Cycle Management Professionals
  • Billing and Coding Personnel

Centers for Medicare and Medicaid (CMS) policy has a tremendous influence on how we practice and receive reimbursement for clinical medicine. Although the initial statutes in 1965 declared otherwise, I think you would agree that it did not take long to show that regulation was a key component for ensuring and promoting quality healthcare in our industry.

The rising costs in Medicare and Medicaid claims, as well as concerns over fraud and abuse, Congress decided by the early 1970s that closer oversight of the medical care system was necessary. It is essential that all healthcare organizations understand these evolutions and potential risks that may impact your organization. Being aware of these changes, benefits, and risks in advance will help provide a pathway for effective management strategies in your organization. The organizational goal is set at meeting the needs of the Medicare and Medicaid patients and also ensuring accurate and compliant reimbursements.

PAMELA JOSLIN
PAMELA JOSLIN
20 Years

Pam Joslin, MM, CMC, CMIS, CMOM, CMCO, CEMA, CMCA-E/M

has more than 20 years of medical practice management, billing, and coding, reimbursement, compliance, and auditing experience. She is an engaging presenter via webinar, classroom, and conference on various topics that may impact the revenue cycle of every practice. She has managed in medical practices ranging from single to multi-specialty groups, including ASC. She is an advocate of process improvement and maximizing and empowering employees to bring about the "best practice” results for your organization. She received her Masters in Management from the University of Phoenix. Pam maintains memberships in professional organizations to support her continuing cycle of learning in the ever-changing healthcare industry.  

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