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Understanding Medicare, Medicaid, & Hospice Benefits for Providers

According to the Centers for Medicare & Medicaid Services (CMS), 66.2 million Americans were enrolled in Medicare as of July 2023 (the most recent monthly enrollment data available), while Medicaid provides health coverage to over 82.3 million (total enrollment) Americans. Each year, many patients and families also enroll in the Medicare Hospice insurance program, which covers care for terminal illness and related conditions.

With so many patients in these insurance programs, it’s important for our health professional learners to understand their structure and appreciate the perspectives of patients, providers, and payers receiving these CMS services. 

Dr. James Pacala
James Pacala, MD, MS

Working with the Minnesota Northstar Geriatrics Workforce Enhancement Program (MN-GWEP), James Pacala, MD, MS, professor and head of the Department of Family Medicine and Community Health, authored the Understanding Medicare, Medicaid, & Hospice Benefits for Providers toolkit. The toolkit includes three video presentations, as well as a student and facilitator guide, to provide a structured discussion. 

"This is a succinct and thorough explanation of how Medicare, Medicaid, and Medicare Hospice Services work,” said Kristine Talley, PhD, CNP, RN, FGSA, associate professor of nursing and MN-GWEP co-director. “Every health professional working with older adults should view these!"

Brian J. Isetts, PhD, BCPS, FAPhA, who worked at Medicare in Baltimore for nearly three years, said he gained useful information and knowledge from the toolkit’s overview.

“This policy toolkit is one of the most complete and thorough overviews of the Medicare, Medicaid and hospice programs I have ever seen,” said Isetts, who is a professor in the Department of Pharmaceutical Care & Health Systems. “I plan to utilize this policy toolkit in our College of Pharmacy. I also see great potential in providing patients and consumers with access to this toolkit.”

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