A Brief History of Medicare for the Senior Population
Peak Vista Accepts New Medicare Patients
By Scott Robinson, DO, Director Senior Health Centers, Assistant Vice President of Medical, Peak Vista, Colorado Springs LIVING WELL Magazine
For most of our lives we have taken Medicare for granted – but how did this government-funded insurance originate? In the early 1930s, President Franklin D. Roosevelt tried to impose legislation transferring healthcare payments to the federal government, but was met with strong opposition from the public. Through many legislative steps, partners in his administration pressed the issue and got the bill establishing Medicare passed in 1964. Shortly before this time, an insurance company in Dallas called BlueCross/BlueShield (BC/BS) had grown out of the desire of a nearby hospital administrator to provide healthcare benefits to his employees. Since the federal government had no way to administer the payment of claims for healthcare bills from providers, they formed an alliance with BC/BS. The federal government then formed an organization called the Health Care Financing Administration (HCFA) that processed payments to BC/BS to pay the providers who submitted claims. Later on, to better monitor the system, the federal government created a division of HCFA that is now known as the Centers for Medicare Services (CMS).
Originally, Medicare reimbursed both physicians and hospitals based on a fee-for-service, essentially whatever the provider felt was reasonable. Initially this worked well, but over time the costs rapidly crept up. To control the increase, Medicare began cutting costs directly to providers, and got more and more specific in each category of care.
Now the payments have been cut so drastically that some physicians are unable to accept payments from Medicare and many essential preventative services are no longer covered. This means that patients must either pay their bills to those providers outright or seek care elsewhere. As part of what is now called “Obama-care,” there are some efforts to get essential services paid for, and if the bill stays intact until 2014, they likely will be. One of the benefits of Peak Vista is that due to our designation as a Federally Qualified Health Center, we are happy to take Medicare patients with some adjustments and act as a safety net for patients who would otherwise not have a provider. Peak Vista welcomes new Medicare patients, and currently has five providers at two senior health centers.
If you find yourself without a provider in these turbulent times Peak Vista can assist you. Call 719-329-7100 for information.
Author’s note: The historical facts of this article were summarized for the sake of brevity and dates are approximate.
