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Assignment Prompt & Instructions

– ## 6555.docx **## 6555.docx** Respond to the post below by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues. 150-200 words. APA format 2 intext citation Monicah discussion post 1. Children’s Health Insurance Program (CHIP) Children’s Health Insurance Program (CHIP) is a comprehensive health coverage for children. Each State has the flexibility to design its program within the federal guidelines. The States may choose between a Medicaid expansion program, a separate CHIP, or a combination of both programs (Medicaid.gov, n.d). Beneficiaries are children of families that earn too much money to qualify for Medicaid but not enough to afford private insurance. Some states provide coverage under CHIP for pregnant women (Medicaid.gov, n.d). Services covered differ from state to state, but all must cover services regulated by federal guidelines. Wellness visits, preventative care, and vaccinations are free, but other services may have copays. Families are expected to pay a percentage of their income towards insurance, but no more than five percent (Healthcare.gov, n.d). Eligibility based on income is determined using Modified Adjusted Gross Income (MAGI). Income limits vary by state and range as low as 170 percent of the Federal Poverty Level (FPL) up to 400 percent of the FPL (Medicaid.gov, n.d). Program Evaluation Evaluation is an invaluable component of all policies. It provides data, commentary, and critical evidence for ongoing improvement, enhancement, and effectiveness of programs (Milstead & Short, 2019, p. 126). Each state must share the data monthly with the Centers for Medicare and Medicaid CSM to evaluate CHIP's invaluable components. According to the Medicaid website, the process of reporting is as follows: A forum is provided by Data Analytics MAC Learning Collaborative that State officials and CSM workers use to enter data and analyze it. Data to be provided by each state includes critical application, eligibility, and enrollment processes within Medicaid and CHIP programs. CMS then evaluates the data for outcomes, drives continuous improvements, and enhances transparency and accountability. States' performance is then publicly shared by CMS (Medicaid.gov, n.d). Social Determinate Addressed by CHIP Social determinants of health are non-medical factors influencing health outcomes and daily life. These factors include socioeconomic status, education, neighborhood, physical environment, employment, social support networks, and access to healthcare (Artiga & Hinton, 2018). CHIP addresses Socioeconomic status by allowing the beneficiary families to have health coverage for their children without a significant impact on their finances; families do not have to go into debt to pay for their medical bills and medications for their children even if they do not qualify for Medicaid. The families can keep their employment and do not have to change or lower their income to qualify for Medicaid. Their income can be sufficient to meet their needs and maintain a good living standard since they are not spending most of their income on health coverage. Beneficiaries can receive quality care and social support networks as they participate in federal and state Health Care Systems. Federal and state Health Care Systems provide initiatives for states, health plans, and providers to identify and address social determinants of health (Artiga & Hinton, 2018). Generally, CHIP offers many benefits for families and children who would otherwise struggle or have hardships in life. 2. Yinka discussion post The program of my choice is the Adult Evaluation and Review Services (AERS) which assists functionally and chronically sick individuals who are at the risk of institutionalization. AERS staff conduct a comprehensive evaluation to identify home and community-based services, that will help the individual to avoid institutionalization and remain as independent as possible in the least restrictive environment. The evaluation is conducted in the client's current location or home ("Adult evaluation and review services (AERS)," n.d.). Evaluating the effectiveness of this program is monitoring patient progress and using feedback for clinical decision-making enhances treatment outcomes. The effectiveness of the adult evaluation and review services can be measured by looking at the outcomes achieved for individuals. This includes improvements in their overall well-being, increased access to appropriate support services, and the achievement of their personal goals (Hensen-Doss et al.,2018). Individuals from lower socioeconomic backgrounds may face barriers in accessing adult evaluation and review services due to financial constraints, lack of insurance coverage, or limited transportation options. The stigma associated with certain health conditions or disabilities can create barriers to seeking and accessing evaluation and review services. Fear of judgment or discrimination may discourage individuals from seeking help or fully engaging in the evaluation process ("Social determinants of health and older adults," 2023). **## 6555.docx** Respond to the post below by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues. 150-200 words. APA format 2 intext citation Monicah discussion post 1. Children’s Health Insurance Program (CHIP) Children’s Health Insurance Program (CHIP) is a comprehensive health coverage for children. Each State has the flexibility to design its program within the federal guidelines. The States may choose between a Medicaid expansion program, a separate CHIP, or a combination of both programs (Medicaid.gov, n.d). Beneficiaries are children of families that earn too much money to qualify for Medicaid but not enough to afford private insurance. Some states provide coverage under CHIP for pregnant women (Medicaid.gov, n.d). Services covered differ from state to state, but all must cover services regulated by federal guidelines. Wellness visits, preventative care, and vaccinations are free, but other services may have copays. Families are expected to pay a percentage of their income towards insurance, but no more than five percent (Healthcare.gov, n.d). Eligibility based on income is determined using Modified Adjusted Gross Income (MAGI). Income limits vary by state and range as low as 170 percent of the Federal Poverty Level (FPL) up to 400 percent of the FPL (Medicaid.gov, n.d). Program Evaluation Evaluation is an invaluable component of all policies. It provides data, commentary, and critical evidence for ongoing improvement, enhancement, and effectiveness of programs (Milstead & Short, 2019, p. 126). Each state must share the data monthly with the Centers for Medicare and Medicaid CSM to evaluate CHIP's invaluable components. According to the Medicaid website, the process of reporting is as follows: A forum is provided by Data Analytics MAC Learning Collaborative that State officials and CSM workers use to enter data and analyze it. Data to be provided by each state includes critical application, eligibility, and enrollment processes within Medicaid and CHIP programs. CMS then evaluates the data for outcomes, drives continuous improvements, and enhances transparency and accountability. States' performance is then publicly shared by CMS (Medicaid.gov, n.d). Social Determinate Addressed by CHIP Social determinants of health are non-medical factors influencing health outcomes and daily life. These factors include socioeconomic status, education, neighborhood, physical environment, employment, social support networks, and access to healthcare (Artiga & Hinton, 2018). CHIP addresses Socioeconomic status by allowing the beneficiary families to have health coverage for their children without a significant impact on their finances; families do not have to go into debt to pay for their medical bills and medications for their children even if they do not qualify for Medicaid. The families can keep their employment and do not have to change or lower their income to qualify for Medicaid. Their income can be sufficient to meet their needs and maintain a good living standard since they are not spending most of their income on health coverage. Beneficiaries can receive quality care and social support networks as they participate in federal and state Health Care Systems. Federal and state Health Care Systems provide initiatives for states, health plans, and providers to identify and address social determinants of health (Artiga & Hinton, 2018). Generally, CHIP offers many benefits for families and children who would otherwise struggle or have hardships in life. 2. Yinka discussion post The program of my choice is the Adult Evaluation and Review Services (AERS) which assists functionally and chronically sick individuals who are at the risk of institutionalization. AERS staff conduct a comprehensive evaluation to identify home and community-based services, that will help the individual to avoid institutionalization and remain as independent as possible in the least restrictive environment. The evaluation is conducted in the client's current location or home ("Adult evaluation and review services (AERS)," n.d.). Evaluating the effectiveness of this program is monitoring patient progress and using feedback for clinical decision-making enhances treatment outcomes. The effectiveness of the adult evaluation and review services can be measured by looking at the outcomes achieved for individuals. This includes improvements in their overall well-being, increased access to appropriate support services, and the achievement of their personal goals (Hensen-Doss et al.,2018). Individuals from lower socioeconomic backgrounds may face barriers in accessing adult evaluation and review services due to financial constraints, lack of insurance coverage, or limited transportation options. The stigma associated with certain health conditions or disabilities can create barriers to seeking and accessing evaluation and review services. Fear of judgment or discrimination may discourage individuals from seeking help or fully engaging in the evaluation process ("Social determinants of health and older adults," 2023).