Management of Continuum of Care Services As the new director appointed for the Medicare and Medicaid Services (CMS), I realize the climbing costs of payments of these two programs and have met with the other members to come up with a plan of that will help enforce the strategies and guidelines in the state of North Carolina that can help us follow a budget that will assist the overall national requirements for persistent care. In doing so fellow board members have met with me to look at the Medicare Modernization Act (MMA), Administration on Aging (AoA), and other parts of the medical services to help come up with an arrangement that will help us reduce costs in our particular area that will assist the national healthcare problems that we currently face.

After looking at the problems within our own area we have decided to enforce the guidelines of the current healthcare coverage to the people that are eligible and already receiving Medicaid and Medicare services first because it will get the attention of healthcare providers and their patients they will have to follow. While other measures are being adjusted and determined, we can start enforcing these care services to create a more seamless continuum of care by regulations and physicians in the area can be easily informed of the changes. For starters, physicians who are treating new and established Medicaid and Medicare patients have been asked to supply a certain number (a percentage from their office) of sample and starter kit medications instead writing prescriptions for any enforcement to keep appointments made if they do have a doctor's appointment. All participants must have a written referral from their regular family doctor in order to make an appointment with a specialist. We feel some specialists are unnecessary and requires the patients to have more expensive co-pays and office visits that Medicaid and Medicare is responsible to when the family physician can handle some of the care themselves without the patient being charged extra. Patients who make appointments are required to show up for any doctor's appointment because if they do not show or follow cancelation policies they may still charge them and CMS has to pay for the appointment regardless. Patients are being informed when they make any appointment in the future of their requirements to follow these procedures or it results in not being able to reschedule and more time untreated.

Now, the members of our services also want to look at the Administration on Aging (AoA) who continue to provide low cost services to the senior population and improve independent living of the elderly in their own homes as long as they choose. The long-term health care will involve affordable living assistance services and assistance to remain at home and decrease the number of readmissions, provide transportation to and from doctor visits, preparation of meals, and other daily living needs. There was a decrease in using the base of one-time, special funding for the Senior Community Service that will transfer to the Administration on…