...Financing and Structuring Health Care Detra Smith Dr. Cynthia Davis HSA 500 October 31, 2011 The three main types of health insurance in the United States are voluntary health insurance, social health insurance, and public welfare health care programs. Voluntary health insurance (VHI) is private insurance made up of Blue Cross and Blue Shield, private or commercial insurance companies, and health maintenance organizations. Private health insurance was a source of financing for personal health care expenditures. It also started as coverage for hospitals and physicians. Social health insurance (SHI) includes workers’ compensation, Medicare, and other special groups. It is an entitlement program. Payroll taxes fund this program. Public welfare health care programs include Medicare, Medicaid, and SCHIP and they funded by federal, state, and local governments. There are guidelines in place for persons eligible for any of these programs. The guidelines also vary from state to state. Millions of Americans use this program. Medicare is used by persons who are 65 and over, disabled, and have end stage renal disease. Medicaid is designed to help the poor, children, and pregnant women who are uninsured, underinsured, or cannot afford health insurance. The three methods for categorizing health insurance in the United States are according to the typical combination of products, by the type of organization sponsoring the coverage, and by the funding mechanisms. Principal...
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...Financing and Structuring Health Care Strayer University HSA 500 Health Services Organization Mr. David Tataw July 24, 2011 1. Identify and describe the three main types of health insurances in the U. S. The three main types of health insurance in the United States are the commercial health Insurance, Blue Cross and Blue Shield, and Health Maintenance Organization (HMO). The commercial Health Insurance is typically offered by agents or brokers. These insurance carriers’ objective is to make a profit. The commercial health companies are owned by their policyholders or stockholders. Commercial Health insurance is classified by their renewal provision and the benefits it offers to the insured. The coverage includes medical expenses and disability income, which could be long or short term needs. The category of commercial health Insurance companies offer insurance on other property such as home, auto, business etc. (Williams, & Torrens, 2010). Companies that offer a portfolio of services from insurance coverage to pension plan and other financial services are consider multiline carriers (Williams, & Torrens, 2010). Within the commercial health industries, there are companies that are considered single-line carriers that offer health insurance and related employee benefits only (Williams, & Torrens, 2010). Blue Cross and Blue Shield were closely affiliated with the American Hospital Association; their initial focus was on insuring hospitals...
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...Financing and Structuring Health Care Assignment #2 Health Services Organization – HSA 500 1. Identify and describe the three main types of health insurances in the U. S. The three main types of are Voluntary Health Insurance (VHI), Social Health Insurance, and Public Assistance or Welfare medicine. Each type of health insurance provides medical benefits which provide payment for medical services rendered. Voluntary health insurance (VHI) can be divided into three categories: BCBS, private or commercial insurance companies and Health Maintenance Organizations (HMO). VHI began in 1929 when Baylor teachers in Dallas, Texas contracted with Blue Cross to provide hospital coverage for three cents a day. This was the beginning of hospital coverage provided by an insurance company. Other states began to provide this same type of coverage for their employees. Since this time health coverage has been extended to provide benefits for physicians, pharmacies and other medical providers. More than 70 years later over 70 percent of the US population under age 65 has some form of VHI, and more than 90 percent of these have health coverage linked through employment. The United States mandates two social health insurance (SHI) programs: Workers Compensation which covers the cost associated with job-related injuries, and Medicare which provides health insurance for the elderly, disabled and other special groups. Workers Compensation provides two basic benefits: cash replacement for...
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...Financing and Structuring Health Care 1 Financing and Structuring Health Care Lisa Martin Strayer University Professor Tataw July 18, 2011 Financing and Structuring Health Care 2 1. Indentify and describe the three main types of health insurances in the U.S. The main 3 types are the commercial health insurance industry, Blue cross and Blue shield plans and Health Maintenance Organizations. With the commercial health insurance industry there are two distinctions, which are between mutual and stock insurers. Mutual insurance companies, are essentially owned by their policyholders, in contrast to stock insurance companies, which are owned in the more traditional corporate fashion by stockholders. Commercial health insurance companies are either “multiline” carriers or “single –line” insurers. The multiline insurers offer other insurance products like life, auto, homeowners, worker’s compensation, business liability and some offer renters insurance as well. There are some multi-line insurers that also offer a range of financial services, like pension and investment areas. The single-line health insurers offer health insurance ...
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...Financing and Structuring Health Care Assignment #2 Nicole S. Wells Dr. J. Queensberry Health Services Organization- HAS 500 April 29, 2012 Assignment #4 Financing and Structuring Health Care There are three main types of health insurance in the United States which can be put into the following categories: voluntary health care (VHI), social health insurance (SHI), and public health care programs. Voluntary health care insurance is private insurance which is employer-sponsored insurance where an employee can receive health benefits for not just themselves but their family as well. An employee pays out a specified amount from their gross income whether weekly, biweekly, or monthly to the insurance provider of their choice. The employer pays a portion of the premium as well. Voluntary health care insurance provides services such as medical, dental, and vision as well as in and out-patient services, office visits, and prescription medicines just to name a few. This type of insurance benefits those whose are gainfully employed full-time. Social health insurance is insurance that is sponsored by the government which can be grouped into two major mandatory programs. The first social healthcare insurance program is workers’ compensation. This program allows for covered medical costs for those who suffer an accident or injury while on the job. It reimburses a portion of lost wages due to the injury or disability while paying medical expenses. The second...
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...head: FINANCING AND STRUCTURING HEALTH CARE Financing and Structuring Health Care Health Services Organization- HSA 500 December 15, 2011 Identify and describe the three main types of health insurance in the U.S. The three main types of health insurance are: * Voluntary Health Insurance * Social Health Insurance * Welfare Health Care According to the authors of our textbook (Williams & Torrens, 2010) “Voluntary or private health insurance in the United States can be subdivided into three distinct categories: (1) Blue Cross and Blue Shield, (2) private or commercial insurance companies, and (3) health maintenance organizations” (p. 82). Initially, Blue Cross and Blue Shield were two separate entities. Before merging in the early eighties, Blue Cross provided coverage for hospital services and Blue Shield covered physician services only. The companies under the Blue Cross and Blue Shield umbrella are licensees and operate independently of each other but all offer plans within specific areas of the country. Private or commercial insurance companies are those that provide health benefits to groups or individuals which are paid for by other parties (ex: employers, employees, unions, etc.) besides the United States government. This particular type of insurance can vary in cost and the benefits received; it all depends upon who is paying and what they are willing to cover. Health Maintenance Organizations (HMOs) are companies that manage the care between...
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...HealthCare Financing and Structuring Health Care Erroll Reese Instructor: HSA 500 – Health Services Organization January 23, 2010 Table of Contents Introduction ……………………………………………………………………………………. 3 Identify and describe the three main types of health insurance in the U.S ……………..…….... 3 Describe the three methods for categorizing health insurance in the U.S……………………….. 5 Identify the three types of managed care plans and provide the pros and cons of each for the health care provider, insurer, and patient……………………………………...............................5 Describe the impact of managed care on both the Medicare and Medicaid programs.…………. 8 Conclusion ……………………………………………….……………………………………… 8 References …………………………………………….………………………….……………… 9 Introduction Our stable outlook on the U.S. health insurance sector reflects our belief that industry risk is moderating, business conditions--including growth and retention opportunities and access to capital--have improved, and health insurers' financial fundamentals are now relatively strong. Offsetting these favorable factors are concerns about slowing economic growth, growing governmental fiscal pressures (particularly at the state and local levels), and health care reform issues. We believe these factors will affect each business and individuals differently and will likely keep the number of rating actions moderate for 2012. Identify and describe the three main types of health insurance in...
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...attempted to enforce The Health Security Act. His efforts to bring universal health care coverage to the United States is one that nearly ended his presidency. The intention of the President was to enhance the healthcare system and to provide universal health care coverage to Americans much like that of almost all other industrialized countries. The Health Security Plan, however, failed. There were both good and bad aspects of the plan but ultimately it was too flawed to even come before congress for a vote. President Clinton had the best of intentions when he attempted health care reform, he wanted to provide universal health care coverage with cost control. He felt that all Americans deserved health insurance and that inflation was skyrocketing and making health care unaffordable and unattainable for many Americans.The core element of the Health Security Plan were to enforce a mandate that requires all employers to provide health insurance coverage to all employees. Besides universal coverage and a basic benefit package, provisions included health insurance reform, regional alliances for structuring competition among health insurance plans, consumer choice of health plans, and provisions for Medicaid beneficiaries. Proposed mental health and substance abuse provisions included coverage of intensive nonresidential services, medical management, evaluation and assessment services, and case management. Initial limitations on coverage of inpatient mental health services and psychotherapy...
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...Assignment #2: Financing and Structuring Health Care. 1. Describe and identify the three main types of health insurance in the U.S. Today in the United States, the three main types of health insurances are as follows: 1) Voluntary Health Insurance (VHI): is a private health insurance currently used for industrial employment. It can be subdivided into three categories, such as Blue Cross and Blue Shield, private or commercial insurance companies, and health maintenance organizations (HMO). Blue Cross was initiated by Baylor teachers in Dallas, Texas who organized to provide hospital care for three cents (Williams& Torrens, 2010). The Farmer’s Union started its Cooperative Health Association in 1929 in Oklahoma. It was the first HMO. 2) Social Health Insurance (SHI): This has two major programs sponsored by the U.S. government. These programs are worker’s compensation and pain- related to job injury, and Medicare. Worker’s compensation is the first type of social insurance enacted in a nation and the vast majority of nations worldwide have some form of industrial accident insurance (Williams& Torrens, 2010). It provides two basics benefits, such as cash replacement of portion of wages lost by disability from work injury, and payment for all or part of medical care. For example, a caregiver had back injury upon lifting a handicap patient at the Nursing Home. Medicare is an insurance program run by the Health Care Financing, a federal agency (Robert H....
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...healthcare system has been the subject of much debate and policy change. With the enactment of the patient protection and the affordable care act much of what is known about the healthcare system is changing. This has been one of the most drastic departure from the traditional healthcare systems that we had. Why do we have to change healthcare system? How do we get to a place where healthcare reform and structuring was needed? To answer these questions, we must look back to our history to see how the political system, policies, programs and values have shift our modern health system leading up to the 2010 major healthcare reform to be signed by president Obama. 1900s was the period in which organized medicine took shape....
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...Financing and Structuring Health Care Nicole Bryant Kevin Williams Health Services Organization and Management HSA 500 Fall 2010 October 31, 2010 1) Identify and describe at least three main types of health insurance in the U.S. The main types of health insurance are voluntary health insurance, social health insurance, and welfare medicine. In voluntary insurance or private health insurance in the United States can be subdivided in to three distinct categories: (1) Blue Cross and Blue Shield, (2) private or commercial insurance companies, and (3) health maintenance organizations. Nowadays, it is common for Blues and commercials to own and operate HMOs and other managed care plans. Social Health Insurance has two major mandatory social health insurance programs: (1) Workers’ Compensation for the costs and pain of suffering job-related accidents, and (2) Medicare for the elderly, disabled, and other special groups. Several states sponsor social insurance programs in the areas of temporary disability (California) or health insurance (Hawaii and Vermont). Workers’ Compensation provides two basic benefits: (1) cash replacement of a portion of wages lost due to disability and (2) payment for all or part of the medical care necessary. Welfare Medicine is a public assistance that is sponsored by a plethora of federal, state, and local government programs, but the most far-reaching program is Medicaid (Title XIX of the Social Security Act). The distinction between...
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...Financing and Structuring Health Care Alicia Rodgers HSA 500 – Health Services Organization Instructor – James P. Driscoll Jr. July 24, 2011 Abstract There are many explanations on how health insurance is financed and structured. In this paper, different types of insured plans are reviewed and broken down to fully understand the design and goal of each policy. Overall, this research is very significant and consistent on the procedures of how these policies were developed. These health insurance plans have their advantages and disadvantages but they all aim as a beneficiary for the purchaser. According to Merriam-Webster, health insurance is defined as a form of policy that provides compensation for medical expenses and loss through illness. Health insurance can be obtained individually from a provider or through an employer or organization. When purchasing health insurance, the policy holder must pay a premium, which is the amount one pays to health plan to keep coverage. Identify and describe the three main types of health insurances in the U.S. There are three main types of health insurances in the United States. They include: Indemnities, Managed Care, and Health Savings Accounts (HAS). Indemnity plans are a fee-for-service plan. It is a flexible insurance that allows the policy holder to choose what physicians, facilities, and services they want. For this plan, the policy holder will pay an annual deductible and the insurance will pay the rest of the bill....
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... FINANCING AND STRUCTURING HEALTHCARE JULIUS AKINGBEHIN JANUARY 28, 2012 INTRODUCTION For more than seven decades, the United States healthcare system has improve significantly, compared to century ago and more has been done in terms of providing good healthcare an an antidotes to many disease process, this has been able to achieve due to the new healthcare technologies to tackle many diseases that were affecting citizens. In this modern day, it is apparently clear that the healthcare is one of the largest employer of labor according to the text (Williams and torrens, 2010) introduction to health services organization and management. The United States federal government have spent significant amount since the advent of Medicare in the country, in the late 1960s to date and this has rapidly grown to date. 1 – Identify and describe the three main types of health insurance in the U.S. The three main types of health insurance available in the U.S. today are voluntary health insurance, social health insurance and welfare medicine. Voluntary health insurance is subdivided into three categories. The first is Blue Cross Blue Shield which began as...
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...a company from Developed countries and Draw out its Functional Departmentalization and Products/Brand departmentalization Economic factor Analysis of Argentina The economy of Argentina has been recently on rise after the recovery from a severe economic crisis of 2001/2002. Over the last 5 years, the country's GDP growth has been quite high: 9.2% in 2005, 8.6% in 2007 and 6.6% in 2008 (slowed down by the international financial crises). GDP Annual Growth Rate in Argentina averaged 3.29% from 1994 until 2015, reaching an all time high of 12.50% in the second quarter of 2010 and a record low of -16.30% in the first quarter of 2002. With a Gross Domestic Product (GDP) of more than US$ 540 billion, Argentina invested heavily in health and education, areas which account for 7% and 6% of GDP, respectively. Argentina was the top performer in the region in reducing poverty and boosting shared prosperity between 2004 and 2008. Incomes of the bottom 40% grew at an annualized rate of 11.8% compared to average income growth of 7.6%. This trend continued but slowed after 2008. As of 2014, 12.7% lived in poverty – defined as living on under $4 a-day. A third of the population lives on between 4 and 10 dollars a day and remains at risk of falling back into poverty. The country prioritized social spending through various programs, including the Universal Child Allowance, which reaches approximately 3.7 million children and adolescents up to age 18, 9.3% of the population. The...
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...There is a body of literature by Canadian and international academics examining the determinants of health care expenditures, thereby offering suggestions regarding what variables can be influenced to reduce the health care expenditures. One Canadian researcher, Livio Di Matteo, did many studies on the determinants of Canadian health care expenditures. In Livio Di Matteo and Rosanna Di Matteo (1998), they used a pooled time-series cross-section model and provincial data over the period 1965-1991 to examine the determinants of real per capita provincial government health expenditure, finding that the real per capita provincial government health expenditures were positively and significantly affected by real provincial per capita income, the...
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