Premium Essay

Hcs/440 Economics: the Financing of Health Care

In:

Submitted By kmandy13
Words 1120
Pages 5
The Economic Impact on HMOs

Katria Anderson

HCS/440 ECONOMICS: THE FINANCING OF HEALTH CARE November 18, 2013
Jeanne Hutsberger Major

The Economic Impact on HMOs Health care insurance has always been a hot commodity for people in the United States. Over the course of the past decade the demand has become even greater. Health care reform has implemented laws that state the employers must offer health insurance. Because of this companies are looking for ways they can offer insurance with the lowest possible impact on their administrative budget. This is no easy task, but there are insurance companies that offer plans that will work for all parties involved. In order to offer companies plans that will suit their employees and not break the bank close attention to detail must be paid to the company’s overall state of health. An in-depth analysis is conducted and health conditions are looked at with much scrutiny. Although it appears to be much to go through for health insurance coverage, it is an absolute necessity. “Insurers have to determine a premium price based on risk factors balanced over the entire group, using general information on members of the group, such as age or gender” (National Conference of State Legislatures, 2013). Castor Collins Health Plans has taken on the task of deciding on offering coverage to one of two businesses. The businesses are Constructit Construction and E-Editor. Both company profiles were carefully reviewed before a decision was made regarding whether Constructit or E-Editors would be more suitable for health insurance coverage under Castor Collins Health Plan. In making the decisions the following information was taken into consideration basic demographics of the employees, the health care risk factors or potential areas of

Similar Documents

Premium Essay

Health Care History

...History and Evolution of Health Care Angeline Anderson Economics: The Financing of Health Care HCS/440 November 22, 2011 Humberto Munoz History and Evolution of Healthcare http://www.stfm.org/fmhub/fm2004/january/malcolms20.pdf While some can contribute these changes due to the evolutionary changes the US has undergone since her inception, the major contributing factors that influence the changes in health care economics are advances in technology and medical care. By understanding the history of health care economics, and identify the flow of funds system, financial managers are able to be more adequately prepared for the future. It is essential to remember that the driving force behind health care economics is money, and it plays an integral part to the success of the health care industry.     “Who pays for what has changed dramatically in the past 60 years. Whereas in the past, the majority of individuals paid their medical bills with private funds, today insurance companies and other third parties cover the majority of payments, with individuals paying only a small fraction of the total flow of funds with private money” (Getzen & Moore, 2007, p. 3, para. 1).   The flow of funds is a system in which financial managers are able to “follow” the money through the health care system, and as stated above the initial flow of funds have drastically changed from past years. History shows that many physicians would trade services for non-money items (such as...

Words: 354 - Pages: 2

Premium Essay

Economic Stimulation

...Economic Issues Simulation HCS 440 May 30, 2011 Professor Humberto Munoz Constructit is a business organization that currently does not offer employer paid health insurance. Constructit is compromised of 1,000 people and they are willing to pay up to $4,000 per person for their annual premium. The organization consists of 550 men and 450 women ranging in age of 26 to 45 years old. Fifty-seven percent of the workers range from high activity to moderate activity level while the remaining forty-three percent are mainly in a sitting position most of times. One factor to consider when determining which type of insurance to offer the group is the amount of health risk factors that affect all the employees. Thirty-eight percent of the employees have been deemed to have no major risk factors at all; however, almost eighteen percent of the workers are smokers and thirteen and a half percent of them suffer from some form of respiratory disease or illness. One of the biggest risk factors affecting the entire group of people is obesity. Obesity affects thirty-nine percent of these workers which in turn, increases the risk for obesity related diseases and illnesses. These diseases include but not limited to heart disease, hypertension, hyperlipidemia, and diabetes. This will increase the utilization of many healthcare services including prescription drugs, diagnostic services, and outpatient office visits (University of Phoenix, 2010). Castor Collins is a regional...

Words: 1221 - Pages: 5

Free Essay

Economic Issues Simulation

...HCS 440 Economic Issues Simulation University of Phoenix, Axia Date: xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Instructor: xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Economic Issues Simulation: Constructit Constructit is a company that currently does not have any employer paid health insurance. This company consists of 1,000 people and they are willing to pay up to $4,000 per person for their annual premium. The group of people is compromised of 550 men and 450 women ranging in age from 26 to 45 years old. Fifty-seven percent of the workers range from high activity to moderate activity level while the remaining forty-three percent are in predominately sedentary positions. One factor to consider when determining which type of insurance to offer the group is the amount of health risk factors that affect the entire group of people. Thirty-eight percent of the workers have been determined to have no major risk factors at all. However; almost eighteen percent of the workers are smokers and 13.50 percent of them suffer from some type of respiratory disease or illness. One of the biggest risk factors affecting this group of people is obesity. Obesity affects thirty-nine percent of these workers which increases the risk for obesity related diseases and illnesses. These can include heart disease, hypertension, hyperlipidemia, and diabetes. This will increase the utilization of many healthcare services including prescription medications, diagnostic imaging and services...

Words: 1125 - Pages: 5

Free Essay

Economic Paper

...Economic Issues Simulation Paper HCS/440 Economics: The Financing of Health Care June 4, 2012 Caryn Callahan I’m a representative of Castor Collins Health Plans insurance. As a representative of the company my job is to maximize profit and minimize risk for the company. The simulation states Castor Collins has been approached by two groups of people for health insurance (University of Phoenix, 2007). Both companies have a set rate that their employees are willing to pay. According to the simulation the first group, Constructit consists of 1,000 while, the second group, E-Editors, comprises of 1,600 people (University of Phoenix, 2007). It is up to my team to select the appropriate plan that meets Constructit maximum annual premium of $4000, and E-Editors maximum annual amount of $4,500 (University of Phoenix, 2007). The simulation stated the three insurance plans that Castor has are Castor Standard, Castor Enhanced, and Castor Enhanced Minor (University of Phoenix, 2007. Although Castor Standard is good plan it does not cover pre-existing conditions. The Castor Enhanced does cover pre-existing conditions. In addition, we have the Castor Enhanced Minor Plan that is also a customized plan. With this plan we have the option of removing adding services that may have high utilization in an effort to satisfy our client Constructit needs (University of Phoenix, 2007. Demographics of Constructit According to the simulation Constructit consists of 550 men and 450 women, in the...

Words: 452 - Pages: 2

Premium Essay

Economic Issue

...Econ Economic Issues Lindsay Honea HCS/440 June 7, 2016 Christopher Clarke Economic Issues Health care economics provides theories of production, inequalities, effectiveness, regulation and competition to help keep health care running smoothly and efficiently (Getzen, 2013, p. 2-15). One key factor that health care economist are watching is medical plans provided to help cover the cost of care for individuals. These plans are put in place to help take some of the burdens off of the person while helping find affordable, reliable, quality care. Castor Collins is a health insurance group that provides insurance plans to companies to help cover their employees. In the University of Phoenix simulation (n.d.), two large organizations have come to Castor Collins to determine the right plan for their employees. As the VP of Castor Collins, it is my job to help them find the plan that fits their budget, one that is cost effective, and provides quality care. Castor Collins Health Plan is a regional HMO plan that started in 1999. This plan provides coverage to 100,000 people in its state. They are looking to increase the number of individuals that it covers. My colleagues (Helen Feuerman CEO, Jonathan Wilkes, MD, Chief Medical Officer, and Adam Hunter Executive Vice President of Planning and development) and I will be looking at options of the best way to provide this coverage for the individual, the companies who employ them, and Castro Collins (University of Phoenix, n.d...

Words: 1101 - Pages: 5

Premium Essay

Hcs 440 Week 4 Constructit Simulation

...Constructit Insurance Selection Economics: The Financing of Health Care HCS 440 December 27, 2013 Constructit Insurance Selection Companies that are considering offering insurance to employees must make some decisions on plans, costs to both the business and the employee, and services provided. The insurance company offering the insurance looks at the level of coverage they are willing to provide for the services they will cover and to make a profit. This becomes a delicate balance of offering quality insurance coverage while making a profit. Castor Collins is evaluating the best selection based on the coverage requested by the separate companies and the amount the companies are willing to pay per employee. This student will analyze the data put together through the simulation assignment as the Vice President of Strategy and Financial Planning at Castor Collins with the information gained about both companies and advice from other professionals at Castor Collins regarding the chosen business, employee demographics, health concerns, premiums, and plan selection. Company Selection Approaching Castor Collins for insurance are Constructit and E-Editors. Both companies are seeking insurance plans for their employees, but both companies have different amounts the employees are able to pay towards an insurance plan. Constructit has 1,000 employees and are willing to pay $4,000 per employee towards a maximum annual premium. E-Editors have 1,600 employees and are willing...

Words: 479 - Pages: 2

Premium Essay

Terms in Health Care Industry

...Economic Terms in the Health Care Industry Nicole Hunter HCS/440 Economics: The Financing of Health Care August 27, 2012 Kristin McFarland, MSA, AASPR Economic Terms in the Health Care Industry In this paper the history of economics will be discussed and how economics pertains to today’s health care world. Understanding terms that are used in economics can help with better understanding this subject. We will discuss terms such as economics, supply and demand, macroeconomics, microeconomics, elasticity, inelasticity, and GDP. Supply and demand will also be researched further and the different issues that it can apply to in the health care industry. Economics Economics is a science that focuses on distribution, production, and consumption of services and goods. Resources that can be used include talent and time available, buildings, land, knowledge, and equipment. Knowledge of how to use all of these resources to create a successful products and services is also useful in economics. Some choices that are made in economics are, just how much time to dedicate, how much money to save, how much money to save, combining of resource, and the role of the government. Supply and Demand The price of a commodity is the relationship between supply and demand. Supply and demand is essentially the backbone of the economy. Demand refers to the quantity of products and services that buyers wants and are willing to buy within a certain price range. Supply is how much can be offered...

Words: 1035 - Pages: 5

Premium Essay

Health Care Spending

...Health Care Spending Jackie Shaw HCS 440 December 19th 2011 Health Care Spending The United States spends more on health care than any other country in the world. The current level of national health care expenditures is astounding. “In 2011, the anticipated total of health care government spending in the United States is 1108.2 billion dollars” (Chantrill, n.d.). Over the years the total of health care spending has increasingly amplified; in 1996 $396.78 billion was spent on health care in 2000 $469.80 billion was spent on health care, and in 2009 $989.65 billion was spent on health care (Chantrill, n.d.). Between 1996 and 2009, a period of 13 years, health care spending increased $592.87 billion dollars. In the following I will discuss the level of current national health care expenditures, whether spending is too much or not enough, where the nation should add or cut funds and why, how the public’s health care needs are paid and the future economic needs of the health care system. The level of current national health care expenditures The level of national health care expenditures is considerably high in comparison, to any other country in the world. “Health spending in the United States is much higher than in other countries – at least $2,535 dollars, or 51% higher than Norway, the next largest per capita spender” (Kaiser Family Foundation, 2011, para. 3). In addition in 2009 the United States spent more than 17% of its gross domestic product on healthcare, which...

Words: 1554 - Pages: 7

Premium Essay

Health Care Spending Paper

...Health Care Spending Paper Candace Kovacs HCS 440 January 23, 2012 Pranab Rout Health Care Spending The United States is spending trillions of dollars on health care every year. Health care spending is continuing to rise to higher levels at unsustainable rates. The excessive amounts spent on health care accounts for a substantial portion of the national budget. Trends such as the aging of the population, obesity, and technological changes are expected to affect the future of health care spending patterns (RAND Corporation, 2011). Even though health care spending seems excessive right now, there are several ways it can be addressed effectively to decrease the amount in the future. Spending The National Health Expenditures (NHE) includes the amount of spending on private and public administrative costs, personal health services, government public health spending and investments involving costs of equipment, non-commercial medical research, and buildings (U.S. Department of Health and Human Services, 2011). The current level of the NHE has raised $2.1 trillion in the year 2006, $2.25 trillion in 2007, and projects to reach $4.3 trillion by 2017 (U.S. Department of Health and Human Services, 2011). The most recent forecasts of health care estimates a yearly growth rate of seven percent, which equals to the gross domestic product (GDP) of 19.5 % by 2017 (U.S. Department of Health and Human Services...

Words: 1379 - Pages: 6

Premium Essay

Health Care Spending

...Health Care Spending Sheilah Schmidt HCS/440 July 21, 2014 Marcia Smith Health Care Spending Health care is rising rapidly. Health care spending is a serious and major issue that needs more focus and stability. In 2009, the gross domestic product (GDP) rose to 17.6% and reached $2.5 trillion. The United States spends thousands of dollars per person for health care. People treated and diagnosed for chronic conditions, and obesity rates are still at large. The current health expenditure for the United States is 15.7% in Gross Domestic Product (GDP). Hospital care, physician and clinical services are responsible for half of the national health care spending increase between 2005 and 2009 (Understanding U.S. Health Care Spending, 2011). If nobody takes action, bankruptcy may be present. Further readings will explain the level of current national health care expenditures and whether the spending is too much or not enough. Further readings will also address where the nation should add the cut; how the public’s health care needs are paid for; and the future economic needs of the health care system. Current National Health Care Expenditures In 2012, the United States spent $2.87 trillion on health care (Management, 2013, p. 1). In 2013, the United States spent $2.9 trillion on health care which is a 3.8% increase. According to Emanuel (2013), the United States spent more than the French and German economy. Health care spending is a big issue in the United States than in any...

Words: 1582 - Pages: 7

Premium Essay

Healthcare

...Health Care Spending HCS/ 440 Health Care Spending In our society today, heath care is one of the top major concerns within the United States. Many individuals do not always agree with the decisions made for health care, the more concerned issues are the increase and where the money will be coming from to pay the costs of increase. Patient’s costs has doubled more in the U.S than any other country along with leaving some people without health care. This paper will discuss health care expenditures, as well as spending is too much or not enough. This paper will also discuss whether or not the nation should add or cut in certain areas and why. How the public need for health care are financed and the percentage of expenditures they represent. Lastly, I will provide future economic needs of the health care system along with reasoning for addressing these needs, and envisions for financing these needs. The spending for health care uses a great deal of the economy revenue, the national studies that have been completed within the past decade clearly shows many U.S citizens will have to make decisions that are disconcerting based on their ability to obtain affordable health care. As health care cost has been on the rise for many years. The expenditures in the United States to health care rose above $2 trillion in 2008. This has affected many families and businesses as well as the budget for the public. Health care spending cost are increasing at a more rapid rate than the economy...

Words: 1343 - Pages: 6

Premium Essay

Information System Briefing

...Information System Briefing Introduction Within the health care organizations it is a constant strive and struggle in keeping up with all the new technical advances that are occurring in order to have the best services available to every patient. Success is something that is expected and needed to be obtained in the health organizations. Some of the success that is much needed comes from information systems (IT), and how these systems meet quality standards that are set and required within the health care industry. Implementing an information system can be a big challenge, which is why it is important in choosing an information system that will assist the organization in meeting all of the goals it has set for the organization. Stakeholder input is a very vital in these organizations because it helps to ensure that the correct system has been chosen. The following briefing will discuss the process of selecting and acquiring an information system, the goals of the organization, and how the stakeholders affect the selection process. Selection and Acquisition Before any selection and acquisitions of any IT can begin for any types of information systems it is important that a steering committee is chosen so that all parts of the project go the correct way. An important person that needs to be assigned is a project manager, and then team will determine the process of implementation and conduct research regarding in which type of information system will be best for the organization...

Words: 1033 - Pages: 5

Free Essay

Medical Care for an Aging Population

...Medical Care for an Aging Population HCS/440 Economics: The Financing of Healthcare University of Phoenix Online Medical Care for an Aging Population There are many issues that face the health care system for the aging population such as the strain on major funding programs such as Medicare, Medicaid, and social security by not having enough funding to cover the growing baby boomer population as they reach retirement age. Social security is the largest federal spending program and Medicare is the fastest growing program and with less working adults than those 65 and older, these programs face issues that could be solved in several ways including raising the retirement age beyond 65, Raising the taxable wage limits for social security and Medicare, and building more long term care and memory care facilities. With an increase in the aging population medical care may be difficult to afford as the increased use of services puts a strain on funding programs requiring changes on how we fund these programs and who will qualify. Raising Retirement Age There are many issues that face the health care system for the aging population such as the strain on major funding programs such as Medicare, Medicaid, and social security by not having enough funding to cover the growing baby boomer population as they reach retirement age. Raising the retirement age beyond age 65 is a proposed solution to increase the funding for the program. Life expectancy continues to grow and we are living...

Words: 863 - Pages: 4

Premium Essay

Economic Issue Smiluation Paper

...Economic Issue stimulation paper July 8, 2015 HCS/440 Health Maintenance organization (HMO) is an organization that offer a wide range of health services insurance through a network of providers dealing with supplying services to they member. Self-funded health care benefit plans, individual and other entities as a connection with health care providers or hospital on a prepaid basic. In this stimulation I will review the company demographic, the HMO plans, an overview of castor Collin plans, reason why each plan could be selected and reason for my decision. Castor Collin health plan was founded in 1990 in Pantone, and offer Health Maintenance to organization. Castor Collin provide health insurance and health maintenance to enrollees through it statewide network of physician and hospital. Castor Collin currently has 10,000 enrollees throughout the Unites State and is looking forward to increasing this number. Two company are trying to find coverage for they employees and looking to see what Castor Collin has to offer them. The two company are E-editor and Constructit that are currently seeking coverage. Constructit consist of 1,000 employee and E-editor have 1,600 employee. Both of these company have provided the maximum amount they are willing to pay, the demographics, and health risk factor of their employee. E-editor are willingly to pay an annually maximum amount of $4,500 per employee, and Constructit is willing to pay $4,000 per employee annually. As a representative...

Words: 897 - Pages: 4

Premium Essay

Economic Issue Smiluation Paper

...Yvancia, Benjamin Economic Issue stimulation paper July 8, 2015 HCS/440 Health Maintenance organization (HMO) is an organization that offer a wide range of health services insurance through a network of providers dealing with supplying services to they member. Self-funded health care benefit plans, individual and other entities as a connection with health care providers or hospital on a prepaid basic. In this stimulation I will review the company demographic, the HMO plans, an overview of castor Collin plans, reason why each plan could be selected and reason for my decision. Castor Collin health plan was founded in 1990 in Pantone, and offer Health Maintenance to organization. Castor Collin provide health insurance and health maintenance to enrollees through it statewide network of physician and hospital. Castor Collin currently has 10,000 enrollees throughout the Unites State and is looking forward to increasing this number. Two company are trying to find coverage for they employees and looking to see what Castor Collin has to offer them. The two company are E-editor and Constructit that are currently seeking coverage. Constructit consist of 1,000 employee and E-editor have 1,600 employee. Both of these company have provided the maximum amount they are willing to pay, the demographics, and health risk factor of their employee. E-editor are willingly to pay an annually maximum amount of $4,500 per employee, and Constructit is willing to pay $4,000 per employee annually...

Words: 899 - Pages: 4