...In the United States (U.S.), Private Health Insurance is the primary source of healthcare system for most people. For elderly citizens and eligible children and families from low-income households, public programs are the main source of health cover. Public programs consist of Medicare, Medicaid, State Children Health Insurance Programs (SCHIP). In 2010, the Patient Protection and Affordable Care Act (ACA) carries out a mandate that every American must have health insurance, or pay a fine [1]. ACA, also known as ObamaCare, aims to reduce healthcare costs, and provide affordable healthcare for everyone. Accordingly, the health insurance coverage increases from 84% to 88.5% [2]. The ACA health insurance marketplaces, namely health insurance...
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...On October 1st, 2013, ObamaCare Health Insurance Exchange Marketplace was opened for the first time for general browsing. Individuals can sign on to the website and choose coverage from different health providers and see if the individual or family qualifies for cost savings. The open enrollment phase opened on November 15th, 2014 and ended February 15th, 2015, which gives plenty of time for individuals to choose the right coverage for them and their family. The government allows individuals four ways to have easy access to the marketplace, which include the website, over the phone, paper application, and local community help (ObamaCare, n.d). For every full month that an individual and a family does not enroll in a health plan, they have...
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...Contraception as an Employee Health Insurance Benefit The Issue: The Supreme Court recently agreed to hear a case regarding whether nonprofit groups affiliated with religious institutions are required to provide free insurance coverage for contraception to employees. (Liptak, A. 2015, November 6) The Department of Health and Human Services (DHHS) allows religious, nonprofit organizations to be exempted from directly financing access to birth control; however, the employees still have a right to birth control and the insurance companies subsidize contraceptives for the religious nonprofit organizations. (Burwell v. Hobby Lobby 2014) In the new case that will be before the Supreme Court early next year, nonprofit organizations will be arguing that the act of filing for an exemption to shift the financial requirement for employee access to birth control through employer sponsored health...
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...The Children’s Health Insurance Program (CHIP), the Health Insurance Portability and Accountability Act (HIPAA) had different aspects including the significance of existing administrative capacity and expertise, organizational routines, reporting requirements, resources, incentives and political will. The CHIP was successful because states where encouraged to innovate by designing alternative programs and they received incentives to participate through federal reimbursements, states were given the flexibility to design their programs, set their own rules, benefit levels, provider payments and other program requirements. States were given control while the federal government had oversight and mandatory reporting requirements. So the federal...
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...SYNOPSIS TOPIC “Study of consumer awareness and perception towards health insurance portability.” INTRODUCTION Healthcare Insurance Market in India is unique and has a strong growth potential than the other insurance markets. Life insurance includes all risks related to the lives of human beings. IRDA (Insurance Regulatory and Development Authority) allowed to the customer to change their insurance company in case of dissatisfaction with company. Health insurance portability gives the flexibility to the customer and increase the fair competition among companies. The concept of Portability is new in India so the awareness and perception towards portability of customers depends on several factors. The study covers all the fundamental aspects of awareness and customer preference towards healthcare insurance portability in India. The objective of this study is therefore to examine some of the influences such as consumer awareness and enthusiasm, the role of social influences like advertising, services provided by company, groups and family in affecting consumer’s perception and evaluations of health insurance. RATIONALE OF STUDY • The main logic behind doing this study is that the concept of Health insurance portability is new in India so the awareness of that is not measure till now. • The second rationale of the study is that there are certain reason to influence the customer to change their service provider. • Another rationale of study is to understand the...
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...Health Insurance Needs, Awareness and Assessment in the Bahraich District, Uttar Pradesh JANUARY 2008 This publication was produced for review by the United States Agency for International Development. It was prepared by Constella Futures, New Delhi ITAP is a three-year project funded by United States Agency for International Development under Contract No. GPO-1-01-0400015-00 beginning April 1, 2005_ The project is being implemented by Constella Futures in partnership with Bearing Point, Sibley International, Johns Hopkins University, QED, Urban Institute and Association of Reproductive Health Professionals (ARHP). For further information contact: Constella Futures 1 D-11, Parkwood Estates Rao Tula RamMarg New Delhi 1100 022 Health Insurance Needs, Awareness and Assessment in the Bahraich District, Uttar Pradesh JANUARY 2008 The authors' views expreseed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government Contents List of Tables List of Figures List of Abbreviations Executive Summary Chapter 1: Background and Methodology .......................................................... 1.1 Introduction... 1.2 Objectives of the Study ................................. 1.3 Study Design and Methodology ....................................................................... 1.3.1 Sampling and Sample 1.3.2 Study techniques ..............................................
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...Introduction A case study is a puzzle that has to be solved. The first thing to remember about writing a case study is that the case should have a problem for the readers to solve. The case should have enough information in it that readers can understand what the problem is and, after thinking about it and analyzing the information; the readers should be able to come up with a proposed solution. Writing an interesting case study is a bit like writing a detective story. You want to keep your readers very interested in the situation. In this case study we try discuss about Southern California Supermarket Strike. The Southern California Supermarket Strike of 2003-2004 was a strike among supermarket workers in Southern California. The walkout lasted for twenty weeks. In this case study, we try to discuss common issues related to the strike of Southern California Supermarket's staff. We are discussing various alternatives and solutions related with it. To prepare this case study we follow Goggle, Wikipedia and various article related with this situation. Overview Grocery clerks in Southern California are fairly well paid when compared to other grocery workers in the US. Their health benefits are not as good as the benefits of, say, most K12 teachers, but better than most other wage workers -- also true of their pensions. This gave the grocery workers what they themselves see as a middle-class income, whether that is in fact the case or not. Wages of...
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...Impact of Affordability on Access to Health Care Services: a Case Study of Texas Introduction Access to healthcare arguably forms an integral aspect of human existence. However, in recent times, access to health care appears to have been militated by Health care and health insurance laws, the US policies on health insurances, earnings of an individual and a host of other factors. Although the enactment of the Patient Protection and Affordable Care Act (ACA) appears to serve as a partial force which enables people to have access to health care if earnings are below the stipulated national minimum wage, however the extent to which this solve this situation is still a subject of controversy (Sommers, Buchmueller, Decker, Carey, & Kronick,...
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...and accessible health care coverage and services. Within the past thirty to forty years, the scope and cost of health care coverage and services has drastically changed, altering the manner in which health care was previously managed. There are several factors that have affected the cost of health care coverage over the course of the past two to three decades. One of these factors is the introduction and rapidly increasing enrollment in managed health care insurance plans. Managed care health insurance plans can, in most cases, help to alleviate the rising costs of effective medical coverage. Another important factor that has affected health care costs is the invention and implementation of new medical technologies. As prominent researchers and economic analysts have discovered, there is a distinct and direct correlat! ion between advancing medical technologies and rising health care costs. Medical innovation has been proven time and again to be an important determinant of health care cost growth. It would appear that managed care health insurance plans, which attempt to lower health care costs, and highly expensive new medical innovations and procedures are at cross purposes, pulling against one another in very different directions. Market-level comparisons have found the cost growth of health care in markets with greater managed care penetration to be generally slower than that of non-managed care health insurance markets. However...
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...Health Insurance Fraud By: WAHEED ALKHAMEES KHALED ALNAFEE Further Issues Hospital Administration PA 551 Master of Health and Hospital Administration (Parallel) King Saud University One:- Introduction Definition Insurance is the equitable transfer of the risk of a loss, from one entity to another in exchange for payment. It is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss. An insurer, or insurance carrier, is a company selling the insurance; the insured, or policyholder, is the person or entity buying the insurance policy. The amount of money to be charged for a certain amount of insurance coverage is called the premium. Risk management, the practice of appraising and controlling risk, has evolved as a discrete field of study and practice. The transaction involves the insured assuming a guaranteed and known relatively small loss in the form of payment to the insurer in exchange for the insurer's promise to compensate (indemnify) the insured in the case of a financial (personal) loss. The insured receives a contract, called the insurance policy, which details the conditions and circumstances under which the insured will be financially compensated. Types of Insurance Services Insurance can take a number of different forms. Some of these types: Auto insurance Auto insurance protects the policyholder against financial loss in the event of an incident involving a vehicle they own, such as...
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...CASE STUDY ANALYSIS UNIT 12 MODULE 64 Case Study Analysis Module 64- Health Care Legislation When government decided to pass the health care reform act, I have always supported this effort. I rank my response as a two within the parameters of “strongly in favor.” For years many people in American have suffered at the mercy of insurance companies using their power and authority to blindside and push the American people into a corner mentally, physically, and financially leaving them desperate and in need health care. I have always felt that it was the government’s duty to step in and regulate this matter in a way that would turn the tables on the negative tactics of the insurance industry and allow the American people to benefit from proper health care coverage for themselves and their families. The government has not only stepped in but has stepped in with aggression, even posing fines on citizens that do not purchase health coverage. Although I support the health care reform act, I am against the portion of the law that poses fines on people for not purchasing health care. I rank my response as a 6 within the parameters of “strongly oppose.” I fully understand the impact that uncovered citizen’s cause on the economy and tax payers. The penalty itself sends a message that speaks volumes and punishes people in ways that are not fair or just. According to povertyusa.gov, more than 46 million Americans live in poverty; American families were having a difficult time making ends...
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...competitive markets in health care can offer patients greater quality, more options, and lower costs. The Federal Employees Health Benefits Program and Medicare Part D serve as two illustrative examples of competition in health care today. Proper reforms to add further competition to the health care industry would be quite significant and would further America’s position as the world’s leader in health care for years to come. KEY POINTS 1. The body of peer-reviewed academic literature suggests that health care can and should operate like a traditional market. 2. Market-oriented reforms have the potential to improve the quality and cost-effectiveness of care, as demonstrated by the Federal Employees Health Benefits Program (FEHBP) and Medicare Part D. 3. Consumer-driven health plans are viable alternatives to traditional plans, and consumers should have the option of choosing such plans. 4. Proper risk adjustment mechanisms can prevent adverse selection. 5. Migrating toward value-based payment systems will result in greater quality of care at lower costs, in part by incentivizing the health care industry to make great strides in offering integrated care, innovative treatments, and personalized medicine. ABOUT THE AUTHOR Kevin D. Dayaratna, Ph.D.Senior Statistician and Research Programmer Center for Data Analysis Over the course of the past several decades, federal and state lawmakers have proposed a variety of initiatives to reform America’s health care system and...
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...The existing arrangement of the U.S. health care system leaves large numbers of the American population without access to adequate health care. Currently, about 45 million Americans do not have any health insurance, resulting in inability to receive the necessary care required for a healthy and productive life (NCHC). Further, government run programs such as Medicaid and SCHIP, the State Children’s Health Insurance Program, are not sufficient and effective means of providing care for those eligible for them. Poor Families in America’s Health Care Crisis by Ronald J. Angel, Laura Lein, and Jane Henrici illustrates how the safety net for health care through current government programs does not work and how access to health care cannot be considered universal. The Three City Study, a large, multidisciplinary examination of the consequences of welfare reform for children and families in poor neighborhoods in Boston, Chicago, and San Antonio, gives a personalized look into the flaws of the United States’ welfare and health care systems (Angel 7). Through these ethnographic studies, it can be determined that the current safety net for poor Americans is made ineffective because of discontinuity of care and the employer-based nature of health care. Poverty can be defined as the “lack of social capital or power to control one’s life or that of one’s children in important ways” (Angel 30). With this being said, it can easily be seen why poor Americans live very chaotic and unstable...
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...INTRODUCTION Health insurance is fast emerging as an important mechanism to finance health care needs of the people. Healthcare Insurance Market in India is unique and has a strong growth potential than the other insurance markets. Life insurance includes all risks related to the lives of human beings. IRDA (Insurance Regulatory and Development Authority) allowed to the customer to change their insurance company in case of dissatisfaction with company. Health insurance portability gives the flexibility to the customer and increase the fair competition among companies. The concept of Portability is new in India so the awareness and perception towards portability of customers depends on several factors. The study covers all the fundamental aspects of awareness and customer preference towards healthcare insurance portability in India. The objective of this study is therefore to examine some of the influences such as consumer awareness and enthusiasm, the role of social influences like advertising, services provided by company, groups and family in affecting consumer’s perception and evaluations of health insurance. The need for an insurance system that works on the basic principle of pooling of risks of unexpected costs of persons falling ill and needing hospitalization by charging premium from a wider population base of the same community. In the present scenario the annual expenditure on health in India amounts to about $7.00 in rural areas and $10.00 in urban areas...
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...STUDY ON PUBLIC SPONSORED HEALTH INSURANCE SCHEMES IN INDIA Abstract The main of this study is to analyse the public sponsored health insurance models in India. The main aim of government sponsored health insurance schemes is to assist the BPL families in catastrophic health expenditure and thereby provide them access to quality health care. This report goes through the working procedure of health insurance schemes, especially Rajiv Aarogyasri (Andhra Pradesh), Vajpayee aarogyasri (Karnataka) and Chief Ministers Comprehensive health insurance scheme (Tamil Nadu) and analyse how far they succeeded in their respective aims. Introduction Health insurance as a measure to uplift the living standard and improve the status of the poor has become popular recently in India. The health care system in India was dominated by private sector, which accounts for about 60% of hospitalisation and 80% of outpatient treatment as per NSSO survey on health care (60th round). This can lead to huge out of pocket expenditure by households on health care. Even though the idea of health insurance was an earlier concept, to use this as a measure to ease the burden on health expenditure by public (especially the poor) became popular from last five-six years, when both central and State governments introduced various publically funded health insurance schemes. This is evident from the fact that there is a steep increase in population covered under insurance from 75 million in 2007 to 302 million in...
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