...Summary of Chapter 10 Case * Frontline PR is a public relations firm with 150 full time employees, consists mainly of their staff plus some administrative and operations people. Frontline is currently struggling with the cost of health care insurance * Currently offers their employees fee-for-standard, 300 deductibles, 20 percent co insurance, FSA Flexible spending account * After attending and speaking with several experts at the national conference on compensation on Health Savings Account, she thinks an HSA will be a viable option for Frontline. * She believes that making such change from standard fee-for-service plan to HSA with high- deductible insurance plan could result in significant cost savings for the company. Even though the company would contribute to each employee`s HSA, the overall costs for healthcare benefits would still be less than its current option * Susan discussed the HSA option to the Finance Director Allison Jones, from the financial perspective Allison agrees that the option would be a good step to start controlling healthcare cost although Allison thinks that as an employee he is not sure if high deductible health insurance plan is the right option for the company. * Susan is convinced that HSA would offer a significant cost savings to the company, after talking with Allison she is unsure if she will recommend it for Frontline employees. QUESTIONS What are some advantages of implementing HSA option? What are some potential...
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...Case Study Comparisons HCS/490 February 9, 2015 Case Study Comparisons There is a lot to consider when it comes to choosing a healthcare plan for you and your family. We are going to talk about the different options you have, such as whether you want a HMO, PPO, or a CDHP. There are many things you need to consider when looking at health plans. Some of these include your age, health, and whether you are single or have a family. We will discuss each of the options and which one may work the best for this situation. HMO Health maintenance organization or HMO, is a standard health care plan available through most health insurance companies. An individual with an HMO maintains their health by visiting their primary care physician on a regular basis for routine check-ups. Typically with an HMO, the individual will select their primary care physician within the preferred network. The individual will see their primary care physician for routine check-ups and preventive care. If the individual has a particular issue, they must go to their primary care physician first. If the primary care physician is unable to treat the patient, the patient will be referred to a specialist by their primary care physician. If the individual chooses to see a doctor outside their preferred network, the individual will be subjected to pay 100% of costs. Health maintenance organizations tend to be more cost effect for the insurance provider and less expensive for the patient. When choosing the...
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...ESSAY ASSIGNMENT ESSAY #1 DOMESTIC MARKET Health care reform is a political and economic topic that has been debated for years. Most recently in the United States under the president Barack Obama's current term he passed a law that most of us Americans refer to as Obama Care but is also known as the Affordable Care Act. This law requires every American to have some sort of health care coverage. However, is affordable health care really that affordable? There are some countries that have national health insurance systems where government uses tax revenues to provide a basic health care package. However, in America most citizens are enrolled in private health care Insurance usually provided by their employer. Health care provided by employers does come at a cost. It does drive up the cost of labor because it’s another cost incurred by the firm and sometimes the employee. Several companies I have worked for in the past have shared the cost of insurance; by doing this the firm does not incur all the costs of health care; the firm also avoids being fined for not providing health care. If the firm does not provide health care and has more than 50 employees the firm will incur of fine of $5,000. Thus, employers are essentially forced to either incur the costs of health care or pass part or all the costs onto the employee, therefore, decreasing the overall amount the employee actually makes. Some employers could use health care benefits as an enticement to keep their labor force...
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...University of Phoenix Material Case Study Comparisons Part 1 Complete the chart below that differentiates the following insurance types. |Plan Type |Characteristics of Plan (5 to 7 characteristics) |Target Audience for Plan | |Indemnity Plan |Able to choose hospital and doctor, Fee for service, deductible, |Individuals and Families | | |co payments, | | |Preferred Provider Organization (PPO) |Able to choose any medical facility or provider, Out of network |Individuals and Families | | |claims, No need for referrals to visit specialist, Annual | | | |deductible, Premiums | | |Health Maintenance Organization (HMO) |Fixed monthly fee, Focus on wellness and preventive care, For |Individuals and Families ...
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...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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...Quality Management Case Study Mike Baker OSCM440-F1WW-W14 John Rice March 1, 2014 Can improving health care quality result in a way that is beneficial to both the patients and the investors? This will create a way for lower costs to patients and higher returns to investors without sacrificing the quality care expected and deserved. VARIABLES Wellness programs Staying in the hospital longer Lack of communication between all the people involved Reduction in medical errors Healthcare improvements ALTERNATIVES Higher premiums for companies Shorter stays or no stays in hospitals Good communication between patients and doctors Improvements in healthcare may be optional Using technology to keep track of patient care When looking at the first alternative which is higher premiums for companies, it makes sense for companies to offer wellness...
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...Case Study Comparisons Shelly Collins HCS/490 April 25, 2015 Humana Health Care has different coverage options and plans to choose from. For example there is Coverage First, HMO, High Deductible Health Plan, Humana Classic, and Humana Simplicity. Humana Simplicity is a co-payment only plan, no deductible will need to be paid. Humana also offers a variety of products and services with their coverage plans, including a prescription drug plan (Humana Health Insurance, Medicare, & Dental Insurance, 2015). This female is an 80 year old widow, and takes several medications for chronic health conditions that must be monitored daily. It is important to find an affordable plan that fits her needs. For this individual there are two plans that she could choose from that would fit her needs. Humana has an Individual plan and a Medicare plan. The Individual plan includes medical, prescription drug coverage, and discounted dental and vision plans (Humana Health Insurance, Medicare, & Dental Insurance 2015). The Humana Medicare Advantage Plan probably makes the most since. The Medicare Advantage Plan offers more benefits, both medical and drug coverage are combined into one, and at no cost it includes a wellness program (Humana Health Insurance, Medicare, & Dental Insurance, 2015). Humana also offers extra support from other sources. For example, if there is a need for more care such as in the home, there is At Home Service Care. Humana has a program...
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...Chapter 9 health and disability insurance |CHAPTER OVERVIEW | Planning a health insurance program needs careful study because the protection should be shaped to the needs of the individual or the family. However, the task is simplified for many families because a foundation for their coverage is already provided by group health insurance at work. We begin the chapter by recognizing the importance of health insurance in financial planning and define health insurance. Then we analyze the benefits and limitations of the various types of health insurance coverage. Private and governmental sources of health insurance and health care are presented next, with a complete coverage of health maintenance organizations (HMOs). Then, we discuss the importance of disability insurance in financial planning and identify its resources. Finally, we explore why the costs of health insurance and health care have been increasing and what is being done to curtail them. |LEARNING OBJECTIVES |CHAPTER SUMMARY | After studying this chapter, students will be able to: |Obj. 1 |Recognize the importance of health |Health insurance is protection that provides payments of benefits for a covered sickness | | |insurance in financial planning. |or injury. Health insurance should be a part of your overall insurance program to | |...
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...Preventive Care Veronica Lee Regis College HP-622-01-11FA, Economics of Health Care December 4, 2011 Is There a Real Cost Savings with Preventive Care? Introduction: On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law, which creates health insurance reforms that will transform healthcare over the next four years. The PPACA will ensure that all Americans have access to quality, affordable health care and will create the transformation with the health care system necessary to contain costs (The Patient Protection). One of those health insurance reforms started on September 23, 2010, which will provide free preventive care. The PPACA will eliminate co-pays and deductibles for recommended preventive care, including preventive care for women, provide individuals with the information they need to make healthy decisions, improve education on disease prevention and public health, and invest in a national prevention and public health strategy (The Patient Protection). There are some exceptions to the law for grandfathered insurance plans. This preventive services provision applies only to people enrolled in job-related health plans or individual health insurance policies created after March 23, 2010 (Preventive Care). This law is supposed to improve quality healthcare and lower costs for patients. This paper will discuss what effect the new law may have on the United States healthcare system. What is Preventive Care? The...
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...are different types of Marketplace health insurance plans designed to meet different needs. Some types of plans restrict or encourage you to get care from the plan’s network of doctors, hospitals, pharmacies, and other medical service providers. Others pay a greater share of costs for providers outside the plan’s network.” (Comparing health plans). However choosing the best form of medical coverage and being able to pay for it can be stressful to some. Each person and family may need different types of coverage and finding one that suits everyone in the household and accepts all family members due to their medical needs can be hard to find. This case study will look at such a family. A family with multiple medical issues to include, two members having diabetes and being obese, one of which has COPD and a child with asthma. We will look into different health care options and cost, a recommended plan for the family and then take a look at what the family will need within a year. Health care costs & coverage options Health Maintenance Organization Plans (HMOs) have a low out-of-pocket cost, which makes them a good choice if you want to avoid spending a lot of money. Also, since your co-pay commonly covers services outside the basic office visits, it is rather wide ranging. On the other hand, there are disadvantages for the reason that your choices are much more limited versus other plans such as, having to choose one primary care doctor and receiving referrals to see...
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...University of Phoenix Material Case Study Comparisons Part 1 Complete the chart below that differentiates the following insurance types. |Plan Type |Characteristics of Plan (5 to 7 characteristics) |Target Audience for Plan | |Indemnity Plan |No referrals needed, can see any doctor or specialist, No primary |Someone that wants the freedom to choose which doctor they want| | |doctor needed, fee-for-service plan, Sometimes does not cover |to see, does not want to have to get referrals | | |preventative care. | | |Preferred Provider Organization (PPO) |Freedom to choose your provider, encouraged to use in-network |Most employers may offer this benefit to their employees. This| | |providers, may have a small copay, annual deductible before |will give employees a variety of physicians that they can see | | |insurance will pay, and in-network will be covered at a higher |for any ailment. ...
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...Elite Financial has created an edge for themselves surrounding their excellent benefits. While other companies in the same field as financial planning are reducing their healthcare program costs, you are still maintaining low deductibles for your employees, and paying 90% of the premiums. I understand Elite also provides basic fee-for service indemnity for ALL 275 employees, which is composed of 60 single, 75 employee and spouse and the rest are family plans. Along so, you have included vision and dental. It will be easy to say, Mr. Johnson you have created your own monster and are above average when it comes to healthcare benefits being offered. Let’s look at ways to reduce costs. On average, a single employee will pay up to 21% of their premium and families will pay up to 32%. At Elite Financial you offer fee for service, which is a contract between the employer and insurance company which limits a covered individual’s financial liability. A different plan that could be substituted are managed care plans which are cost controlling by limiting an employee’s choice of doctors and hospitals. Three forms of managed care include HMP, PPO, and POS. An HMO plan provides prepaid medical services. A PPO closely resembles the fee-for service plan with close deductibles, out of pocket maximums, and coinsurances. A POS is a combination of fee for service and HMO’s which allow employees to pay nominal copayment for each visit, the one major difference of POS is that employees can go out of...
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...Read and study information related to: Integration of technology in health care evaluation and planning. Planning of health care services. Effectiveness of the delivery of health care services. 2. Prepare an outline of the most relevant aspects of the readings to be discussed in class. A. Integration of technology in health care evaluation and planning. a. As part of the strategy for the nation to put information technology to work in health care. This includes a variety of electronic methods used to manage information on health and health care of people 1.- Clinical decision support 2.- Diseases computerized records 3.-Computerized provider order entry 4.-Electronic medical records (EMR, EHR and PHR) 5.-Telehealth b. It makes it possible for health care providers to better manage patient care through secure use and sharing of health information. By developing records and private insurance for most Americans and provide electronic health information electronic health when and where needed, can improve healthcare quality, even as it makes health care be more profitable. B. Planning of health care services. a. Health care plan means a plan that promises to make arrangements for the provision of health care services to enrollees, or to pay or reimburse any of the cost for these services, in exchange for a fee paid in advance or periodic paid by or on behalf of the subscribers or enrollees. Also known as the service plan specialized medical care. C. Effectiveness...
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...The Future of Medicine Andrew Hovey GEN 499 Eric Fox 03/03/14 In theory, the Affordable Care Act is a great plan but the execution has been terrible because People do not understand what the ACA even actually allows them to do. The ability to keep insurance that was already owned was a fallacy, and the ability of people to actually get insurance via the ACA has been mediocre at best. It does however, represent our best shot at a country where everyone has access to medical care at an affordable rate and moves us toward what I believe to be an eventuality and something that is sorely needed, socialized medicine. The reason that I believe it is sorely needed is due to the fact that the fiasco with the website marketplace rollout involved with the ACA has shown us that even the government is not capable of keeping track of all of the different insurance providers and quite frankly the only thing they have done is confuse people as to what coverage they can receive. This would not be necessary if there were one non-private entity that handled insurance for the people. Many European countries use socialized medicine and admittedly, there are varying degrees of success but our system is broken. Competing healthcare companies, different degrees of care and skyrocketing costs have made healthcare un-palletable for many. Just shopping for healthcare on the Heathcare.gov website, one can see how confusing and frustrating the search...
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...operate properly. Economics includes the study of labor, land, and investments, of money, income and production, and of taxes and government costs. “Economists seek to measure well-being, to learn how well-being may increase over time, and to evaluate the well-being of the rich and the poor. The most famous book in economics is the Inquiry into the Nature and Causes of The Wealth of Nations written by Adam Smith, and published in 1776 in Scotland. ("What is economics,”) With healthcare increasing in the country and insurance agencies providing consumers with the proper coverage for care these conditions are becoming a stress. But within this tension agencies are finding ways to merge and accommodate all aspects of consumers need financially and providing the care needed. According to the “Competitive Effects Analyses of Hospital Mergers” over the past decade, there have been more than 500 hospital transactions and realignment is expected to continue in 2014 and beyond. (Guerin- Calvert, 2014) Economically to control the flow, smaller independent hospitals are being advised to affiliate themselves with larger facilities to better contain their businesses as well as their patients. Innermost concern that patients have is the cost of coverage for the care that will be provided to them. And the trends in network to diminish a patient and their finances benefits are designed with lower premiums and out of pocket costs such as deductibles and copays. But, within this plan a...
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