Free Essay

Hospital Income for All

In:

Submitted By adrianette07
Words 1453
Pages 6
Hospital Income for All
Reasons why Hospital Income should be available for people with chronic health issues.

Upon the start of this course my boyfriend’s son got sick. It wasn’t the first time that he’d gotten that sick because he has Sickle Cell Anemia. His deductible was high and he had lots of out of pocket expenses once the hospital stay lasted longer than expected. I began doing research on Hospital Income policies wondering if he would be eligible. Since I work for State Farm, I called a friend in Underwriting and was told that he was ineligible due to his preexisting condition. This was when I started comparing Hospital Income (HI) to the Affordable Care Act (ACA) wondering when all insurance will be on the same accord. What good is it when the people that need it most cannot use it?
Where the curiosity originated?
In the past two years I have become more educated on insurance products. Since I am pursuing a degree in Health Care quite naturally I was drawn to Health Insurance. An opportunity presented itself in a State Farm Agent’s office so I transitioned from sales to a more in depth position, which gave me the opportunity to expand upon my understanding of health products. Hospital Income was the first product that my new Agent taught me. This was where I was shown the statistical data behind why parents buy HI and why people do not buy it until it is too late. This curiosity lead to me purchasing a policy for my daughter and myself and pivoting to HI each time it was appropriate.
Basis for my research
Although there are several preexisting conditions to choose from, I decided to choose asthma because it yields the most data. Asthma is easily diagnosed and more patients are treated in the Emergency Room from asthma each year. Upon researching several conditions, asthma has the most patient trends and seems to be one of the most common reasons that patients visit the Emergency Room. Asthma was chosen from sickle cell, cancer, asthma and HIV/AIDS.
Number of people seen in ER each year for asthma. To make the sample easier to understand I have limited the information to asthma patients only. Each year, an estimated 1.81 million people with asthma require treatment in the emergency department with approximately 500,000 hospitalizations. (American Lung Association) These treatments can vary in cost from state to state and based on area. Some patients have private health care and some have coverage through the ACA so their deductibles can also vary. Blue Cross Blue Shield has a co-payment of $125 for emergency care. (Blue Cross Blue Shield of California, 2015) This can cost policyholders thousands of dollars a year in ER visits for having asthma alone, that’s not to mention any of the other preexisting conditions.
I will speak only in teams of State Farm’s HI policy and BCBS’ ER co-pay in this portion. With that being said, Hospital Income can save a policyholder all of their co-pay because the payout amount of the Hospital Income is more than the ER co-pay. For example, State Farm Insurance Companies offers $250 per occurrence with an additional $250 per day spent in the hospital if admitted. The patient will also receive an additional $250 if an outpatient surgery is required. (State Farm Insurance Companies, 2015) This can make a significant difference to a patient that has been admitted due to an asthma attack when the bills start to come in. The American Lung Association says, “The cost of illness related to asthma is around $19.7 billion per year in the United States.” (American Lung Association) The organization also says that 34.6% of these cases end in hospitalization. This can save these patients $250 per day. Some of these patients are adults that are losing wages due to hospitalization. That money can not only make up for those lost wages but also pay the patients co-pays, deductibles or any other personal fees that the patient incurs do to being hospitalized.
How this ties into the Affordable Care Act? The purpose of the Affordable Care Act is to reform health care so that more Americans have access to and are able to afford health care. Along with the reform, Americans are no longer being denied coverage due to preexisting conditions. Meaning, health care is now accessible, no matter what the health status. This was an issue for insurance companies because it forced them to accept the people that were previously denied coverage. Taking on a policyholder with a preexisting health issue can mean thousands of dollars in loss per claim. An insurance companies goal is to remain profitable and with the ACA now mandating the way policies would be underwritten, insurance companies were in trouble. So insurance companies had to take advantage somewhere. They did it by taking control over the policies that weren’t controlled by managed care.
How that affected Hospital Income? Since the ACA was suppose to reform health care and make it more affordable and more accessible the insurance companies changed their other policies to accommodate for the loss they took on Health Insurance. Hospital Income was one of the policies that suffered. The policy was drastically changed and the changes were more conditional than monetary. State Farm Insurance Companies realized how much of a loss it would be to cover the losses of preexisting conditions on regular health policies and Hospital Income so changes had to be made. They took the option away to rate (pay higher premium) a customer with a preexisting condition and made them ineligible all together. There has to be a better answer.
Health care reform should be made to reform all health care, not just some policies. What has been happening lately seems counterintuitive. As a health care professional I want to see everyone have the same opportunities. LeTourneau is a Christian University and since becoming a student here I have been looking at things beyond what is on the surface. Everything that happens is for a reason so why are we offering something to some but not to others? Some people have cancer, asthma or sickle cell. It is like having A, B, AB or O blood type. It is one of those things in life that we can’t just change about ourselves. Health insurance isn’t like car insurance. People that drive reckless have a choice. People that get asthma or inherit conditions from their family don’t. My Christian faith just won’t let me apply the same thinking to health. It’s just not fair.
Hospital Income is a very inexpensive policy. State Farm should offer the policy on conditional terms. The patient’s payout should be decreased once a certain number of Emergency Room visits have been reached. There is currently a maximum of three times per calendar year for State Farm Insurance Companies. (State Farm Insurance Companies, 2015) The payout should be reduced once they reach the 3rd ER visit of the year. The number of visits should also be extended to 3 visits per six months. These are just a few of the changes that I’d like to see.
This coverage can be more comprehensive to offer better options for those that need it most. Hospital Income is made to help those families that are in need of a supplemental coverage. That coverage is most needed by someone that is in the Emergency Room the most. The only issue is that they aren’t offered the coverage because of whom they are. I have had migraines since I was thirteen years old and they have become a part of me. I personally consider it discrimination to deny a person coverage because of something that has become a part of them. There is nothing they can do about it. Hospital Income was created for this reason and should be used for that reason. Hospital Income should be given to all.

Works Cited
American Lung Association. (n.d.). Retrieved 08 16, 2015, from lung.org: http://www.lung.org/associations/states/colorado/asthma/Asthma.html

Blue Cross Blue Shield of California. (2015). Live Fearless. (BCBS, Producer, & BCBS) Retrieved August 18, 2015, from Blue Shield: https://www.blueshieldca.com/sites/fep/documents/2015_PPO_sbs2sides_101414.pdf

Healthcare.gov. (n.d.). Retrieved August 22, 2015, from Coverage for Preexisting Conditions: https://www.healthcare.gov/health-care-law-protections/pre-existing-conditions/

Obama Care Facts . (n.d.). Retrieved August 22, 2015, from Affordable Care Act Summary: http://obamacarefacts.com/affordablecareact-summary/

State Farm Insurance Companies. (2015). Hospital Income Insurance-Texas. Retrieved August 20, 2015, from State Farm: https://www.statefarm.com/insurance/health/supplemental-insurance/texas/

Similar Documents

Premium Essay

Healthcare Policy Law and Ethics

...ASSIGNMENT: 3 ORGANIZATION OF A HEALTH CARE FACILITY HEALTH CARE POLICY LAW AND ETHICS AUGUST 10TH. 2013 Your reputation as a renowned administrator to successfully lead mergers and acquisitions of hospitals precedes you, and you have been hired to create and open a new specialty health care business. This is a clinic with physicians who specialize in the following areas: dermatology, gynecology, heart disease, respiratory disease, surgery, and gastroenterology. It is located in an exclusive neighborhood. 1. Determine whether you would incorporate and state the advantages and disadvantages of doing so. The first order of business is to analyze the demographics of the neighborhood and its residents. Incorporating so many specialties in an exclusive neighborhood can bring about several challenges such as an influx of a variety of individuals from all walks of life. In addition, there could be a traffic nightmare with having so many specialties in a neighborhood such as women with children, old and young adults. The advantages of incorporating multiple specialties in a new clinic would be financially rewarding for the owners. The reason for the financial rewards would be that if one specialty does not do well, then the other would offset any deficits incurred. Another advantage of group practice from the perspective of the provider include shared operation of the practice, joint ownership of facilities and equipment, centralized administrative...

Words: 2106 - Pages: 9

Premium Essay

Business Law

...A Community Leader’s Guide to Hospital Finance E VA L U AT I N G H O W A H O S P I TA L G E T S A N D S P E N D S I T S M O N E Y Prepared for The Access Project by Sarah Gunther Lane, MS Elizabeth Longstreth, BA Victoria Nixon, MS Under the supervision of Nancy Kane, DBA Harvard School of Public Health The Access Project is a national healthcare initiative supported by The Robert Wood Johnson Foundation and the Annie E. Casey Foundation. It works in partnership with Brandeis University’s Heller Graduate School and the Collaborative for Community Health Development. It began its efforts in early 1998. The mission of The Access Project is to improve the health of our nation by assisting local communities in developing and sustaining efforts that improve health care and promote universal coverage, with a focus on people who are without insurance. If you have any questions or would like to learn more about our work, please contact us. The Access Project 30 Winter Street, Suite 930 Boston, MA 02108 Phone: 617-654-9911 FAX: 617-654-9922 E-mail: info@accessproject.org Web site: www.accessproject.org Catherine M. Dunham, Ed.D, National Program Director Mark Rukavina, MBA, Deputy Director for Programs and Policy Gwen Pritchard, MPA, Deputy Director for Communication and Administration © 2001 by The Access Project This publication may be reproduced or quoted with appropriate credit. Acknowledgments The Access Project would like to thank and...

Words: 12691 - Pages: 51

Premium Essay

Health Care Organization

...Hospitals around the United States Hospitals were not always large, nor did they have the technology that is used in today’s time. Hospitals did not exist until around 1736, in which they were referred to as almshouses (Hospitals, 2013). Almshouses were first founded in New York and could treat up to 6 or 7 patients at one time (Hospitals, 2013). After the New York almshouse was successful, new hospitals started to appear all over the United States. The US now has around 5,000 community hospitals that facilitate to people in need of medical attention (American Hospital Association, 2014). The 5,000 hospitals are broken down into for-profit, not-for-profit, and governmental organizations. All of the hospitals have the common goal of quality care for patients but have a different financial structure. For-profit, nor-for-profit, and governmental agencies are the types of organizations that make up the health care system. For-profit hospitals make up a little over a 1,000 of the community hospitals around the United States (American Hospital Association, 2014). For-Profit hospitals are usually owned by a private or public investor. The profits that the hospitals make go to pay expenses, salaries, and also the shareholders. For-profit organizations have to give some of the profits to the shareholders in order for the company to remain viable within the market. For-profit hospitals have higher cost of health care services than other hospitals or organizations (Horwitz...

Words: 1588 - Pages: 7

Premium Essay

Hospital Supply Inc

...A Financial Breakdown Of Hospital Supply Inc This case is comprised of various situations that deal with behavioral costs in order to maximize profits. The use of break-even analysis and opportunity cost is used along with recognizing and using the fixed and variable cost. The Hospital Supply, Inc. case is where they manufacture hydraulic hoists and have a normal volume of 3,000 units per month. Using a break-even analysis the determination of the sales volume and prices will reveal what the company will need to profitably sell its product. There are also scenarios given to determine which options to take to maximize profit or at least minimize loss. Exhibit 1 displays the cost per unit for hydraulic hoists and will provide the information needed to determine how Hospital Supply Inc. can maximize its profit in the following various scenarios. Part one is to determine both the break-even volume in units and in sales dollars. First we need to add all the variable costs per unit = $550 + $825 + $420 + $275 = $ 2,070 and fixed costs per unit = $660 + $770 = $1,430. Given information within the problem include: Normal volume = 3,000 units Regular selling price = $4,350 To find total fixed cost = 3,000 units *$1,430/unit = $4,290,000 By taking the regular selling price and subtract the variable cost per unit gives the unit contribution: = price/unit – variable cost/unit = $4,350 - $2,070 = $2,280 Contribution percent = $2,280/$4,350 = 0.524138 - Break-even...

Words: 1383 - Pages: 6

Premium Essay

Finance

...(State): Date: Sources of funding There are different sources of financing that the hospital uses to finance its operations. The hospital uses both internal and external sources to fund its operations. One of the internal sources of financing that the hospital utilizes is the revenue that is collected from the services offered to both inpatients and outpatients. The second source of internal finance that the company uses is the sale of fixed assets that are not require in the hospital. The hospital on annual basis carries out an evaluation of the assets that it no longer requires and disposes them as a way of financing its operations. The hospital further uses external methods of financing its activities. One of the main sources of finance is through the use of bank loans and overdrafts. The company seeks for both long-term and short-term loans to finance its operations. Other sources include government grants and charities from non-governmental institutions. Financial stakeholders and their various expectations Stakeholders are referred to those individuals who have an interest in the running of Moorfield’s Eye hospital. These stakeholders may commit their resources towards running of the hospital directly or indirectly. Volunteers Volunteers are individuals who offer their services...

Words: 2363 - Pages: 10

Premium Essay

Hcs/405

...financial statements are reports that are useful in many ways including showing where the cash going into the business comes from and how this money is used. Financial statements will also show if a company can pay back the debts that have accrued. Other useful indications for financial statements are to track a trend in any issues related to the probability, and identify individual business transactions details. To understand the financial condition of an organization, an individual would look at the organization's financial statements (Baker & Baker, 2014). Using Patton-Fullers financial statements, Team B will address the difference between unaudited and audited statements and the effect of the revenue sources. Lastly Team B will show how income and expenses are grouped for planning and control. Analyzing Patton-Fuller's financial statements, Team B will address the connections between the sources of revenues and the costs of their financial performance. Audited and Unaudited Difference The financial statements differed between audited and unaudited in one main way; unaudited statements had more information and a more detail break down. For the unaudited financial statements, expenses and revenue are given out to depict clearly where money is coming from and where it does in various costs. The unaudited statements deal with Revenue and Expense as well as the hospital's balance sheet, both based on dollars in thousands. Based on the information...

Words: 1003 - Pages: 5

Free Essay

Microeconomics

...for Health Care: Public or Private? 5. Government’s Program for Health Care 6. Evaluation of the Current Health Care System 7. Conclusion 1. Introduction With a population of over 1.3 billion China has received much attention, including its spectacular economic development since 1978 and the accompanied deterioration of health care for a substantial segment of its large rural population. Section 2 of this paper recounts the success of the PRC in improving the health conditions of its population from 1949 to 1980 and describes the changes of the public heath care system after 1980. In section 3, statistical demand equations for health care are estimated. Using only annual time-series data from 1995 to 2003 I have estimated an income elasticity of somewhat above unity and a price elasticity of...

Words: 9017 - Pages: 37

Premium Essay

Financial Data Analysis

...Analysis HCS/577 July 14, 2014 Financial Data Analysis Patton - Fuller Community Hospital | Balance Sheet as of December 31 | 2009 and 2008 | (In thousands) | (Audited) | 2009 | 2008 | Assets | Current Assets | Cash and Cash Equivalents | $22,995 | $41,851 | Assets of Limited Use | $27,594 | $41,851 | Patient Accounts Receivable (1) | $58,787 | $37,666 | (net of Allowance for Bad Debts 2009: $11,757 / 2008: $7,533) | Other Receivables (3rd party payer settlements | - | $87 | Inventories | $18,396 | $8,370 | Prepaid Expenses | $95 | $201 | Total Current Assets | $127,867 | $130,026 | Other Assets | Funded Depreciation | $137,970 | $167,404 | Held under Bond Indenture | $73,584 | $75,332 | Property, Plant and Equipment, net | $248,346 | $175,774 | Total Assets | $587,767 | $548,535 | Liabilities and Equity | Current Liabilities | Current portion of long-term debt | $14,599 | $4,185 | Accounts payable, accrued expenses | $9,198 | $4,185 | Bond interest payable | $10 | $10 | Total Current Liabilities | $23,807 | $8,380 | Other Liabilities | Long term debt | $452,945 | $209,255 | less: current portion of long term debt | $14,599 | $4,185 | Net long term debt | $438,346 | $205,069 | Total Liabilities | $462,153 | $213,450 | Patton - Fuller Community Hospital | Statement of Revenue and Expense | 2009 and 2008 | (In thousands) | (Audited)...

Words: 1359 - Pages: 6

Premium Essay

Hcs/405 Health Care Financial Accounting

...Financial Statements Review Financial Statements Review The following paper will address the Patton-Fuller Community Hospitals financial statements including the differences between the audited and unaudited financial statements, the effect that revenue sources had on the financial reporting for the hospital and how the hospitals revenue and expenses were grouped for planning and control. When organizations report unaudited financials it is important to realize there may be changes in the audited financial reporting that may occur after an independent review by an outside accounting firm. Additionally it is also important to realize the effect revenue sources can have on financial reporting and the importance of grouping revenue and expenses when implementing internal financial planning and controls. All of the financial information discussed in this paper is important from a financial accounting perspective for external decision makers can evaluate how well the organization has achieved their goals, as well as, a management accounting perspective to provide internal decision makers with financial information to make operational decisions to help them achieve their goals. How Did the Audited and Unaudited Financial Statements Differ? - Stormie There are two types of financial statements, unaudited financial statements are financial statements that are generated based the financial information that has been provided to certified public accountants based on the accuracy of...

Words: 782 - Pages: 4

Free Essay

Asshole

...infection major n must thing once it to an organization such as a hospital hence it can affect many thing in many way , hence if a infection such as a virus is spreads in a ward in the hospital can infect the other patients on no time therefore controlling an infection is must and a major duty to be done by the health care workers therefore these worker should be advocated by professionals for the elimination of a simple infection because it’s the health care workers who involves spreading an infection most of the time not that they do it by purpose but with too much of work load and stress full days there are high chances and risks where they can help a infection to spread since they deal with patients more often therefore it’s a must that they should be more educated on this and its recommended that workshops and audits every month which can help to change the situations where they learn how to prevent a infections such as a viruses to be stop, well this is not only affect the hospital and the patient but it can also affect the country too where immigrations will be restricted because disease can be spread to other countries too, where it will harm them in economical ways where the country will have to face more difficulties in the financial ways and a long stays in a hospital affects the hospital badly and the patient . And such infections that’s are being spread through a hospital is known as a hospital acquired infections (HAIs).further down in this assignments it will...

Words: 1598 - Pages: 7

Premium Essay

Finacial Data Anlysis

... Tricia Jenkins After going over the balance sheet for Patton-Fuller Hospital for the year of 2008-2009, I observed there to be significant differences, these stand- out such as the such as the retained earnings ( or “Net Worth” or “Unrestricted Fund Balance”) drastically decreased from 2008-2009 (Apollo Group 2006). The dollar amount of the decrease is -209,407 this bringing the percentage to 65%. The long- term debt rises to 116% from 2008-2009 as well (Apollo Group 2006). This is very huge increase, along with the total current liabilities increased as a whole by 184.09% (Apollo Group 2006). In the documents of the statement of revenue and expenses there are major differences. The operating income decreased by 98% from 2008-2009 (Apollo Group 2006). Also the net income decreased between the years of 2008-2009, this was also by 98%. Non-operating income was dropped by 77%. From what I observed the total revenue and expenses were all with-in the normal range even though the operating income, non-operating, and net income all have declined and by a very noticeable rate (Apollo Group, 2006). It had a total revenue that had grown by 10%, which equals to $41,668.00. The increase of expenses was $25,869 or in percentages equaled to 5 .91%. According to Apollo Group 2006 these were all in reasonable range for the increase. Many different factors can play a part of the equasion as to why there are so many different...

Words: 780 - Pages: 4

Premium Essay

Health Service Management 340 Final

...1. Question : (TCO 4) Your hospital has just been told that all of your cardiovascular surgeons are transferring their practice to a competitive hospital beginning next year. How would this affect a forecast of volume? Student Answer: First and foremost, if a hospital is suddenly lost all of its cardiovascular surgeons...heads will roll. However, if there are a major lost of service such as the cardiovascular surgeon...there will be a decrease in the volume due to the lost of services. Thus when the hospital have a reduce in the total volume it will also have a reduce in total cost. If the hospital is operating under statistics budget...in the long run, through the development or discontinuation of certain programs volume may be changed, most healthcare firms implicitly assume while developing their statistics budget that they cannot affect their overall volume during the next budgetary period. (Essentials of Health Care Finance, 7th Edition. Jones & Bartlett Publishers p. 362). 2. Question : (TCO 7) Explain the difference between a horizontal merger and a vertical merger. Student Answer: Horizontal mergers involve two firms operating in the same kind of business...i.e...The merger between Hospital A and Hospital B is considered to be a horizonal mergers. Both have the same service or product. Vertical mergers A merger between two companies producing different goods or services for one specific finished product..i.e..Laboratory services and Radiology services...

Words: 1392 - Pages: 6

Premium Essay

Reform and Demand Response in the British National Health Service

...become more responsive to patient demand, which in turn will drive greater eciency in the delivery and funding of health care. However, whether enhanced patient choice will make hospital choice more responsive to quality is not well established, although the consequences of poor quality in health care can be dire. Patients' health can be severely compromised by poor quality care, including, as we show below, an increased risk of death. Thus there is a need to understand the responses of health care consumers when they are o ered more choice. This is exactly the issue we address here. To do this we exploit a reform which introduced patient choice and tie this to the estimation of a structural demand model that explicitly incorporates the institutional features of the reform. This enables us to identify the e ect of increasing choice on patient behavior. We use the model to quantify the gains from the reform in terms of patient welfare and survival and to analyze how the changes in patients' choices translate into changes in the competitive environment faced by hospitals. The reform we exploit is from the English National Health Service (NHS). In 2006, the UK government mandated that patients in the English NHS had to be o ered a choice of 5 hospitals when referred by their physician to a hospital for treatment. Prior to...

Words: 15581 - Pages: 63

Premium Essay

Jackson County Hospital Case Study

...the following nonconformities with the CON application. The first nonconformity exists with §1715 (1). The capacity utilization of the open-heart surgery by the 12th quarter in a 12-month period should be at least 50% which means Jackson County Hospital needs at least 200 procedures Harris, D. (n.d.). Instead, Jackson County Hospital projected a capacity utilization of 195 procedures which does not meet the 50% requirement Harris, D. (n.d.). This means that Jackson County Hospital needs to project at least 50 procedures in the 12th quarter instead of the previously projected 45. The second nonconformity exists with §1715 (5) due to Doctor’s Hospital’s historical utilization not being high enough in order to open another open-heart surgery service in the same geographical area Harris, D. (n.d.). In order to open an additional open-heart surgery within the same area as Jackson County Hospital, the current facility that has an open-heart surgery needs to have a utilization of at least 80%...

Words: 1786 - Pages: 8

Premium Essay

Hcs 577 Workshsheet

...|Specific|1. HCR Manor Care (Private Nursing Home) |1.Mayo Clinic |1.Centers for Medicaid and Medicare Services | |Examples|2. Hospital Corp of America (Private |2.Memorial Hospital (Charitable Hospital) |2.Health and Human Services | | |Hospital) |3.American Red Cross |3. U.S Department of Veterans Affairs (Federal | | |3.HMO’s | |Hospital) | |Similari| | |ties |For all three entities, payments are received from the either the individual, insurance companies, government programs or other third party | |between |payers | |Environm|All environments must maintain financial viability | |ents |Not-for-Profit and Government organizations have property and income tax exemptions...

Words: 273 - Pages: 2