...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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...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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...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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...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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...1. 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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...Provides information on the benefits of foreign travel insurance and what is generally included. Falling ill or experiencing an accident while travelling abroad requires foreign treatment, and, with medical expenses increasing worldwide, this can lead to costs much more difficult to cover than the actual holiday. Medical expenses increase immensely if there’s need for repatriation. Compared to the expenses of an accident in a foreign country, travel insurance is extremely cheap. As a general rule, buying from a travel agent usually means paying a lot more, not to mention the fact that travel agents are often not qualified or keen to discuss the details of the cover. The circumstances may not allow a detailed inspection of the policy, and very often, the policy document...
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...more than 3:1 -- meaning younger, healthier people are being charged more to subsidize people who are older and/or have poorer health habits” which means it’s not actually going to be cheaper. He’s going to be charging somebody more money to make up for him lowering the price for someone else which is going to cause high premiums (Wingfield). Although Obama says he can save the average family $2,500 on their premiums they could in fact double. “Obamacare, will be 99 percent more expensive for men, and 62 percent more expensive for women, than the cheapest plan offered under the old system. And those disparities are even wider for healthy people” that right there is saying that it’s not going to be cheaper or better for the people, it’s going to make the people who make average or a little above pay a higher premium for those who are in poverty or who aren’t working (Roy). Obama isn’t going to lower anything, all he is going to do is make what the people already pay higher. “Insurers and state regulators say that President Barack Obama’s “fix” for policies canceled under his healthcare reform law will create new problems for the industry and could lead to an increase in premiums” this is going to happen since Obama told the insurers that they could extend their policies for a year (Humer). A solution to higher premiums would be to raise the deductible or add more people to the plan. The Affordable Care Act focuses more on making sure people are covered, than it does on addressing...
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...HEALTH Health is a human right, which has also been accepted in the constitution. Its accessibility and affordability has to be insured. While the well-to-do segment of the population both in rural & urban areas have acceptability and affordability to wards medical care, at the same time cannot be said about the people who belong to poor segment of the society. It is well known that more then 75% of the population utilizes private sectors for medical care unfortunately medical care becoming costlier day by day and it has become almost out of reach of the poor people. Today there is need for injection of substantial resources in the health sectors to ensure affordability of medical care to all. Health insurance is an important option, which needs to be considered by the policy makers and planners. HEALTH CARE SCENARIO Health care has always been a problem area for India, a nation with a large population and a larger percentage of this population living in urban slums and in rural area, below the poverty line. Before independence the health structure was in dismal condition i.e. high morbidity and high mortalities, and prevalence of infectious diseases. Since independence emphasis has been put on Primary Health Care and we have made considerable progress in improving the Health Status of the country. CG: Central Government PH: Primary Health MCH: Maternal and Child Health. • Access to health care service providers and availability of physicians is one part of the...
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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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...The Cost of 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...
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...(for the elderly), Medicaid (for the very poor and disabled), and the Children’s Health Insurance Program (CHIP)for children, the American health care system can best be described as a patchwork of public and private programs (such as employer-based coverage). A mixture of public programs and private programs is common among nations that essentially cover all residents, but the American system is unique — and often uniquely inefficient in economic terms. Keywords Accessibility; Adverse Selection; HMO (Health Maintenance Organization); Medicaid; Medicare; Medicare Modernization Act of 2003 (Part D); Managed Care; "Play or Pay" State Health Care Tax Policies; Rationing Health Care; Single-Payer Health Care System; CHIP (Children’s Health Insurance Program); Socialized Medicine; Two-Tiered Health Care System; VA (United States Department of Veterans Affairs) The US Health Care System Social Issues Overview Health Care Systems The medical business defies the normal laws of economics in at least three important ways: * Government-run programs are often cheaper, more administratively efficient, and even of superior quality than privately-run programs at the national level. * Medical insurance functions poorly by market principles unless potential policy holders most in need of health insurance are either denied coverage or are denied the right to redeem policies — both of which result in high administrative costs;. * Improved medical technology results in higher rather...
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...Jennifer Hitt Trends in Health Care Health insurance can provide you with peace of mind. It protects you by covering much of what you would be expected to pay should you need medical care and saves you from the burden of paying the full costs for your care most of the time. Health insurance covers not only the unexpected expenses, like a trip to the emergency room, but it also covers preventive care like annual doctor visits and routine mammograms. Some insurance even covers all or part of prescription cost as well vision and dental care. Whether you’re seeing a doctor or filling a prescription, taking care of your health can be costly. That’s where health insurance can help. Health insurance is an essential protection from the high and often unexpected costs of medical bills. Several sources can provide you with health insurance, including: * Employer group insurance * Government insurance When shopping for the best health insurance policy always consider cost and coverage because it is important to examine all the avenues that are available. Employer Group Insurance Many individuals are able to receive health insurance through their employers, or from other organizations to which they belong, because they offer “group” coverage. The majority of Americans have group health insurance coverage through their employer or the employer of a family member. One advantage that employees in a group health plan receive is the contribution...
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...higher taxes, reduced benefits (for example Social Security), and higher interest rates. The national debt has continued to increase approximately $2.05 billion dollars per day since September 2012 (Trading Economics, 2015). If the U.S. government doesn’t find a way to curb the current expansionary fiscal policy, the United States could find itself in a situation similar to Greece over the past few weeks. As a healthcare provider and someone who sees the firsthand effects of the current system on patients and healthcare organizations, I am very interest in healthcare reform and its impact on the Federal budget deficit. With healthcare expenditures in the U.S projected to reach 34% of the GDP by 2040, the case for healthcare reform is a no-brainer, and President Obama’s monetary policies sought to remedy this. However, the Affordable Care Act in its current form is not the answer. The Department of Health and Human Services estimates Obamacare enrollment of 9.6 million people in 2015, with current enrollment only 1 million lives shy of that goal (Market Watch). However, just because more people are insured doesn’t mean that access to care is really any better. A Gallup study...
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...Wal-Mart Increases Employee Health Benefits - by Dr. Sanjit Bagchi - Health Care News Wal-Mart Increases Employee Health Benefits Health Care News > February 2008 Economic Development Economic Development > Wal-Mart Email a Friend Written By: Dr. Sanjit Bagchi Published In: Health Care News > February 2008 Publication date: 02/01/2008 Publisher: The Heartland Institute Beset by threats of tailor-made state and local laws intended to force it to increase workers' health care benefits, retail giant Wal-Mart is providing health coverage to more of its employees. In 2008, Wal-Mart will provide employees with $4 co-payments for 2,400 generic drugs and will offer health insurance with monthly premiums as low as $5 to $8. "The non-unionized Wal-Mart has taken a lot of heat on health care, including a custom-made bill in Maryland and copycat bills in other states mandating 'pay or play' rules for employee health coverage," noted Diana Ernst, a health care policy fellow at the Pacific Research Institute in San Francisco. "The company's new plan, however, has drawn praise from even its biggest critics." According to a mid-September news release by the company, "Associates will now have more than 50 ways of customizing their health care coverage options, which will allow them to select various deductibles, health care credits [which enable employees to visit doctors and purchase prescription drugs without paying anything out of pocket], and premiums, depending...
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...CASE STUDY Third-party motor insurance: Your premiums may see only modest hike By Preeti Kulkarni, ET Bureau | 20 Mar, 2015, 11.47AM IST MUMBAI: The insurance regulator has invited responses to a proposal to increase the third-party motor insurance premium by 14% to 108%. However, industry observers believe that the hike will not be so steep. "Like last year, the hike will be moderated. It may not go beyond 20%," said a senior executive[->0] of a private general insurance company. In February 2014, the Insurance Regulatory and Development Authority of India (IRDAI) had proposed an increase of 25-136% and 0.96-45% for private cars and twowheelers, respectively. However, the final hike was only around 20%. Third-party motor insurance is mandatory and protects the owner of the vehicle against any compensation sought by the victim of a road accident caused by the vehicle.There is no cap on the compensation that a victim can claim in case of an accident. But there is a cap on the third-party premium. Insurers want this cap removed so that they can charge according to the risk they undertake. "The regulator and insurers understand that they need to make a pitch for higher rates to get what they actually aim for. That is the reason why the proposed hike looks steep. It will be significantly watered down when the final rates are announced, " said a Mumbai-based insurance broker[->1]. Moreover, third-party component accounts for a small portion (10-20%) of your comprehensive...
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