Reference no: EM133623445
Part 1:?Comparing Health Plans
Health insurance can protect individuals from unexpected, high medical costs. In exchange for the payments of insurance premiums, the payer (insurance company) is responsible for paying some or most of the costs of medical services. The payer bears the risk for medical expenses, which is subject to cost sharing and coverage limitations.
In Part 1 of your initial post,
Select a managed care plan such as a health maintenance organization (HMO), preferred provider organization (PPO), point-of-service (POS), or exclusive provider organization (EPO).
Discuss the features, advantages, and disadvantages of your selected managed care plan.
Explain the main features of a consumer-directed health plan (CDHP).
Assume the role of the decision-maker looking for a health plan for your family,
- Select one of the plans among HMO, PPO, POS, EPO, or CDHP. Be sure to include a real-life health plan (e.g., Cigna 2000 Choice with a health savings account) that could be the health plan offered by your employer.
- Discuss the rationales of your selected plan in terms of (a) covered benefits, (b) choice of providers, and (c) level of cost sharing.
Part 2:?Managed Care Trends
The intent of controlling health care costs has promoted the development of managed care organizations (MCOs) in the past few decades. On the other hand, there have been several legislations enacted to contain health care costs and facilitate the growth of managed care. Managed care is a complex system organized to manage cost, quality, and utilization for delivering and financing health care. Managed care has three main aims: improve health care quality, reduce health care costs, and increase access to health care.
In Part 2 of your initial post,
- Examine how the Patient Protection and Affordable Care Act of 2010 has impacted health plans in terms of quality, cost, and access.
- Analyze the current and future trends of managed care in the context of health care reforms.