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Essay Available:
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2 pages/β‰ˆ550 words
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2 Sources
Style:
APA
Subject:
Health, Medicine, Nursing
Type:
Coursework
Language:
English (U.S.)
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MS Word
Date:
Total cost:
$ 10.37
Topic:

Financing Health Care

Coursework Instructions:

This module discussed how the health care system is financed. As the costs of care have been increasing,so have efforts to contain them including implementing strategies such as managed care, gate keeping,and developing integrated health systems. It is important for professionals to have a broad understanding of the different ways care is provided,especially as funding options are continually changing. One of the key elements of this system, especially as we move forward, is the changing interactions between patients, third-party payors, employers, and health care providers, and the role of cost sharing in decision-making. Keep this in mind when answering the assignment.


• Interview two people you know ( not a family member or "significant other' that are using two different types of insurance models (i.e., Medicare/Medicaid, Tricare, Employer,Self-pay). Ask them about the type of insurance they have, the type of plan they have (POS, HMO, PPO, etc.), any eligibility criteria they needed to meet for obtaining the insurance, what it costs them to have it/use it, and how those costs impact when/how they use care.


o  Note: Do not use two examples of the same insurance type offered by two different companies (i.e.,Aetna PPO compared to Blue Cross PPO or Medicare HMO compared to Medicare PPO).


For this d iscussion, in at least 350 words, using the information you gathered from the interviews:



  • Explain the exper iences the two people have had with their health care.

  • Describe how the individuals interact with their health care providers,emp\oyer andinsurance companies to receive care (i.e.,gatekeeping,employer \ncent\ es personal health records, premium and co-payment costs,etc.).

Coursework Sample Content Preview:

Financing Health Care
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Financing Health Care
Individuals risk falling sick at one point or another in their life. This instance usually makes them invest in the healthcare system. Even though the insurance covers are supposed to cater to the same condition, they are charging different premiums and offering varying plans. This instance has caused much attention. Therefore, most people should conduct in-depth research on the following covers before investing in the facility. To understand how different insurance models work, I interviewed two people with different insurance models. One of the individuals had employer insurance coverage under Point of Sale (POS), while the other subscribed to self-pay insurance under Preferred Provider Organization (PPO) plan.
The two individuals usually have varying experiences. For example, the individual having the PPO plan has a deductible that the person has to meet before starting to share the cost. On the other hand, the person having POS did not have a deductible since he had chosen the Primary Care Provider (PCP) in the plan’s network and had referrals to other providers. Furthermore, the individual having PPO had a higher premium than the one who had the POS plan. The main reason for paying higher premiums is that the person had more treatment options. Even though these plans have differences, they have some similarities. For instance, both plans had copays where the person fee to the doctor during the visit or medicine prescription.
Even though both people will get healthcare services after getting ill, these individuals have different experiences with healthcare providers. For example, the PPO gives individuals more freedom to choose different treatment options. For example, the person with a PPO healthcare plan ...
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