Cigna Case Study

Partners HealthCare is a non-profit, health system located in Boston that created a data based transformation (Davenport, 2013). It integrated a new system that aligned the participating organizations to cohesively run as one and to help shape the future of the organization. The system didn’t stop there as it was responsible for bettering the patient financing experience and the delivery of healthcare information to other organizations (Davenport, 2013). The initial goal of the organization was making patient care more affordable and accountable by providing integrated, evidence based, patient-oriented care.

When senior executive at Best Employer Company (Heather) was vacationing in the USA, she expected to return injury free. As Human Resource Manager, it is my responsibility to familiarize myself with the company benefits and inform Heather of the details. I feel the information below is well researched and offer good support about why I selected each benefit.

This week I began my 6-week internship at Blue Cross Blue Shield of Nebraska (BCBSNE). The first day was a common orientation for all new employees, internally denoted to as the “onboarding process” where all employees are told they matter. This full-day session communicates the core mission, vision and goals of BCBSNE, organizational structure, operating objectives, and workplace culture. BCBSNE is a not-for-profit health insurance company that is focused on collaboration to find the best solution for their customers; in other words, they are customer-focused. Since the implementation of the Affordable Care Act (ACA), many changes to the health insurance market required a change in the organizational structure and culture of BCBSNE. Through partnerships with providers, the goals of BCBSNE are to be responsive, accountable, minimize errors, and decrease costs – all components of the ACA. BCBSNE has strategically aligned their goals to those of the government-mandated goals, and implemented them at all levels of the organization, making them competitive in the health insurance market. I found this very fascinating: I was very excited after day one!

Employees are expected to return to work immediately upon release by a health care provider or at the expiration of the approved leave of absence. At the end of the leave, the employee will be reinstated to the same or an equivalent position. If the employee does not return to work upon release by a health care provider or at the expiration of the approved leave of absence, the employee will be considered to be absent without authorized leave and subject to disciplinary action, up to and including termination. An employee who has been released by a health care provider to return to work and fails to return to his/her employment may be held responsible for costs incurred by the County

1. Using the historical data as a guide (Exhibit 6.1), construct a pro forma (forecasted) profit and loss statement for the clinic's average month for all of 2010 assuming the status quo. With no change in volume (utilization), is the clinic projected to make a profit?

Health insurance and the affordable care act is a major topic in the United States today. This being said, there are many questions that run through one’s mind when the topic is discussed. Questions such as, what exactly is health insurance? What is the Aetna-Humana merge, and how beneficial is it? Should healthy citizens help pay for citizens with prior known health issues? Should people with preexisting conditions even have the option to purchase insurance to help cover medical cost? Although the Affordable Care Act has been in effect for a few years now, there are still some problems today the health insurers face because of this law.

CVS Health announced in 2014 that it wanted to stop selling all tobacco related products. This will affect every CVS location in the United States of America. The problem that arises in the U.S. is the usage of tobacco products. As a successful pharmacy chain and a lucrative company, CVS health wants to do its best to strengthen the health of American citizens. In order to solve the tobacco problem, the health professionals are taking it upon themselves to make a difference. If the distribution of tobacco products come to a halt at CVS pharmacies, consumers will either stop buying the products all together or looking for the products elsewhere.

As the industry continues to move away from some of the Medicare programs that were created during the Obama presidency,  the Centers for Medicare & Medicaid Services (CMS) is also pulling away from specific value-based initiatives, such as mandatory bundled payments. The CMS officially canceled two of the models that were included in the Bundled Payments for Care Improvement (BPCI) Initiative.

CVS health hasn’t always been that name at one point they went by CVS Caremark and still some of the things they have out there are named CVS Caremark. The main corporation is based out of Woonsocket Rhode Island. There are roughly 8,500 CVS Health pharmacies and clinics around the world with more to be built eventually. CVS Health is ranked number ten on the fortune 500 and has went up in ranking yearly. CVS stands for convenience, value, service.

The metropolitan classification program is used to determine home mortgage loans, loyalty pay program and varying policies within the Medicare program. The geographic established boundaries of a metropolitan area are representative of that area’s marketplace. Property data collected from the area is reported to bank regulators who will use the data to evaluate lending performance. The data collected could potentially cause bank regulators to consider altering lending practices to suit the area.

The purpose of this essay is to discuss and learn the story of Baylor Scott & White Healthcare, which has been known for high quality medical care for its clients. The discussion aims to review the history of Baylor Scott & White Healthcare, its corporate structure and even the business model that it uses.

It was in 1977 that the United Healthcare United Health group was founded by Richard Burke. The headquarters of the company are in Minnetonka, Minnesota. This organization works towards the betterment of people's health, it help them in living a healthy life by providing them with the kind of health care that would be best for them. The main focus of United Healthcare which is a major division of the United Health group is to provide the people with better health benefits and coverage.

The Omega Ultrasound System would be the best choice to green light for the Healthymagination initiative. After assessing all the potential products, we determined that the lack of concrete metrics, difficulty or uncertainty in measuring outcomes, or clinical relevance to the Healthymagination goal rendered the TEEMax, UltraLipo, and HepEcho unfit for launch. We’ve outlined justification for this decision in (Figure 1.), but we believe the Omega system provides the greatest opportunity for meeting Healthymagination standards with the best chance of obtaining definitive evidence to support the certification.

Columbus Regional Health (n.d.) serves 10 counties in Southeast Indiana. The demographics include a predominantly Caucasian population of approximately 300,000 people (Economic Opportunities through Education by 2015, n.d.). In southeastern Indiana, about 140,000 individuals have employment, and 15% of them, who are over the age of 24, have a bachelor’s degree (Economic Opportunities through Education by 2015, n.d.). Approximately 30% of the high-school students drop out in this mainly rural area with a flat population growth (Economic Opportunities through Education by 2015, n.d.).

The Fortune 500 company I chose is CVS Health. I chose this for a few different reasons. First, I recently had to visit the Minute Clinic in the CVS store twice within the last month. Secondly, I chose CVS because it is part of the health care initiative and I work for a healthcare company.