Controlling Health Care Benefits Costs

Health care coverage can be obtained from many different sources. The most common source is through employer-based insurance. The coverage offered to employees through a group health plan can benefit the employees as well as the business. According to Small Business Majority (2017), purchasing a group policy will allow the employees to have better access to care, which results in healthier employees. In addition, being more affordable and having the sense that medical expenses would not be as expensive if they did not have insurance (Small Business Majority, 2017). Finally, tax benefits that businesses may receive for paying at least half of the employee's premiums, according to Small Business Majority (2017). These benefits assist in creating a healthier atmosphere in a business.

I currently work for a hospital which is part of an academic medical center. It offers 3 health plan options to choose from. The first is the hospitals own medical plan which which is has features of an EPO, and can be categorized as a CDHP (Consumer Driven Health Plan). It has a higher monthly cost, but lower out-of-pocket costs when care is needed. It has a large network of providers including the hospital, and a network of providers who have partnered with the institution. You are not required to have a PCP, but it is recommended, you must use in-network providers, it has a HIA (Health Incentive Account) with wellness incentive funds available for members. The second is a POS plan from one of the larger Insurance companies with 2 tiers of in-network providers, lowest monthly cost, but a higher out-of-pocket cost when care is needed, until you meet the annual deductible amount. This has a Health Savings Account (HSA) attached, and you can have tax deductible contributions go to the fund, and wellness incentives funds can be deposited into the HSA. The third is an HMO plan with the highest monthly cost, but a lower out-of-pocket cost compared to the POS plan when care is needed. It also has an HIA attached as well.

Federal health care costs continue to exceed the American economy fueled by federal health care law, rising enrollments, and increased enrollee spending. The 2010 Affordable Care Act (ACA) significantly changed federal health care policies in the key areas of insurance coverage, access to care, medical care financing, and Medicare program operations. ACA provides good benefits to Americans but comes with a 12.2% increase in cost to the federal government (Meyer, 2017). Health care costs are projected to increase to more than $4 trillion dollars by the end of 2017 nearly doubling since 2006 (Meyer, 2017). Economists project this trend to continue estimating a 6.9% increase annually making it the single highest cost to the federal government (Edwards, 2017). The cost of health care is approaching a crisis if unchecked will continue to grow. Congress has struggled to reach consensus on a more efficient approach to managing health cares costs failing in 2017 to repeal or replace ACA. They will need to reengage now to enact laws to stabilize this looming threat to the American people. I recommend three changes to reduce the impact to federal debt. These changes are repeal individual and employer mandates,

The nation health care system is facing significant challenges that requiring immediate major reforms. Lately close attention is drawn to the uninsured Americans, such as the most painful dilemmas of health care system. The problem of uninsured and uncompensated care continues significantly contribute to the rise of the health care cost and has been a chief topic for public debates and political campaigns for a long time. The purpose of this paper is to describe the current extent of uninsured care and provide the strategies from the nursing point of view how to change the trajectory of this prevalent issue in the USA health care system.

Discuss why we have the healthcare system that we have today. In doing so, use sociological theories to guide your analysis/argument and incorporate pertinent historical, cultural and societal events/information.

As a national issue, there is a problem of the reemerging of rising health care costs. Over the last thirty-five years, the United States has tried to control the health costs. In 1960, there was the passing of Medicare and Medicaid. The program took some of the load off the private sector

This presentation provides an overview of healthcare, and also health insurance to give an understanding of what the basis of this PowerPoint will show . I also use this presentation as an opportunity to incorporate key factors in the decreasing costs of healthcare. Additionally, I provide the audience with two main care plans, which are traditional and managed care plans. Discussion topics will include:

It has been understood that health care coverage is important. So important that not having health care insurance can place an individual at major risk health care wise. These risk could be minimized by simply purchasing health care insurance. There is not just one type of health care insurance but there are several types in which will accommodate the needs of the patient and what he or she may be able to afford. With many varieties with coverage plans like Point of Service (POS), Preferred Providers (PPO) and Exclusive Provider Organization (EPO); Health Maintenance Organization (HMO) is the most preferred health insurance plan by companies. While finding what plan is best for each group it is important to minimize risk and maximize companies

Traditionally the American health care system relied heavily a repayment model referred to as fee-for-service which is described as a form of repayment that generates a greater emphasis on the volume of patients seen rather than healthy outcomes produced under a physician’s care. The fee-for-service repayment method poses multiple issues such as: duplicating services which in turn renders some of the services unnecessary, utilization of expensive technology because of the revenue generation rather than as a valuable diagnostic tool and crowding caseloads to an unmanageable level in order to achieve highest level of reimbursement. The aforementioned events not only have the possibility of being unethical but also drive up the cost of health care in the United States. Currently, health care costs have not only increased, but the Office of the Actuary projected that U.S. healthcare spending will make up nearly 20 percent of the economy in 2019. One would argue that if as a country we are spending so much on health care that we should be a “healthier” nation, but this is not the case. Even though America continues to be the largest spender on health care, collectively we experience a lower life expectancy rate compared to other industrialized countries (hfma.com, 2011, p. 2). To assist with climbing health care rates healthcare purchasers have called for repayment reform. One such reform that has been on the forefront is Value-Based Health Care (VBH), also known as outcome

Rising health care cost has challenged organizational leaders to develop new strategies and initiatives to reduce cost. New initiatives are important because the rising health care cost often interferes with an organization's ability to make a profit or stay in business (Littler, 2007). Possible initiatives for combating rising health care cost could be shifting all responsibility to employees or redesigning the benefit where both parties share the responsibility. Some organizational leaders have chosen the strategy of shifting costs to employees over redesigning their benefits system to combat rising health care cost (Larsen & Pomeranz, 2009). The redesigning of the system could include dropping health insurance coverage for employees (Blumenthal,

Health care costs currently exceed around twenty percent and continue to rise where other countries spend less of their funding on health care but have the same increasing trend. An aging population and the development of new treatments are cause for some of the increase. Unrealistic incentives also contribute: third-party insurance companies and governments who reimburse for procedures performed rather than outcomes achieved, and patients bear little responsibility for the cost of the health care services they demand. However, few acknowledge a more fundamental source of increasing costs: the system by which those costs are measured. Honestly, there is almost a complete lack of understanding of how much it costs to deliver patient care,

In the United States, there are three basic systems in which healthcare are financed: private insurance, public insurance, and uninsured. Within private and public insurance, there are several different types of plans that assist in financing health care. Private health insurance utilizes various healthcare providers to provide cost-sharing in receiving healthcare services through benefits provided by employers or for premiums (Shi & Singh, 2015). Some examples of healthcare providers are commercial insurance companies, self-insured businesses, and managed care organizations (Shi & Singh, 2015). Each healthcare provider outlines the coverage benefits, individual out-of-pocket requirements, and limitations through an insurance contract or plan

Most health care analyst believes that health benefits provided by employers are provided as part of the overall compensation paid to workers. Because of the rising cost of the health care benefits, employers’ shares of

Benefits are a key factor in an employee’s decision to work for a specific company, in many cases an employment decision is based purely on the benefits offered by the company. More specifically health and disability insurance, they can all cost thousands of dollars and are vital to everyone’s career and life. From an employee's standpoint it is critically important to fully understand the types of insurance the company is offering to you. Findings from the 2014 Aflac WorkForces report show that many Americans underestimate their risk of experiencing a disabling illness or injury and overestimate the resources available to them. Generation x, millennials, and generation z are the most affected by this thought

Stakeholders such as employers have always considered quality as the primary importance in their business and that one of it is the quality in health care. Employees invested so much on healthcare so they expect value for their money. In addition, the interest of employers in improving the quality of healthcare also started when health insurance premiums were rising every year to almost 20%. Because of this, employers have become more involved in developing strategies for the purchasing of health insurance. Another reason for employer’s interest in improving quality of care is that access to high-quality healthcare can increase employees’ general health, which results in reduced in health care expenditures, absenteeism, and disability.