HSA Qualified Plans Case Study

Due to financial constraints, employer-sponsored pension plans have evolved from being primarily defined benefit pensions (to which employees do not have to contribute their own monies) to

A hospital marketing director has several research projects to undertake this quarter. He must try to determine the appropriate sampling methodology in light of each problem. Describe the methodology that should be used in each of the following and explain why:

Health care professional, patients, families, and policy makers all struggle to understand how health is affected by behavior, economic and social structure and provided the knowledge to improve the health status of individuals and populations. Our health is affected by behaviors, economics, and social structure. Many behaviors and lifestyle patterns affect our health, such as: exposure to violence, vehicular accidents, alcohol, drugs, and infectious agents (Williams/Torrens). According to our textbook (Williams/Torrens), alcohol, tobacco and illicit drug use creates several of problems that affect our health and society.

Regrettably, there is a downside of High Deductible Health Plans (HDHP), and that is the likelihood of higher expense later on if there is any cataclysmic medical issue with you or your family. With a High Deductible Health Insurance Plan, you run the risk of having higher out-of-pocket expenses. For example, a major medical issue warrant surgery, you would have to pay your deductible before the insurance company pays anything. This may cause you to forgo crucial health care needs; due to the high-deductible and out-of-pocket expenses you would occur. Lastly, if your monthly out-of-pocket expenses are high, this will enable you to have an advantageous use of your health savings account (HSA).

When Americans enroll in health insurance they opt for cheaper premiums, rather than premiums that would be suitable for them. The issue with enrollees choosing cheaper premium leads to higher deductibles. According to the Centers for Medicine and Medicaid Services, 68 percent of marketplace enrollees have chosen silver plans and 21 percent bronze plans. Enrollees who have silver plans could potentially see relatively small deductibles, but bronze enrollees may be subjected to higher deductibles that are too expensive to afford. Janet Varion, an

The Affordable Care Act is a health care system that has insured over 20 million American that was uninsured. This is a law that was passed in 2010. There are three metal categories, which are Bronze, Silver, Gold, and Platinum. The metal categories are associated with the cost that the consumer will pay as well as the plan. It is also important to know that the quality of care remains the same for all four categories. For example, the Bronze category will cost the consumer 40 percent while the insurance company would pay 60 percent, while the Silver will cost the consumer 30 percent, while the insurance company pays 70 percent, also the Gold category would cost the consumer 20 percent, while the insurance company would pay 80 percent, and the Platinum would cost the consumer ten percent, while the insurance company would pay 90 percent (“Understanding marketplace health insurance categories”, 2010).

Price recommends that individuals currently covered by a government provided health program should contribute to their insurance plans through health savings accounts. Proponents of this policy argue that it will hold consumers to be more responsible when seeking healthcare services. Opponents argue that while it might decrease the growth of health care costs, it will worsen health care outcomes.

The Office of Inspector General (OIG) has established a set of guidelines (e.g., auditing, monitoring, internal controls, sampling, due diligence, and standards of organizational and employee behavior, etc. Page 508 of the textbook) that physician practices should follow when creating a compliance plan. State an opinion as to which OIG guideline would be the single most significant aspect of a compliance plan for a small practice. Provide a rationale for your response.

In order for this type of coverage to be affordable compliance of a majority is necessary component of ACA. Without an individual mandate a typically healthy person could hold off buying insurance till they became ill. Therefore reducing the total share of people insured and make costs rise considerably.

The act provides health insurance tax credits to millions of small businesses to help them provide insurance benefits to their workers. The health care law also allows for a wide range of recommended preventive services, such as mammograms, cancer screenings and vaccinations to be made available for free in all new plans. The ACA allows for lower healthcare cost by mandating that plans sold to individuals and small employers have at least 80% of the premium spent on benefits and quality improvement. If insurance companies do not meet these goals, because their administrative costs or profits are too high, they must provide rebates to

Even with employer coverage and the expansion of Medicaid, many Americans would still not be covered if the ACA had not offered a new way to buy insurance individually. This new way is called a health insurance marketplace where private insurers compete for individuals business. This allows people to decide how much coverage they want as well as how much they want to pay for it. For example, choices range from cheaper, high deductible coverage, to more expensive coverage. Still, all plans cover a set of services, such as hospital visits, maternity care, prescription drugs, and mental healthcare.

HSAs are to be used in conjunction with a high-deductible health plan, which in the current plan year is defined as a medial plan with a minimum annual deductible of $1300 for self-only and $2600 for family coverage (wherein "family" consists of any combination of

The advantages of the Marketplace (Affordable Care Act) policy would be that you have more choices that you can pick from (Medical Mutual, n.d.). You have the option to review the plans, deductibles, and the coinsurance that is suitable for your family needs. You can also switch plans, options or even health insurance companies when you want. The less stress and fear of losing your coverage on

The price of health care is a concern for both the consumer and the provider. Consumers frequently worry about being able to afford medical care while the physician concern is whether or not they will receive reimbursement for the treatment they provide their patients. In the past insurance companies had the option to decline coverage or charge an excessive premium for those people with pre-existing conditions. One of the benefits for consumers under the Affordable Care Act is to provide coverage regardless of any pre-existing ailment and at a reasonable cost. In the case of pre-existing conditions consumer and provider incentives working together, there will be no limits on benefits which allow the patient to get the continuous care that they

ACA has increased routine preventative care services with no deductible or copay charge. I believe this was strategically implemented, so individuals can attend their medical appointment. However, that’s more likely why some of the private health plans exited the government health insurance market place. The private insurance sector is not profiting modeling the ACA. I believe employers have their employees to pay high deductibles, to decrease utilization. I am not sure if the private sector will ever change.