Private Insurance Essay

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Private Insurance
Employment-based insurance. The majority of Americans are covered by private or employer-based insurance, with the employer subsidizing the premiums and the employee pays a coinsurance or copay when a claim is filed. Sharp rises in insurance premiums have forced employers to shifts costs to the employee by increasing deductibles, coinsurance, and pharmacy benefits (Trude, Christianson, Lesser, Watts, & Benoit, 2002). Employers may offer their employees a choice of plans in the defined benefit model of health insurance benefits. Many of these plans have high-deductibles (referred to as high deductible health plans or HDHPs) that shift costs to the employee, the premiums are generally less expensive than managed care
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Managed Care Managed care is credited by some as having been one of the most important factors impacting U.S. healthcare financing and organization since its prime in the 1990s (Shi & Singh, 2008). In fact, in 2011, the majority of all workers were enrolled some sort of managed care plan through their employer-sponsored insurance plans (Shi and Singh, 2013). Managed care organizations (MCOs) were embraced as a response to employers’ concerns over escalating costs associated with health insurance premiums (Shi & Singh, 2008). While managed care did succeed in controlling the use of health care services and slowing the escalation of health care costs, in the late 1990s it suffered backlash from the public and providers (Shi & Singh, 2013). This backlash prompted some MCOs to loosen their regulation over health services somewhat although they did not give up all control over utilization of services (Shi & Singh, 2013). The result was a compromise between MCOs, providers, and patients with fee-for-service reimbursement, capitation for some services, along with a larger choice of providers (Shi & Singh, 2013).

Medicare and
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