Hcs 440 Week 3 Economic Issues Simulation
Economics Issues Simulation Paper
HCS/440 – Economics: The Financing of Health Care
August 15, 2011
Ms Kathie Iaconetti
Economic Issues Simulation The purpose of a managed care organization is to coordinate the costs and delivery of health care. A managed care organization oversees money spent on labor, technology, and facilities such as physician offices and hospitals. A type of managed care organization is a Health Maintenance Organization (HMO). A HMO “provides medical care for all its enrollees in return for a fixed annual fee per enrollee” (University of Phoenix, 2010, Key Terms and Concepts Section). An HMO tightly oversees the use of health care services thereby reducing costs and controlling utilization. For example, HMO’s …show more content…
Managed care organizations can save money by providing lower prices through contracting large volumes of services and reducing the amount of hospitalizations (Getzen & Allen, 2011). This essay presents a scenario in which I am a representative of Castor Collins Health Plans responsible for maximizing profits and minimizing risks. Within my job description, I am advised to develop a comprehensive health insurance plan for two entities: ConstructIt and E – Editors. This essay explains the company’s employee demographics, health risk factors, premium amount the company is willing to pay, and what company I chose to offer a health insurance plan. Based upon my analysis of potential utilization, I will provide two reasons …show more content…
These factors include limitations and exclusions for what Castor Collins is willing to pay. Castor Standard health plan does not cover pre – existing conditions where as Castor Enhanced does provide coverage for enrollees with pre – existing conditions. One reason for why I can offer Castor Standard health plans to ConstrucIt is that the majority of ConstructIt employees are younger in age and almost half the population is free from major health risks. A second reason for why I can offer Castor Standard Insurance plans to ConstructIt is that it costs less while covering more conditions. One reason for why I can offer Castor Enhanced health plans to both ConstructIt and E – Editors is because both companies have employees with pre – existing conditions. A second reason for why I can offer Castor Enhanced health plans is E – Editors contains a larger amount of middle – aged individuals requiring specialized services. Many pre – existing conditions require specialized services that may be added or customized to the Castor Enhanced health
HCS/440 – Economics: The Financing of Health Care
August 15, 2011
Ms Kathie Iaconetti
Economic Issues Simulation The purpose of a managed care organization is to coordinate the costs and delivery of health care. A managed care organization oversees money spent on labor, technology, and facilities such as physician offices and hospitals. A type of managed care organization is a Health Maintenance Organization (HMO). A HMO “provides medical care for all its enrollees in return for a fixed annual fee per enrollee” (University of Phoenix, 2010, Key Terms and Concepts Section). An HMO tightly oversees the use of health care services thereby reducing costs and controlling utilization. For example, HMO’s …show more content…
Managed care organizations can save money by providing lower prices through contracting large volumes of services and reducing the amount of hospitalizations (Getzen & Allen, 2011). This essay presents a scenario in which I am a representative of Castor Collins Health Plans responsible for maximizing profits and minimizing risks. Within my job description, I am advised to develop a comprehensive health insurance plan for two entities: ConstructIt and E – Editors. This essay explains the company’s employee demographics, health risk factors, premium amount the company is willing to pay, and what company I chose to offer a health insurance plan. Based upon my analysis of potential utilization, I will provide two reasons …show more content…
These factors include limitations and exclusions for what Castor Collins is willing to pay. Castor Standard health plan does not cover pre – existing conditions where as Castor Enhanced does provide coverage for enrollees with pre – existing conditions. One reason for why I can offer Castor Standard health plans to ConstrucIt is that the majority of ConstructIt employees are younger in age and almost half the population is free from major health risks. A second reason for why I can offer Castor Standard Insurance plans to ConstructIt is that it costs less while covering more conditions. One reason for why I can offer Castor Enhanced health plans to both ConstructIt and E – Editors is because both companies have employees with pre – existing conditions. A second reason for why I can offer Castor Enhanced health plans is E – Editors contains a larger amount of middle – aged individuals requiring specialized services. Many pre – existing conditions require specialized services that may be added or customized to the Castor Enhanced health