Successes And Failures Within The CO-OP Program Case Study

Successes and Failures Within the CO-OP Program Of the 23 CO-OP plans that originated under the ACA provisions, only four remain operational, and are slated to provide coverage to the states of Montana, Idaho, Wisconsin, New Mexico, and Maine in 2018 (Meulemans, 2017). Numerous economic considerations have factored into the failure of most CO-OPs. First, funding to the program was reduced in 2011, and was later eliminated for the establishment of any new CO-OPS. Many plans found themselves with insufficient government support as a result. Other issues contributing to failure were primarily misjudgments in operation: some plans set premiums very low in order to compete, but did not account for the lack of funds required to pay out claims; others
CHO Care Managers and Navigators are registered nurses, dietitians, and social workers. Other health care providers that are associated with CHO are Behavioral Health Providers, Primary Care Physicians, Nurse Practitioners and Specialists, all who allow members to get the quality of care they require. In Behavioral Health, there are providers such as Clinical Nurse Specialist, Nurse Practitioners, Psychiatrist, Psychologist, Therapist, and Counselors. For Primary Care, there are providers for Family practice, Internal Medicine, Nurse Practitioners, and Pediatricians. There is also access to a multitude of Specialist and specialties from Allergy and Immunology to specialized Surgery. Through this vast number of providers associated with CHO, members medical issues can be addressed at every level of
The behavioral risk factors consist of tobacco use, narcotics use, stimulant prescriptions, and tranquilizer use. An environmental risk factor is the high number of homes built prior to 1978, that could potentially expose individuals to lead. Looking at the health risk factors in this population, it is well documented that persons of color, especially African-Americans are at greater risk for poor health outcomes, which is due to experiences with discrimination, lack of access to quality health care, lower educational and employment opportunities, and poor housing and work conditions that still continue as of today (Maine CDC, 2016). Additional health factors include several chronic disease indicators such as COPD 7.6%, Asthma (adults) 11.7%, Hypertension 32.8%, Diabetes 9.5%, adult obesity 28%, and adult overweight 36.0%. There are also mental health and abuse indicators such as Anxiety 19.4%, depression 23.5%, mental health treatment 17.7%, heavy drinkers 7.3%, and smokers 20.2%(CDC,