You Decide
You Decide - Case Study
HMO which stands for Health Maintenance Organizations are licensed health plans that place providers, as well as the health plans, with dealing with HMO’s there is a risk of medical expenses. The downfall with HMO is that patients must stay inside their network and if the go outside the network they will have to pay out of pocket expenses. HMO is very limited; many patients don’t like limitations when it comes to their decision about their health.
PPO which stands for Preferred Provider Organizations provides patients any provider of their choosing. It is known for PPO plans for patients to take advantage of discounts if they choose inside their network. The downfall with this plan, it can be costly if the patients go out of their network. The insurance company will pay 80% of the insurance and the patient is responsible for the remaining cost 20%. If the patient wants to go out of their network then the insurance company would have to pay half the cost and the patient will be responsible for paying the remaining costs.
Indemnity insurance is when a policy based upon a fee scale, such a sliding fee, with minimum limits on healthcare costs. The downfall is with this plan is the patients will get stuck with the bill which was not covered by the insurance company.
Problem Identification:
As reviewing Cooper-Pearson Sports Marketing Company, the company CEO, Mr. Donovan has told me that for the past two years he has lost fifteen key senior employees. Mr. Donovan states he believe one major reason he is losing his staff is because his company cannot afford to hire and train the best. He feels it is waste a time and money, especially if the companies have to hire new staff. Fearing the in the short run the new employees will not stay with company.
When doing the exit interviews, he noticed majority of the interviews with past employees, they would consistently mention leaving because of the lack of adequate or affordable medical insurance.
HMO which stands for Health Maintenance Organizations are licensed health plans that place providers, as well as the health plans, with dealing with HMO’s there is a risk of medical expenses. The downfall with HMO is that patients must stay inside their network and if the go outside the network they will have to pay out of pocket expenses. HMO is very limited; many patients don’t like limitations when it comes to their decision about their health.
PPO which stands for Preferred Provider Organizations provides patients any provider of their choosing. It is known for PPO plans for patients to take advantage of discounts if they choose inside their network. The downfall with this plan, it can be costly if the patients go out of their network. The insurance company will pay 80% of the insurance and the patient is responsible for the remaining cost 20%. If the patient wants to go out of their network then the insurance company would have to pay half the cost and the patient will be responsible for paying the remaining costs.
Indemnity insurance is when a policy based upon a fee scale, such a sliding fee, with minimum limits on healthcare costs. The downfall is with this plan is the patients will get stuck with the bill which was not covered by the insurance company.
Problem Identification:
As reviewing Cooper-Pearson Sports Marketing Company, the company CEO, Mr. Donovan has told me that for the past two years he has lost fifteen key senior employees. Mr. Donovan states he believe one major reason he is losing his staff is because his company cannot afford to hire and train the best. He feels it is waste a time and money, especially if the companies have to hire new staff. Fearing the in the short run the new employees will not stay with company.
When doing the exit interviews, he noticed majority of the interviews with past employees, they would consistently mention leaving because of the lack of adequate or affordable medical insurance.