HSA 312 – MANAGED HEALTH CARE
SPRING 2021: CONTEXT, QUESTIONS AND INSTRUCTIONS
CASE STUDY 1: THE PROBLEM OF HIGH DEDUCTIBLES AND CONSUMER DIRECTED HEALTH CARE IN U.S. HEALTH INSURANCE
DUE DATE – 11:59 PM, SUNDAY, MARCH 28, 2021
CONTEXT :UNDERSTANDING THE PROBLEM OF CONSUMER DIRECTED HEALTH PLANS AND HIGH DEDUCTIBLES:
In keeping with analysis by the Commonwealth Fund, a basis centered on well being care, 21.three % of Individuals have insurance coverage so skimpy that they rely as underinsured:
Their out-of-pocket health-care bills, excluding premiums, quantity to no less than 5 to 10 % of family revenue. The boundaries in protection imply their plans would possibly present little monetary safety in a health-care disaster.
Excessive-deductible plans supplied by employers are one a part of the issue. Amongst folks coated by the businesses they work for, enrollment in high-deductible well being plans rose from four % in 2006 to 30 % in 2019, based on a report from the Kaiser Household Basis. The typical annual deductibles in such plans are $2,583 for a person and $5,335 for households.
• In concept, high-deductible plans, which make folks spend plenty of their very own cash earlier than insurance coverage kicks in, flip folks into cautious customers. However analysis finds that folks coated by such plans skip care, each pointless (elective beauty surgical procedure, as an example) and obligatory (most cancers screenings and remedy, and prescriptions). Black Individuals in these plans disproportionately keep away from remedy, widening racial well being inequities.
• Well being financial savings accounts are designed to blunt the dangerous results of high-deductible plans: Contributions by employers, and pretax contributions by people, Help to cowl prices till the deductible is reached. However not all high-deductible well being plans provide such accounts, and many individuals in lower-wage jobs don’t have them.
INSTRUCTIONS AND QUESTIONS
1. READ THE INDICATED READINGS, WHICH ARE ATTACHED.
2. PROVIDE WRITTEN RESPONSES TO THE QUESTIONS POSED BELOW.
• Your response by way of BlackBoard Assignments ought to have the next format and comply with the principles indicated beneath:
Single spaced.
In Arial 12 font.
Your response needs to be in a separate Microsoft Doc connected to and submitted via Blackboard Task: CASE STUDY 1.
Every part of the response ought to correspond to one of many Questions beneath – 1.A., 1.B., 2.A., 2.B., three.A., AND three.B. WRITE 1 SHORT PARAGRAPH FOR EACH RESPONSE.
In your responses, with out utilizing too many sentences, use the connected paperwork to offer your particular reply to every Question Assignment.
If in case you have made and posted a couple of response on Blackboard, I’ll learn, grade, and reply to your most up-to-date response by day and date.
QUESTIONS – PROVIDE A WRITTEN RESPONSE:
RESPOND TO QUESTIONS 1, 2, AND three, EACH OF WHICH HAS A PART A. AND PART B.
QUESTION 1: How is Shopper Directed Well being Insurance coverage Imagined to Deal with the Issues of Ethical Hazard? – READINGS 1, 1.A. and a couple of.
(Utilizing Federally Certified Shopper Directed Well being Insurance coverage Plans for example):
PART A.: What are the BASIC FEATURES of those excessive deductible medical insurance plans which are speculated to encourage well being plan members to make higher remedy decisions, and to scale back the chance of ethical hazard?
PART B.: How are these BASIC FEATURES speculated to have an effect on a well being plan member’s alternative of well being care items and providers – how are they speculated to encourage and Help higher decisions and interactions with docs, leading to inexpensive therapies, use of decrease depth therapies, and wiser use of specialty consultations and medical imaging?
QUESTION 2: Shopper Directed Well being Plans: How are they anticipated to work VERSUS how they really work? READING three.
HINT: YOUR ANSWER TO PART A. BELOW SHOULD BUILD ON YOUR ANSWER TO QUESTION 1 – THEY ARE RELATED TO EACH OTHER.
PART A.: How are enrollees in Shopper Directed Well being Plans anticipated to behave by utilizing totally different sorts of supplier value and high quality of care info, and being conscious of their price sharing obligations, after they buy well being care items and providers?
PART. B.: Utilizing one (1) instance from Studying three – what’s the proof that folks in Shopper Directed Well being Plans do NOT act because the literature predicts they are going to after they buy well being care items and providers? Briefly describe TWO (2) KEY FINDINGS.
QUESTION three: What are the potential issues of Excessive Deductible Shopper Directed Well being Insurance coverage when it comes to affected person entry to obligatory Private Well being Care Companies? READING four and READING 5.
PART A.: How would possibly Excessive Deductible Well being Plans discourage plan members from receiving Private Well being Care Companies that they want, particularly through the present pandemic GIVE TWO (2) EXAMPLES.
PART. B.: Point out ONE (1) WAY wherein Shopper Directed Well being Plans is perhaps modified to unravel this drawback.
