Categories: Uncategorized

Select a managed care plan such as an HMO, PPO, POS, or EPO and discuss its advantages and disadvantages | Online Healthcare Help

In preparing for this discussion, read Chapters 1 and 2 of the course text. For your initial post, address the following in the discussion forum:

Select a managed care plan such as an HMO, PPO, POS, or EPO and discuss its advantages and disadvantages.
Explain the main features of a consumer-directed health plan (CDHP).
Examine one real-life example of a CDHP plan (e.g., Cigna 1500) and another for the selected managed care plan (e.g., Aetna Open Choice PPO) in terms of covered benefits, choice of providers, and level of cost sharing and then determine which one would be the optimal choice for your family.
Your initial post should be at least 300 words. Support your response with a minimum of two credible sources that were published in the last five years.

Don't use plagiarized sources. Get Your Custom Essay on
Select a managed care plan such as an HMO, PPO, POS, or EPO and discuss its advantages and disadvantages | Online Healthcare Help
This is a Snippet Preview Access a Complete Custom Written Paper Done by Our Expert Writers
Order Essay

Required Resources
Text
Kongstvedt, P. R. (2012). Essentials of managed health care (6th ed.). Sudbury, MA: Jones and Bartlett Publishers.

Chapter 1: A History of Managed Health Care and Health Insurance in the United States
Chapter 2: Types of Health Insurers, Managed Health Care Organizations, and Integrated Health Care Delivery Systems
Chapter 3: Elements of the Management Control and Governance Structure
Article
Zezza, M. (2011). The final rule for the Medicare Shared Savings Program Download The final rule for the Medicare Shared Savings Program. (n.d). Retrieved from https://www.commonwealthfund.org/publications/other-publication/2011/apr/final-rule-medicare-shared-savings-program

The article contains the final rule for the Medicare Shared Savings Program from CMS and is the required document for the “Comparing Health Plans” discussion this week.
Accessibility Statement does not exist.
Privacy Policy (Links to an external site.)

Recommended Resources
Article
Patient Advocate Foundation. (n.d.). The managed care answer guide (Links to an external site.) [PDF file]. Retrieved from https://www.baxterregional.org/documents/content/managed-care-guide.pdf

This document provides comprehensive information about various managed care plans.
Multimedia
Kaiser Family Foundation. (2014, November 11). Health insurance explained-The YouToons have it covered? (Links to an external site.)[Video file]. Retrieved from https://www.youtube.com/watch?v=-58VD3z7ZiQ

This video explains important insurance concepts, including deductible, premiums, and provider networks. It also illustrates how individuals obtain medical care and prescription drugs when enrolling in various types of health insurance, like HMOs and PPOs.
Accessibility Statement (Links to an external site.)
Privacy Policy (Links to an external site.)
PlanSource. (2011, September 26). What’s the difference between an HMO, PPO, and HDHP plan? (Links to an external site.)[Video file]. Retrieved from https://www.youtube.com/watch?v=coSyGQI28eM

This video provides an overview on HMO, PPO, and HDHP. So students can gain a deeper understanding to use in weekly assignments.
Accessibility Statement (Links to an external site.)
Privacy Policy (Links to an external site.)
Sexton Benefit Resources. (2009, April 8). HMO vs POS vs PPO (Links to an external site.) [Video file]. Retrieved from https://www.youtube.com/watch?v=25G9hFRmCM8

This video details the differences among HMO, POS and PPO managed health care plans.
Accessibility Statement (Links to an external site.)
Privacy Policy (Links to an external site.)
Web Pages
Kaiser Family Foundation. (2012 October). Consumer-directed health plans: Do they deliver? (Links to an external site.) Retrieved from
http://www.rwjf.org/en/library/research/2012/10/consumer-directed-health-plans.html

This research synthesis addresses: (1) the characteristics of consumer-directed health plans (CDHPs); (2) different features among the CDHPs available in the market; (3) the effectiveness of controlling utilization and costs in CDHPs; and (4) the impact of the available information provided from CDHPs on their enrollees.
MCOL. (2016). Current national managed care enrollment (Links to an external site.). Retrieved from http://www.mcol.com/current_enrollment

This table exhibits the latest national managed care enrollment in HMO, PPO, POS, and HDHP.
MCOL. (2016). Managed care fact sheets (Links to an external site.). Retrieved from http://www.mcol.com/factsheetindex

This website contains 10 tables and graphs in relation to managed care.
Reports
Fronstin, P., & Elmlinger, A. (2015). Findings from the 2015 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey (Links to an external site.) [PDF file]. Retrieved from https://www.ebri.org/docs/default-source/ebri-issue-brief/ebri_ib_421.pdf?sfvrsn=9fc9292f_0

This document reports the findings from the 2015 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey regarding consumer-directed health plans.
The Kaiser Family Foundation. (2015, September 22). 2015 employer health benefits survey (Links to an external site.) [PDF file]. Retrieved fromhttp://kff.org/

This report details trends in employer-sponsored health coverage including premiums, cost-sharing provision, employee contributions, and employer opinions.
United States Census Bureau. (2015, September). Health insurance coverage in the United States: 2014 (Links to an external site.) [PDF file]. Retrieved from https://www.census.gov/content/dam/Census/library/publications/2015/demo/p60-253.pdf

This report contains rich information regarding health insurance coverage in the United States collected by the 2014 Current Population Survey Annual Social and Economic Supplement (CPSASEC).

superadmin

Recent Posts

Based on your research, do you agree, disagree, or both agree and disagree with arguments Hipps makes in his article? Academic Help

I don’t understand this English question and need help to study. Essay 1: Summary/Response (Closely…

3 years ago

Reflection comparing the similarities and differences about Angel Island Academic Help

Help me study for my History class. I’m stuck and don’t understand. Write a 400…

3 years ago

paper about sex Academic Help

I’m studying for my Philosophy class and don’t understand how to answer this. Can you…

3 years ago

3.8 Chapter 6 Academic Help

I don’t understand this Psychology question and need help to study. In a few sentences,…

3 years ago

​Week #06 Discussion Academic Help

Need help with my Philosophy question - I’m studying for my class. Week #06 Discussion…

3 years ago

History 100 Discussion Board Academic Help

I’m trying to study for my History course and I need some help to understand…

3 years ago