Health Insurance
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Bay City Health is a nonprofit, community-based, healthcare delivery network in Providence, Rhode Island. The network includes two acute-care hospitals, a network of more than 800 physicians, a broad ambulatory care network, home healthcare, and associated support services. The organization has a compliance department that is staffed with a director for compliance and several other supporting staff positions. The responsibility for the Compliance Department includes, but is not limited to, the following:
Ensuring that all departments and lines of business are in compliance with all contact requirements; accreditation standards; and all applicable federal, state, and local laws.
Developing and implementing policy and procedures that is consistent with the organization's mission and goals while ensuring compliance with all external regulations.
Providing technical support to all departments and other lines of business regarding compliance issues.
Assignment:
Library research assignment
You were asked to develop a summary for the Executive Management Team regarding insurance costs that the company purchases for its health care providers at Bay City.
Instructions:
Go to the Library and internet for research and information to help prepare a summary that includes the following information:
Types of insurance that the company purchases for the health care professionals and reason why the organization must have the type of insurance
Cost trends
Recommendations on how costs could be reduced
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Solution Summary
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Summary
In order to provide insurance to its healthcare professionals, the company can purchase from a variety of available plans. As the needs of customers differ from each other, no one type of plan is superior to the other. Generally, the Health insurance is divided into two categories:
A. Traditional Care.
B. Managed Care.
Both these categories include four different types of plans (Types of Health Insurance, 2008):
a. Traditional Indemnity or Fee-for-service- This type of insurance plan provides complete independence in selecting hospitals, health care providers and doctors as well. Here, only reasonable and routine medical expenses are reimbursed by the insurers. However, fee-for-service medicine is restricted to a certain extent. At the same time, it also includes various additional expenses. The company needs to purchase this plan due to its highly flexible nature and hassle-free services.
b. Preferred Provider Organizations (PPOs) - This plan makes arrangements for minimal fees through a ...
Education
- MBA (IP), International Center for Internationa Business
- BBA, University of Rajasthan
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