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Consumer-Driven Health Plans: How do consumer-driven health plans work for different sections of the population? Which socioeconomic group is likely to benefit the most? Consider the following sections of the population: Low-income versus high-income; Well versus unwell (people with chronic conditions and high costs of care) ; Employed, self-employed, unemployed.

Managed Care: Healthcare maintenance organizations (HMOs) are the most prevalent type of Managed Care. Explain the positive benefits and negative aspects, respectively, of HMO managed care from the provider's point of view, a physician and a healthcare facility, and from a patient's point of view.

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The socioeconomic group that is most likely to benefit from a CDHP would be individuals that are (1) willing to take control of their heath and (2) able to help fund any necessary HSA accounts associated with the CDHP. Almost all CDHPs go along with an HSA and the employer makes contributions, however the employee can freely contribute up to $3,100 for an individual plan as well.
The high-income population would be better served by a CDHP compared to the low-income population because on average, those with higher incomes are able to take better charge of their health care. This is why numerous studies have found a relationship between low-income populations and treatable diseases like obesity and high blood pressure. One of the main reasons cited is that people in lower income groups are less able to provide themselves with things that improve their health status, like joining gyms or shopping at farmer's markets for fresh foods, when compared to the higher income population (Natural Health Dossier, 2011). In addition, the higher income population is ...

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The solution discusses consumer-driven health plans and managed care.

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Credentials from the Heathcare Financial Management Association

1. A broad term commonly used for medical professionals who are not nurses and not physicians is allied health personnel. Dental Hygienist is a very well respected allied health profession. Describe the field, and be sure to include training, professional role, and other aspects to this profession.

2. The general public typically uses the terms licensure, certification, and registration interchangeably when referring to medical professionals. However, each term has a specific and important meaning with regard to regulating medical occupations. Explain the meaning of these terms, and relate the important differences among them.

3. Health insurance is a concept developed in the United States and now appearing in many other nations of the world. Its history and development is an interesting story. Briefly trace the history of health insurance in America, from the beginnings with Blue Cross up to the Managed Care era.

4. It is abundantly clear that Americans spend more per capita on health care than any other nation on earth. What are the key drivers of our large health care expenditures in the U.S.? Cite at least five key drivers, and explain the impact of each on total medical spending.

5. An interesting and innovative approach to care of American seniors is adult day care. What exactly is adult day care, where is it provided, and what role is it filling today in our communities? Would you personally utilize this service for a senior family member? Why, or why not?

6. Hospice provides tremendous support for patients and families at time of true need, near the end of a family member's life. But Hospice continues to be poorly utilized in many parts of America. How would you describe the role of Hospice? What can be done to improve the utilization of Hospice services when the need exists?

7. Case Study
Please visit the following site http://www.hfma.org/

Part 1: What is the process for earning credentials from HFMA in the field of health care finance? What kinds of professional roles would individuals earning these credentials typically be able to achieve? Why would one be interested in pursuing a career in medical finance?

Part 2: What types of resources does this organization provide to its members and others in the health care community? As a health care manager, what HFMA resources would one see his or herself utilizing for their facility and career?

Book: Sultz, H., & Young, K. (2011). Health care USA: Understanding its organization and delivery (7th ed.). Burlington, MA: Jones & Bartlett Learning.

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