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How to analyse and select a suitable health plan for employees

Part I

Consider the four health plans below with an eye to choosing one to offer to the company's employees. Assume that the health plans and their annual per employee premiums are as follows:

Health Plan
Aetna Health:Premium, Individual:$4,555, Premium, Family:$11,428

MetroPlus:Premium, Individual:$4,267,Premium, Family:$10,540

Empire:Premium, Individual:$4,217, Premium, Family:$10,767

Oxford:Premium, Individual:$6,029, Premium, Family:$13,417

The employer will pay 80% of the premium for individual coverage, and the employee will pay the remaining 20% as well as the entire additional premium for family coverage. (The premiums listed above, while realistic in magnitude, are hypothetical and computed solely for the purpose of this project.) All of the plans are managed care plans. Assume that the benefit package is the same across all plans, so there is no difference between them in what services are covered.

In addition to the above data, click here to view and investigate the Online Report on Quality Performance Results in New York State, the latest report card issued by the New York State Department of Health, 2013, and incorporate the information into your evaluation.

You can view the various categories of measures on which health plans are rated (e.g., Access to Care, Adult Living with Illness, etc.). Click each link for a summary chart that presents the performance (usually as a percentage score) of each plan in the group on the relevant measures and how each plan compares to regional and statewide scores.

Submit a 2-page analysis in a Microsoft Word document that outlines the plan you selected and why. Generally, you would select the plan with the highest score, but if you chose a plan with a lower score, explain why. Include the following elements in your analysis:

Explain which factors (e.g., price and/or performance measures) were most important to your choice of plan and how you derived the weights for each factor you used.
Indicate, on a scale of 1 to 10, how comfortable or confident you are that you made the right choice, with 10 being most confident.
Part II

You need to use the multiattribute utility (MAU) technique to respond to the following questions. Although the technique can be performed with pencil and paper, it is recommended you use a Microsoft Excel to do the various calculations involved.

Click the following links to access the information on using the MAU technique:

MAU Model
MAU Example
Compare your level of confidence at the time you completed Part I to your confidence level for Part II, when you used this decision aid.
Was it helpful? What were its advantages and disadvantages?
Did it make the decision harder to make or easier to justify?

Support your responses with examples.

Cite any sources in APA format.

Attachments

Solution Preview

Analysis and selection of a suitable health plan for employees
The following is an analysis of four health plans (alternatives) against a set of performance indicators (Attributes) with a view to recommend a suitable plan for employees in an organization
PART I
1. Alternatives and their attributes

1.1. Price- Given the ever escalating cost of healthcare, this is one factor to consider. The guide would be to compare the premiums to be paid by the individual across different plans vs. the employer's contribution. On this basis my preliminary choice is Aetna. Can you figure out how I arrived at that using this reasoning?
2. Important Factors in choosing a plan
2.1. Women's Health-Think about the Millennium Development Goals for health. Is this one of them?
2.2. Satisfaction with care for adults-getting needed care-Why is this important in choosing a health plan to join? Is it important to get needed care?
2.3. Child and Adolescent Health-Refer to the question on MDG's above as a guide in selecting this factor. Does child and adolescent preventive health matter?
2.4. Managing Medications-Think of the question "How important are medicines in the treatment of disease? What are the ...

Solution Summary

Selected attributes and performance scores can be used to select the most appropriate health care plan for employees in an organization.
This assignment presents a solution with a guideline for use to analyze and objectively select a suitable health plan
This easy step by step solution can be used by any student to prepare a multiattribute utility (MAU) model for selection of a suitable choice among alternatives

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