Question

DISCUSSION QUESTION 1-2

MH684 Managed Health Care

Lesson 1: Managed Care: Its Origins and Development

Upon completion of the Required Readings, write a thorough, well-planned narrative answer to the following discussion question. Rely on your Required Readings and the Lecture and Research Update for specific information to answer the discussion question, but turn to your original thoughts when asked to apply, evaluate, analyze, or synthesize the information.  Your Discussion Question response should be both grammatically and mechanically correct, and formatted in the same fashion as the question itself. If there is a Part A, your response should identify a Part A, etc.  In addition, you must appropriately cite all resources used in your responses and document in a bibliography using APA style.

Discussion Question 2 (20 points)

What is meant by a consumer-driven approach to the health care system? Does it relate to the problems with the current system? Does it offer any benefits? Why or why not? (20 points) (A 1-page response is required.)

Answer 1

Answer :

Consumer driven health care : it is defined narrowly ,refers to third tier health insurance plans that allows members to Use health savings account ,health reimbursement account or similar medical payment products to pay routine health care expenses directly ,but high deductible healhealth plan protects them from catastrophic medical expenses .

High deductible policies cost less ,but the user pays medical claims using a prefunded spending account ,often witg special debit card provided by bank or insurance plan.

Goal of CDHP : drive smart health care consumerization by making consumers more responsible for the economic consequences of their health care decisions.

Key priorities for health care consumerisation :

• Empower primary care providers to play larger role in managing patients health
• Create culture of transparency.
• Improve access to care .
• Improve cross provider collaboration
• Compensate providers based on outcome vs .volume of services delivered .

Health care avoidance and dis satisfaction : CDHP participants utilise less health care services including acute and preventive care in order to save out of pocket costs .

Impact of CDHP :

Health outcome : low utilization with unknown impact

Cost savings : short term savings ,but unsustainable if long term health declines.

Patient satisfaction : low satisfaction : less than 30 % CDHP enrollees would recommend to others.

Benefits : benefits that consumer driven service accounts provide to customers include ability to stabilise and possibly reduce insurance premium over time .

Increases employee satisfaction with their plan benefits .