Discussion: Cost-Control Measures in Voluntary Health Insurance Plans.
Discussion: Cost-Control Measures in Voluntary Health Insurance Plans.
If you are not a Medicare or Medicaid beneficiary, then you will either get your health insurance through your employer or buy it yourself through the Health Insurance Marketplace. This type of insurance is referred to as voluntary health insurance.
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The way in which health insurance is available for purchase changed drastically with the enactment of the Affordable Care Act (ACA) in 2010. The ACA was “designed to ensure that all Americans have access to quality health care that is affordable and that will ultimately reduce healthcare costs” (Harrington, 2021, p. 73). The ACA transformed healthcare and the health insurance industry in many ways, some of which will be explained in your readings this week.
In this Discussion, you examine different voluntary health insurance plans, including the ACA, and the way in which they use cost-control measures. You will also discuss how participation in these plans impacts healthcare providers. Consider the scenario in this week’s Introduction as you prepare your Discussion.
References:
Harrington, M. K. (2021). Health care finance and the mechanics of insurance and reimbursement (2nd ed.) Jones & Bartlett Learning.
To prepare for this Discussion:
Review this week’s Learning Resources.
Choose one of the following voluntary health insurance plans:
Coverage through the ACA
Health maintenance organization (HMO)
Preferred provider organization (PPO)
Point of service plan (POS)
Exclusive provider organization (EPO)
Review Chapters 5 and 6 in Harrington (2021).
Find at least one current, reputable online source (e.g., .org, .edu, .gov, or .mil) that discusses the cost-control measures used by the plan you selected and the impact it may have on providers.
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ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
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Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
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Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
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The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
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Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
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Discussion: Cost-Control Measures in Voluntary Health Insurance Plans.