Discuss the importance of Medicaid and Medicare in healthcare./Evaluate the different types of health insurance policies.
Discuss the importance of Medicaid and Medicare in healthcare./Evaluate the different types of health insurance policies./Define managed care./Discuss the history of managed care./What are some of the key differences between traditional indemnity insurance and managed care?/What is organizational integration? What is it ultimate aim? Why did health care organizations integrate?
Overview
Financial aspects of the health care industry are introduced in Week Four. As health care spending has continued to increase over the years, it is imperative that health care administrators understand how it is financed. In the United States, several funding sources are available: publicly funded insurance, privately funded insurance, cash, and charity care.
Insurance is the main source of financing in the health care industry today, and it is important to be knowledgeable of the types of health insurance models available. Some examples include marketplace plans, managed care plans, Medicare, Medicaid, Children?s Health Insurance Program (CHIP), Program of All-Inclusive Care for the Elderly (PACE), worker’s compensation, TRICARE, Veterans Health Administration, and Indian Health Services. As one learns about these different models, it is necessary to understand why they were created. Government funded health insurance models and programs were created to address a vulnerable population whose health care needs were not being met. Privately funded insurance models were purchased either by a group or an individual as a financial protection against loss and risk should a catastrophic health incident occur.
Regardless of the type of health care financing, challenges arise. Health care administrators are continually asked to find solutions to control costs and understand and implement legislative changes as they are adopted into law.
