Discussion Thread_ Financing and Managing Costs in Healthcare REPLIES
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Dec 6, 2023
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Discussion Thread: Financing and Managing Costs in Healthcare
REPLIES
Reply #1:
Hey Ashton,
I appreciated your input to the discussion this week since I was able to hear your perspective on
healthcare finance and cost management. Some of the topics you brought up in your discussion
truly jumped out to me. You were able to emphasize the advantages and disadvantages of each
strategy. The first argument you said that I agree with is that argument-of-sale (POS) is likely the
most advantageous health insurance plan that a patient could sign up for since it provides the best
coverage for the money invested. According to Healthcare Coverage, "a point-of-service (POS)
plan is a type of managed care plan that is a hybrid of HMO and PPO plans" (Point-of-service
plan (POS)). Another point on which I agree is the challenge of rising healthcare costs and the
efforts made under the ACA and other initiatives to address these issues by increasing access to
care, introducing care administration and collaboration, strengthening the level of care, shifting
risk from insurers to providers and patients, and emphasizing less expensive outpatient settings.
Healthcare costs have become a major concern, and reform efforts are aimed at addressing this
issue by increasing access to care, introducing care management and coordination, improving
care quality, shifting risk from insurers to providers and patients, and promoting less expensive
outpatient settings. Concerning their high usage of healthcare resources, high-cost, high-need
patients have been a focus of reform attempts. These efforts attempt to enhance patient outcomes
while lowering total healthcare expenditures by addressing the underlying causes that lead to
their high consumption. But, in general, I like hearing what you highlighted in your thread
throughout the discussion.
References:
https://healthcoverageguide.org/reference-guide/coverage-types/point-of-service-plan-pos/
https://libertyonline.vitalsource.com/reader/books/9781284205312/epubcfi/6/164%5B
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Reply #2:
Hey Sennett,
I liked your contribution to the discussion this week since I was able to hear your viewpoint on
healthcare finance and cost control. Some of the points you raised in your discussion stood out to
me. I liked how you emphasized the similarities and contrasts between fee-for-service and
prepaid health insurance. One point you brought up is that the most effective insurance plan for
organizations is Medicare, such as a Health Maintenance Organization (HMO), which gives the
consumer less freedom in choosing their healthcare provider or facility-with this plan, a facility
or physician knows that if they have an HMO plan patient, they will get paid for all services and
fees-due to them having to go to a specific facility. Another point you stated that I agree with is
that the prepaid health plan would be the better of the two models discussed in this conversation.
This approach, in my opinion, provides the least amount of risk on both sides of the equation. I
believe that healthcare programs are difficult for the typical individual to comprehend. There is
often a lot of jargon that is difficult for most people to grasp, and these regulations should be
simplified down into a simpler format for customers. Many consumers select a plan that is not
always the best fit for their healthcare requirements. "Traditional Medicare has consistently
played a critical role in providing health coverage for those 65 and older, helping them pay for a
wide range of services, including hospitalizations, physician visits, preventive services, and
hospice care (Kent, 2019)." I completely agree that Medicare provides several benefits to its
beneficiaries. Proverbs 17:22, "A merry heart does good, like medicine, but a broken spirit dries
the bones" (NKJV), is a verse I feel applies to this issue. However, I appreciate hearing what you
emphasized in your post during the discussion.
References:
https://healthcoverageguide.org/reference-guide/coverage-types/point-of-service-plan-pos/
https://www.biblegateway.com/passage/?search=Proverbs%2017%3A22&version=NKJV
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