[Solved] Week 3 Discussion- Healthcare Finance

Assignment Prompt & Instructions

**files (2)**

– ## Week3Discussion-HealthcraeFinance.docx

– ## Week3LearningResources-HealthcareFinance.docx

**## Week3Discussion-HealthcraeFinance.docx**

**Healthcare Finance**

**Week 3 Discussion**

**Design of Health Insurance Policies**

Health insurance is designed to protect patients from the risk of expensive medical services. The cost of insurance, however, is steadily rising. When costs are too high, healthier individuals tend to not purchase insurance coverage, resulting in a lower percentage of healthy individuals to pool with those who have health issues. This poses a challenge for employers and the government, as they are tasked with designing viable policies that balance cost and generosity of benefits. For this Discussion, examine the following scenario and consider the type of insurance policy the employer should design and provide for employees.

**To prepare for this Discussion:**

· Review the provided scenario. What is the obligation of the employer and the government in insuring these two populations of individuals? How do moral hazard and adverse selection impact these insurance provisions? How do the social determinants of health reflect in your insurance decision?

· Consider the type of insurance policy the employer should design and provide for its employees. Be sure to consider type and generosity of coverage, premiums, deductibles, and cost-sharing.

**Post** a cohesive response to the following:

· Analyze obligations of the employer and the government in insuring the two populations of individuals described in the scenario.

· Evaluate the impact of moral hazard and adverse selection on these insurance provisions.

· Recommend the type of health insurance policy the employer should design and provide for its employees. Defend your recommendation, including an explanation of how the social determinants of health are addressed in your recommendation.

**Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.**

**## Week3LearningResources-HealthcareFinance.docx**

**Week 3 Learning Resources**

**Healthcare Finance**

**Required Reading**

· Getzen, T. E., & Kobernick, M. S. (2022).
_Health economics & financing_ (6th ed.). Wiley.

· Chapter 4, “Financing Medical Care: Health Insurance Contracts: Managed Care” (pp. 63–95)

· Pink, G. H., & Song, P. H. (2020).
_Gapinski’s understanding healthcare financial management_ (8th ed.). Health Administration Press.

· Chapter 12, “Project Risk Analysis” (pp. 459–503)

· Ackley, C. A. (2022).
[Tiered cost sharing and health care demandLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://www.sciencedirect.com/science/article/pii/S0167629622000807).
_Journal of Health Economics_,
_85_. https://doi.org/10.1016/j.jhealeco.2022.102663

· Frederick, J. D., Fung, D. W. H., Yang, C. C., & Yeh, J. J. H. (2022).
[Individual health insurance reforms in the U.S.: Expanding interstate markets, Medicare for all, or Medicaid for all?Links to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://www.sciencedirect.com/science/article/pii/S0377221721005373) _European Journal of Operational Research_,
_297_(2), 753–765. https://doi.org/10.1016/j.ejor.2021.06.022

· Narita, R. E. (2023).
[Consumption of healthcare services in the United States: The impact of health insuranceLinks to an external site.](https://www.mdpi.com/1911-8074/16/5/277).
_Journal of Risk and Financial Management_,
_16_(5), 277. https://doi.org/10.3390/jrfm16050277

· Pardo, C. (2019).
[Health care reform, adverse selection and health insurance choiceLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://www.sciencedirect.com/science/article/pii/S0167629617310640).
_Journal of Health Economics_,
_67_. https://doi.org/10.1016/j.jhealeco.2019.07.001

**Required Media**

Walden University, LLC. (2024). Healthcare insurance [Video]. Walden University Canvas. https://waldenu.instructure.com

**## Week3LearningResources-HealthcareFinance.docx**

**Week 3 Learning Resources**

**Healthcare Finance**

**Required Reading**

· Getzen, T. E., & Kobernick, M. S. (2022).
_Health economics & financing_ (6th ed.). Wiley.

· Chapter 4, “Financing Medical Care: Health Insurance Contracts: Managed Care” (pp. 63–95)

· Pink, G. H., & Song, P. H. (2020).
_Gapinski’s understanding healthcare financial management_ (8th ed.). Health Administration Press.

· Chapter 12, “Project Risk Analysis” (pp. 459–503)

· Ackley, C. A. (2022).
[Tiered cost sharing and health care demandLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://www.sciencedirect.com/science/article/pii/S0167629622000807).
_Journal of Health Economics_,
_85_. https://doi.org/10.1016/j.jhealeco.2022.102663

· Frederick, J. D., Fung, D. W. H., Yang, C. C., & Yeh, J. J. H. (2022).
[Individual health insurance reforms in the U.S.: Expanding interstate markets, Medicare for all, or Medicaid for all?Links to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://www.sciencedirect.com/science/article/pii/S0377221721005373) _European Journal of Operational Research_,
_297_(2), 753–765. https://doi.org/10.1016/j.ejor.2021.06.022

· Narita, R. E. (2023).
[Consumption of healthcare services in the United States: The impact of health insuranceLinks to an external site.](https://www.mdpi.com/1911-8074/16/5/277).
_Journal of Risk and Financial Management_,
_16_(5), 277. https://doi.org/10.3390/jrfm16050277

· Pardo, C. (2019).
[Health care reform, adverse selection and health insurance choiceLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://www.sciencedirect.com/science/article/pii/S0167629617310640).
_Journal of Health Economics_,
_67_. https://doi.org/10.1016/j.jhealeco.2019.07.001

**Required Media**

Walden University, LLC. (2024). Healthcare insurance [Video]. Walden University Canvas. https://waldenu.instructure.com

**## Week3Discussion-HealthcraeFinance.docx**

**Healthcare Finance**

**Week 3 Discussion**

**Design of Health Insurance Policies**

Health insurance is designed to protect patients from the risk of expensive medical services. The cost of insurance, however, is steadily rising. When costs are too high, healthier individuals tend to not purchase insurance coverage, resulting in a lower percentage of healthy individuals to pool with those who have health issues. This poses a challenge for employers and the government, as they are tasked with designing viable policies that balance cost and generosity of benefits. For this Discussion, examine the following scenario and consider the type of insurance policy the employer should design and provide for employees.

**To prepare for this Discussion:**

· Review the provided scenario. What is the obligation of the employer and the government in insuring these two populations of individuals? How do moral hazard and adverse selection impact these insurance provisions? How do the social determinants of health reflect in your insurance decision?

· Consider the type of insurance policy the employer should design and provide for its employees. Be sure to consider type and generosity of coverage, premiums, deductibles, and cost-sharing.

**Post** a cohesive response to the following:

· Analyze obligations of the employer and the government in insuring the two populations of individuals described in the scenario.

· Evaluate the impact of moral hazard and adverse selection on these insurance provisions.

· Recommend the type of health insurance policy the employer should design and provide for its employees. Defend your recommendation, including an explanation of how the social determinants of health are addressed in your recommendation.

**Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.**

**## Week3LearningResources-HealthcareFinance.docx**

**Week 3 Learning Resources**

**Healthcare Finance**

**Required Reading**

· Getzen, T. E., & Kobernick, M. S. (2022).
_Health economics & financing_ (6th ed.). Wiley.

· Chapter 4, “Financing Medical Care: Health Insurance Contracts: Managed Care” (pp. 63–95)

· Pink, G. H., & Song, P. H. (2020).
_Gapinski’s understanding healthcare financial management_ (8th ed.). Health Administration Press.

· Chapter 12, “Project Risk Analysis” (pp. 459–503)

· Ackley, C. A. (2022).
[Tiered cost sharing and health care demandLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://www.sciencedirect.com/science/article/pii/S0167629622000807).
_Journal of Health Economics_,
_85_. https://doi.org/10.1016/j.jhealeco.2022.102663

· Frederick, J. D., Fung, D. W. H., Yang, C. C., & Yeh, J. J. H. (2022).
[Individual health insurance reforms in the U.S.: Expanding interstate markets, Medicare for all, or Medicaid for all?Links to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://www.sciencedirect.com/science/article/pii/S0377221721005373) _European Journal of Operational Research_,
_297_(2), 753–765. https://doi.org/10.1016/j.ejor.2021.06.022

· Narita, R. E. (2023).
[Consumption of healthcare services in the United States: The impact of health insuranceLinks to an external site.](https://www.mdpi.com/1911-8074/16/5/277).
_Journal of Risk and Financial Management_,
_16_(5), 277. https://doi.org/10.3390/jrfm16050277

· Pardo, C. (2019).
[Health care reform, adverse selection and health insurance choiceLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://www.sciencedirect.com/science/article/pii/S0167629617310640).
_Journal of Health Economics_,
_67_. https://doi.org/10.1016/j.jhealeco.2019.07.001

**Required Media**

Walden University, LLC. (2024). Healthcare insurance [Video]. Walden University Canvas. https://waldenu.instructure.com

**## Week3Discussion-HealthcraeFinance.docx**

**Healthcare Finance**

**Week 3 Discussion**

**Design of Health Insurance Policies**

Health insurance is designed to protect patients from the risk of expensive medical services. The cost of insurance, however, is steadily rising. When costs are too high, healthier individuals tend to not purchase insurance coverage, resulting in a lower percentage of healthy individuals to pool with those who have health issues. This poses a challenge for employers and the government, as they are tasked with designing viable policies that balance cost and generosity of benefits. For this Discussion, examine the following scenario and consider the type of insurance policy the employer should design and provide for employees.

**To prepare for this Discussion:**

· Review the provided scenario. What is the obligation of the employer and the government in insuring these two populations of individuals? How do moral hazard and adverse selection impact these insurance provisions? How do the social determinants of health reflect in your insurance decision?

· Consider the type of insurance policy the employer should design and provide for its employees. Be sure to consider type and generosity of coverage, premiums, deductibles, and cost-sharing.

**Post** a cohesive response to the following:

· Analyze obligations of the employer and the government in insuring the two populations of individuals described in the scenario.

· Evaluate the impact of moral hazard and adverse selection on these insurance provisions.

· Recommend the type of health insurance policy the employer should design and provide for its employees. Defend your recommendation, including an explanation of how the social determinants of health are addressed in your recommendation.

**Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.**

**## Week3LearningResources-HealthcareFinance.docx**

**Week 3 Learning Resources**

**Healthcare Finance**

**Required Reading**

· Getzen, T. E., & Kobernick, M. S. (2022).
_Health economics & financing_ (6th ed.). Wiley.

· Chapter 4, “Financing Medical Care: Health Insurance Contracts: Managed Care” (pp. 63–95)

· Pink, G. H., & Song, P. H. (2020).
_Gapinski’s understanding healthcare financial management_ (8th ed.). Health Administration Press.

· Chapter 12, “Project Risk Analysis” (pp. 459–503)

· Ackley, C. A. (2022).
[Tiered cost sharing and health care demandLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://www.sciencedirect.com/science/article/pii/S0167629622000807).
_Journal of Health Economics_,
_85_. https://doi.org/10.1016/j.jhealeco.2022.102663

· Frederick, J. D., Fung, D. W. H., Yang, C. C., & Yeh, J. J. H. (2022).
[Individual health insurance reforms in the U.S.: Expanding interstate markets, Medicare for all, or Medicaid for all?Links to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://www.sciencedirect.com/science/article/pii/S0377221721005373) _European Journal of Operational Research_,
_297_(2), 753–765. https://doi.org/10.1016/j.ejor.2021.06.022

· Narita, R. E. (2023).
[Consumption of healthcare services in the United States: The impact of health insuranceLinks to an external site.](https://www.mdpi.com/1911-8074/16/5/277).
_Journal of Risk and Financial Management_,
_16_(5), 277. https://doi.org/10.3390/jrfm16050277

· Pardo, C. (2019).
[Health care reform, adverse selection and health insurance choiceLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://www.sciencedirect.com/science/article/pii/S0167629617310640).
_Journal of Health Economics_,
_67_. https://doi.org/10.1016/j.jhealeco.2019.07.001

**Required Media**

Walden University, LLC. (2024). Healthcare insurance [Video]. Walden University Canvas. https://waldenu.instructure.com