Determine the key characteristics of the users of the products and/or services of the health care provider you selected.
Some of the main characteristics of Blue Cross and Blue Shield are long-term, short-term commitment; providing support, learning and development in health care organization. The key services that the majority of Blue Cross and Blue Shield customers use are the following: prescription assistance, hospital admission, emergency medical evacuation, medical repatriation, and medical monitoring. These are all key services that show how Blue Cross and Blue Shield provide support for their customers. Blue Cross and Blue Shield health insurance coverage characteristics will vary depending on the type of health care coverage you have. Coverage for the HMO plans is different from the PPO plans. Therefore, some things that are covered in one may not be covered in the next. “Some of the personal characteristics of users are age, gender/sex, race, income and socioeconomic status, education, availability of care, culture and patients beliefs”.(Kotler, Shalowitz, Stevens)
HMO plans usually have lower up-front costs on most premiums, than any other type of premiums. The HMO plans usually have lower deductibles or no deductible at all. A deductible is the amount of money you pay out-of-pocket before your plan will pay on your doctor visits or other medical services. People also have deductibles to pay on their medicines and other services that are provide by health care providers. People that have the HMOs plans also pay low copayments on medical services. Most people have copayments that are due at the time of service. These are set amounts that you pay for the service that the insurance did not pay for. An example of a copayme...
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...orking, and word of mouth are important to insurance companies. With Blue Cross and Blue Shield they send their agents to training where they can learn how to target their customers and they learn where their profitable niche markets are. Not only do Blue Cross and Blue Shield train in what interest their customer; but they train to learn what each policy is all about. This helps the customer trust the insurance company more.
Blue Cross and Blue Shield give its customers good prices on policies and good quality. This is why they are among the top insurance companies that offers their services in different states; but offers the same good quality and great prices.
REFERENCE
https://bcbsal.org/web/
Health Benefits Plan; BlueCross BlueShield of Alabama; revised 2012.
Strategic Marketing for Health Care Organizations: 2008, Kotler, Shalowitz,Stevens
According to the State Farm website, the company handles nearly 35,000 claims per day. They still use Mercherle’s original vision which is to operate fairly and do the right thing for their customers. By continuing with this vision, State Farm now offers nearly 100 products and services. It is currently ranked number 41 on the Fortune 500 list of largest companies. This company not only focuses on being there for their customers but they are also involved and support communities through “sponsorships, safety programs, education leadership, and service-learning”. Their mission is to be a good neighbor for customers and communities by building a foundation of shared values.
2. In recent years, there has been a growing attempt to measure the performance of health care providers. The federal government and the states have published data on how hospitals are compared to acceptable clinical standards with regard to pneumonia. Explain how these data could affect the consumer decision-making process.
This group is more focused on satisfaction, access and quality of care. Providers, or practitioners, are also key stakeholders within an organization. The term provider can encompasses not only physicians and surgeons, but also nurses, physical and occupational therapists, technicians, and other members of a clinical staff. Providers fall into two categories, primary, which includes hospitals and health departments and secondary, which includes educational institutions and pharmaceutical companies. Providers are focused on the best treatments for patients and are involved in delivering health services and products. The final element of the MCQ model is the employer who by far is the largest paying and purchasing stakeholder of an organization. The employers focus is primarily on their return on investment within an organization. Cost and quality is a focus for employers when choosing health benefits but are mindful that access is just as important. Within the Patient Healthcare model, MCQ explains the interactions between the four elements of employer, patient, provider and payer while the Iron Triangle focuses on the factors of cost, quality, and access. The Patient Healthcare model charges healthcare leaders with the task of balancing satisfaction with the stakeholder (employer, patient, provider, and payer) in relation to cost, quality and access. This may be very difficult since stakeholders may have competing priorities. Changes and variations made in how healthcare organizations operate may have profound effects on how stakeholders perceive the quality, access and cost. For instance, a patient may consider cost to be a top priority when seeking healthcare and at the same time the healthcare organization may consider raising costs and therefore devaluing access and quality. Patients who begin to incur high out-of-pocket costs may begin to perceive a financial
They will want to know both employment rates as well as types of employment. They should look at marital status, median age, and household size. Customer lifestyles and preferences are another important aspect of gathering demographic information. Hobbies and activities popular among customers in this area should be examined. Do they enjoy active, outdoor activities, or do they typically prefer indoor activities such as going to the movies and shopping at malls?
Blue Cross Blue Shield of Florida (BCBSFL) Operating Services is Florida’s largest insurer, serving more than 6 million residents in total. Three trends that redefine how Blue Cross Blue Shield of Florida brings value to its members are through consumer empowerment, E-business, and financial services modernization. BCBSFL holds approximately 30% of the HMO market share in Florida, which is twice the share of its nearest competitor. BCBSFL offers a BlueComplements program filled with discounts and services that allow members to stay healthy. Theses advantages include Healthy Alternatives, Vision One, TruVision, Hearx, GlobalFit, SafeTech, and Walgreens Mail Order Pharmacy.
Health Maintenance Organizations, or HMO’s, are a very important part of the American health care system. Also referred to as managed care programs, HMO's are combinations of doctors and insurance companies that are formed into one organization. This organization provides treatment to its members at fixed costs and decides on what treatment, if any, will be given based on the patient's or doctor's current health plan. Sometimes, no treatment is given at all. HMO's main concerns are to control costs and supposedly provide the best possible treatment to their patients. But it seems to the naked eye that instead their main goal is to get more people enrolled so that they can maintain or raise current premiums paid by consumers using their service. For HMO's, profit comes first- not patients' lives.
One of the five key principles of care practice is to ‘Support people in having a voice and being heard,’ (K101, Unit 4, p.183). The key principles are linked to the National Occupational Standards for ‘Health and Social Care’. They are a means of establishing and maintaining good care practice. Relationships based on trust and respect should be developed between care receivers and care givers, thus promoting confidence whilst discussing personal matters without fear of reprisal and discrimination.
Managed care dominates health care in the United States. It is any health care delivery system that combines the functions of health insurance and the actual delivery of care, where costs and utilization of services are controlled by methods such as gatekeeping, case management, and utilization review. Different types of managed care plans came into development by three major factors. These factors include choice of providers, different ways of arranging the delivery of services, and payment and risk sharing. Types of managed care organizations include Health Maintenance Organizations (HMOs) which consist of five common models that differ according to how the HMO is related to the participating physicians, Preferred Provider Organizations (PPOs), Exclusive Provider Organizations (EPO), and Point of Service Plans (POS). `The information management system in a managed care organization is determined by the structure of the organization' (Peden,1998, p.90). The goal of a managed care system is to provide subscribers and dependants with needed health care services at the lowest possible cost. Certain managed care plans also focus on prevention by trying to keep members healthy.
However, the reason a lot of these insurance companies are not popular among the general public is because they are new to the insurance game and are often unable to handle processing claims that have become second nature to the giants of the insurance industry. Opponents could also claim the ACA’s out of pocket maximum helps people not get drowned in debt. Sure, maybe the individuals themselves aren’t directly in debt and being spammed with outrageous hospital bills. However, the part of their bills that count toward their out of pocket maximum are sometimes unclear. “Even though things are a lot simpler now, depending on your plan not all services are going to be covered 100% and not all services are always going to count toward your out-of-pocket maximum. Double check that your health plan isn’t cutting any of the corners” (Out-of-Pocket) Opponents may also say that the ACA lowers premiums, but that 2008 statement has become increasingly known as a lie. Obama spent 2008 telling the American people throughout his campaign insurance would be reduced “up to”, “on average”, and “typically” $2,500 “per family, per year”. That turned out to be false and “by some estimates, the average rates in the individual market have increased nearly 25 percent compared to what they would have been without Obamacare, and have increased measurably in 45
The three main types of health insurance in the United States are voluntary, social and welfare. These types on insurance a person possess sometimes determine the ability to seek care and how that care is given. Insurance types such as voluntary and social insurance can be very expensive and will make participants consider how important it is for them to see the doctor, while welfare medicine participants have trouble finding a doctor due to the limit number of physicians who are provider or are refusing to take on new patients. Some of the types of voluntary insurance are Blue Cross and Blue Shield (BCBS), private and commercial insurance, and health maintenance organizations. Voluntary insurance is not only limited to health care from physicians, but can also include dental, long-term, and life insurance. One of the most popular voluntary insurance companies is BCBS. Sometime people have trouble paying for insurance especially if is as it related to an on the job injury or because they have reached retirement age and can no longer work.
The purpose of this paper is to discuss how Electronic Medical Records (EMR), affects healthcare delivery. I will discuss the positives and negatives this issue has on healthcare and how it effects the cost and quality for healthcare services. In addition, I will identify any potential trade-offs to cost or quality. Lastly, I will discuss how the EMR affects my job as well as any challenges or opportunities this issue presents.
Human services professionals are those who facilitate and empower those in society who require assistance in meeting their basic human needs both emotionally, mentally, and physically. Human services professionals work with diverse cultures in many different settings to provide prevention, education, and resources for individuals, families, groups and communities. Some of the populations served are, children and families, adolescents, and the homeless. To support groups in crisis human services professionals must be committed, patient, possess listening skills, and have an ability to be empathetic without reducing one’s ability to be empowered (Martin, 2011).
As a future nurse practitioner, I have given immense thought in the selection of a clinical practice based on the primary care setting that utilizes the collaboration model. I have selected this type of clinical practice because it best suits my professional and personal goals. I value autonomy while having the ability to work within a healthcare team and enjoying teach my patients. Nurse practitioners (NP) are a valuable part of the healthcare team. In 1960s, from a vision to improve primary healthcare to under-serviced communities the development of the first NP program developed out of need as a public service and focused on the care of pediatrics and since then the care of other specific populations such as families, adults, geriatrics, and women health has emerged (Anderson & O’Grady, 2009, p. 380).
In this unit, we will be discussing real-life healthcare organizations, the 5 P’s of healthcare marketing, and evaluation strategies that may be used to determine marketing potential. Select and provide a general overview of three (3) healthcare organizations that interest you. Discuss the 5 P’s of healthcare marketing to each healthcare organization. Elaborate how the 5 P’s of healthcare marketing may impact the marketing potential of a healthcare organization. Discuss an assessment or evaluation strategy which may be used to help determine the marketing potential of an organization.
Health insurance provides benefits for sickness, injury, surgery, and prescription medication. There are a variety of plans with different