Humana Incorporated is a health and well-being for-profit health insurance company based out of Louisville, Kentucky. Humana controls in three segments: retail, employer group and healthcare services. Humana insurance products allow members to have access to health care services through its network of health care providers. Humana provides additional services to its members and third parties that support health and wellness, including pharmacy, provider, home-based, and integrated wellness services. Humana’s retail segment consists of products sold on a retail basis to consumers, including medical and supplemental benefit plans. Humana offers an array of health services, health assessments and health programs for members as well as the elderly.
Humana continues to grow by implementing new ideas to continue to provide the excellent quality, access and cost of healthcare services to the consumers. Humana is a company that has developed reward and incentive programs for primary care physicians to encourage their development of population health. Humana has quality clinical, preventative and membership quality programs. Humana has given access to over 400,000 doctors, hospitals, pharmacies and ancillary care providers for consumers of their services. Humana point of service plans (POS) reduce the out-of-pocket costs for their consumers who stay within the network of providers. Humana does not require consumers to have a primary care physician (PCP) but has also given consumers the privilege to develop a relationship with doctors to inform them of healthcare decisions, and allow the doctor to know the patient’s medical history to guide them to the appropriate specialists. Humana encourages consumers to know their budget before choosing plans and services. Humana states that it is important that the consumers know what medications their families use or themselves and the services that are need to determined what is the best plan to choose and that is cost efficient. Humana makes it easier to the consumers but having different levels of healthcare plans starting from high to low that best fit the consumer needs. Humana has financial assistance available for many individuals and families to help with the cost of health care premiums and out-of-pocket expenses. Humana offer premium tax credits to those who qualify to save on out-of-pocket costs. Humana offers many different unique plans to fit the needs of their consumers which has made Humana remain as one of the highest health care providers in the world because of the services, incentives and cost sharing programs to help
Moda Health — Provider of Group and Individual Dental and Medical Insurance Plans. (2014). Retrieved February 20, 2014, from https://www.modahealth.com/
Kaiser Permanente’s mission is to provide care assistance to those in need. As a health maintenance organization, Kaiser Permanente provides preventive care such as prenatal care, immunizations, diagnostics, hospital medical and pharmacy services. Also, they take responsibility and provide exceptional training for their future health professionals for better clinical performance and treatment for the patients. The organization is to ensure fair and proper treatment towards their employees for a pleasant working environment in hospital and to provide medical services especially in a growing population in suburban communities, such as Tracy and Stockton in California.
It is enthralling to note that in spite of the advances in healthcare systems, such as our hospital’s ability to provide patients with lower cost, managed One being the Health Maintenance Organizations (HMO), which was first proposed in the 1960s by Dr. Paul Elwood in the "Health Maintenance Strategy”. The HMO concept was created to decrease increasing health care costs and was set in law as the Health Maintenance Organization Act of 1973, after promotion from the Nixon Administration. HMO would, in exchange for a fee, allow members access to employed physicians and facilities. In return, the HMO received market access and could earn federal development funds.
Evolving since the 1980’s, case management, an essential part of quality assurance programs, promotes excellence and efficiency in consumer health care, while conserving costs for health care organizations. Effective case managers answer the demands of changing health in promoting and facilitating a patient’s progression of care (Scott 2014).
In 2010, the passage of the Patient Protection and Affordable Care Act (PPACA) initiated reforms between healthcare and healthcare providers. For example, Huntsville Hospital Health System developed as smaller healthcare providers sought refuge under Huntsville Hospital’s larger umbrella. Nine separate campuses, among the North Alabama area, constitute the Huntsville Hospital Health System
Universal health insurance is available to everybody with an option to purchase private insurance coverage (The U.S. Health Care System: An International Perspective, 2014). Approximately 90% of the population uses the national system in which premiums are income based. The system uses 240 private insurers for a non-profit, competitive system. Insurance costs are significantly less than the U.S. due to cost negotiations for medical facilities, appointments, and prescription medications (Sick Around the World, 2008). B. United States Healthcare System Healthcare in the U.S. has recently been affected by implementation of the Affordable Care Act (ACA) of 2010.
Target has problems in the area of Human relations because of their training methods; in not hiring people who have unions. This is an example of discrimination, not by color but by what a person has, which is a union. The question that comes up is; how can this motive people to apply for a job at Target? Also Target has issues with boosting morale in their company especially after letting go about 2,000 employees. MPR news reported in March of this year, that “1,700 employees are out of work. Another 1,400 open positions will go unfilled” (Cox, 2015). A problem such as these layoffs and it being reported affects the way current employees as well as applicants view the corporation. In the MPR news article an employee
When one examines managed health care and the hospitals that provide the care, a degree of variation is found in the treatment and care of their patients. This variation can be between hospitals or even between physicians within a health care network. For managed care companies the variation may be beneficial. This may provide them with opportunities to save money when it comes to paying for their policy holder’s care, however this large variation may also be detrimental to the insurance company. This would fall into the category of management of utilization, if hospitals and managed care organizations can control treatment utilization, they can control premium costs for both themselves and their customers (Rodwin 1996). If health care organizations can implement prevention as a way to warrant good health with their consumers, insurance companies can also illuminate unnecessary health care. These are just a few examples of how the health care industry can help benefit their patients, but that does not mean every issue involving physician over utilization or quality of care is erased because there is a management mechanism set in place.
Out of all the industrialized countries in the world, the United States is the only one that doesn’t have a universal health care plan (Yamin 1157). The current health care system in the United States relies on employer-sponsored insurance programs or purchase of individual insurance plans. Employer-sponsored coverage has dropped from roughly 80 percent in 1982 to a little over 60 percent in 2006 (Kinney 809). The government does provide...
The United States (U.S.) has a health care system that is much different than any other health care system in the world (Nies & McEwen, 2015). It is frequently recognized as one with most recent technological inventions, but at the same time is often criticized for being overly expensive (Nies & McEwen, 2015). In 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA) (U. S. Department of Health & Human Services, n.d.) This plan was implemented in an attempt to make preventative care more affordable and accessible for all uninsured Americans (U.S. Department of Health & Human Services, n.d.). Under the law, the new Patient’s Bill of Rights gives consumers the power to be in charge of their health care choices. (U.S. Department of Health & Human Services, n.d.).
Hospital Corporation of America (HCA). Staff Analysis Statement of Problem HCA, after following a conservative financial policy since its establishment, has entered the new decade preparing to make some changes in order to realign their financial strategy and capital structure. Since its establishment, HCA has often been used as a measure for the entire proprietary hospital industry. Is it now time for the market to realign their expectations for the industry as a whole? HCA has target goals that need to be met in order to accomplish milestones in the future.
“KP is the largest non-profit health care delivery system in the United States, and operates in 8 states and the District of Columbia. KP is made up of 3 entities: the Kaiser Foundation Health Plan (KFHP), Kaiser Foundation Hospitals (KFH), and the regional Permanente Medical Groups,” (Selevan, Kindermann, Pines, and Fields (2015). Selevan al et (2015) state that the members of Kaiser Permanente can be compared to other insurance companies in regards to age, race, and employment status, although the members are known to have lower income levels. Additionally, they found that Kaiser Permanente’s model of care focuses on improving the health of patients, promoting population
According to the Case Management Society of America, case management is "a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and available resources to promote quality, cost effective outcomes" (Case Management Society of America [CMSA], 2010). As a method, case management has moved to the forefront of social work practice. The social work profession, along with other fields of study, recognizes the difficulty of locating and accessing comprehensive services to meet needs. Therefore, case managers work with these
Patel, Kavita. “Helping Consumers Understand and Use Health Insurance in 2014” Institute of Medicine. Institute of Medicine. 29 May. 2013. Web. 31 Jan. 2014. .
Healthcare organizations are designed to meet the healthcare needs of individuals and promote a healthy community. The three healthcare organizations that interest me are: The Heart Hospital Baylor of Plano, Texas Health Center for Diagnostics & Surgery Plan, and Parkland Health and Hospital System. Due to the evolving healthcare industry, focusing on just patients and physicians is no longer a marketing strategy. According to Mycek (2015), “Marketing teams need to expand their consideration set and focus on the new 5 P’s of Healthcare Marketing” (p. 1).