Part I
High deductible health insurance plans require health care consumers to pay for their care until they reach a deductible amount. These deductibles have a powerful effect because they can discriminate which will make patients skip care. It will make Americans unhealthy and sick. High responsibility of copays and deductibles will see many patients not receiving the required care.
There are several types of insurance and consumers need to choose the insurance that suits them. When selecting employer sponsored or private health insurance, people should focus copayments and the annual deductible that a person will be making (Thorpe & Ogden, 2010). The cheapest insurance is not always the best. A person needs to consider the benefits and the cover the health insurance provides. Common health insurance plans includes point of service, preferred service, health maintenance and high deductible health insurance plans.
Part II
The review of payment models in health care forms important aspects in the strategies. Payment models change the way hospitals, physicians and other health care providers receive their fee. The aim to lower costs but the quality of service should be the best (Shi et al., 2008). Fee for service payment model refers to payment for a specific service offered to the patient. The cost involved in fee for payment happens through negotiations between service providers and insurers (Brown, 2009). It is expensive for the provider because it is limited to face-to-face appointments. Capitation is a payment model on a per-persons basis usually over a specific period. Capitation makes all the risks shift to the provider because they are the ones liable of paying for any extra costs above the capitation rate. The risks involved in this payment vary depending on the organizational and contract arrangements.
References
Thorpe, K. E. & Ogden, L. L. (2010). The Foundation that Health Reform Lays for Improved Payment, Care Coordination, and Prevention. Health Affairs, 29 (6), 1183-1187. Retrieved from ProQuest on 11/21/2012.
Brown, R. (2009). Strategies for Reining in Medicare Spending through Delivery System Reforms: Assessing the Evidence and Opportunities. Kaiser Family Foundation. Available at http://www.kff.org/medicare/upload/7984.pdf (Retrieved 11/21/2012)
Shi, L., Lebrun, L. & Tsai, J. (2008) Reforming U.S. Healthcare Delivery. Harvard Health Policy Review, 9 (1), 68-77. Available at: http://www.jhsph.edu/research/centers-and- institutes/johns-hopkins-primary-care-policy- center/Publications_PDFs/2008%20HHPR%20p68.pdf (Retrieved 11/21/2012)
