Healthcare †HR Class Essays

Healthcare – HR Class Essays Healthcare – HR Class Paper Healthcare – HR Class Paper Healthcare benefits are an important part of the benefits and services provided to employees. Currently, employees have access to several different types of insurance packages. Each healthcare insurance package has certain benefits and limitations. To better understand the essence and implications of healthcare insurance, the three major types of healthcare insurance packages should be reviewed in detail. These include medical care programs, wellness programs, and employee assistance programs. Medical Care Programs Conventional insurance Conventional insurance represents non-managed type healthcare insurance. â€Å"With conventional health insurance, the insurer pays your bill after treatment has been rendered† (Salley, 2005). Some conventional healthcare insurance packages require that insurers provide properly filled forms to guarantee reimbursement. Different types of out-of-pocket expenses are the participant’s responsibility; these include fees that are not covered by a particular insurance package, copayments, and the fees that are considered unreasonable by the insurer. Health Maintenance Organizations (HMOs) The central idea and the essence of HMOs is in offering the so-called centralized primary care: patients have one primary care physician who knows them well enough to provide them with complete care (Folland, 2006). Those enrolled into HMO packages are obliged to pay monthly fees, combined with fees for each visit of prescription. Other specialists cannot be visited without the primary physicians referral. The strongest benefit of HMOs is in low costs and a wide range of deductibles; HMOs are strongly interested in keeping their patients healthy, and provide participants with extremely effective preventive care. Preferred Provider Organizations Under Preferred Provider Organizations, participants are motivated to visit one specific healthcare provider. PPOs require paying deductibles. Participants are offered discounts when visiting specialists and hospitals covered by health insurance plan. Here, patients have more freedom to decide, what facility and what specialists they want to visit from the list of those covered by the plan. However, seeing physicians outside the PPOs networks is mostly unaffordable (Folland, 2006). Point of Service Plans POS or Point of Service Plans is a hybrid managed care option similar in most respects to both PPOs and HMO plans and can be considered as something of a cross between the two (Salley, 2005). POS participants are required to choose one primary care physician, who will later refer them to other specialists. PPO’s provide their participants with the full list of benefits within the covered network of specialists and healthcare units. Although participants are able to choose specialists outside their insurance network, their coinsurance rates will be somewhat higher (Folland, 2006). Consumer Driven Plans Consumer Driven insurance packages allow their participants choosing their own physicians and healthcare providers. CDP provide participants with sufficient freedom to control their healthcare expenses and benefits. CDP usually involve a three-tier structure of healthcare payments; those who did not have healthcare expenses during a year have a chance to save their money. CDP also offer a full set of support systems that help participants choose the best healthcare provider and monitor their expenses (Salley, 2005). Employee Wellness programs The primary purpose of employee wellness programs is to enhance employee wellbeing, and to increase employee awareness about the importance of healthy lifestyle. It is widely admitted that wellness programs substantially decrease employer healthcare expenses and costs (Hodge, 2007). Wellness programs offer a wide range of preventive measures, including seminars, screening procedures, exercise and relaxation classes, etc. These programs do not provide employees with any insurance guarantees, but ensure that employees do their best to prevent all types of possible health complications. Employee assistance programs â€Å"Employee Assistance Program is a confidential, short term, counseling service for employees with personal problems that affect their work performance† (Folland, 2006). EAP’s cover all possible types of personal issues, including stress, harassment, violence, or parenting issues. All employees are provided with an opportunity to contact an EAP representative. EAP is another bright example of a well-developed set of preventive measures that decrease healthcare risks and prevent various health complications. References Folland, S. (2006). Economics of health and health care. Prentice Hall. Hodge, J. (2007). Lowering healthcare premiums by increasing staff wellness: a staff wellness plan increased the return on investment. Nursing Homes, 55 (11): 66-70. Salley, H. (2005). Health-care benefits and insurance trends. American Business Journal, 44 (7): 14-22.