Posted: March 3rd, 2022

CASE STUDY 1: THE PROBLEM OF HIGH DEDUCTIBLES AND CONSUMER DIRECTED HEALTH CARE IN U.S. HEALTH INSURANCE essay

HSA 312 – MANAGED HEALTH CARE

SPRING 2021: CONTEXT, QUESTIONS AND INSTRUCTIONS

CASE STUDY 1: THE PROBLEM OF HIGH DEDUCTIBLES AND CONSUMER DIRECTED HEALTH CARE IN U.S. HEALTH INSURANCE

DUE DATE – 11:59 PM, SUNDAY, MARCH 28, 2021

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CONTEXT :UNDERSTANDING THE PROBLEM OF CONSUMER DIRECTED HEALTH PLANS AND HIGH DEDUCTIBLES:

According to research by the Commonwealth Fund, a foundation focused on health care, 21.3 percent of Americans have insurance so skimpy that they count as underinsured:

Their out-of-pocket health-care expenses, excluding premiums, amount to at least 5 to 10 percent of household income. The limits in coverage mean their plans might provide little financial protection in a health-care crisis.

High-deductible plans offered by employers are one part of the problem. Among people covered by the companies they work for, enrollment in high-deductible health plans rose from 4 percent in 2006 to 30 percent in 2019, according to a report from the Kaiser Family Foundation. The average annual deductibles in such plans are $2,583 for an individual and $5,335 for families.

• In theory, high-deductible plans, which make people spend lots of their own money before insurance kicks in, turn people into careful consumers. But research finds that people covered by such plans skip care, both unnecessary (elective cosmetic surgery, for instance) and necessary (cancer screenings and treatment, and prescriptions). Black Americans in these plans disproportionately avoid treatment, widening racial health inequities.

• Health savings accounts are designed to blunt the harmful effects of high-deductible plans: Contributions by employers, and pretax contributions by individuals, help to cover costs until the deductible is reached. But not all high-deductible health plans offer such accounts, and many people in lower-wage jobs don’t have them.

INSTRUCTIONS AND QUESTIONS

1. READ THE INDICATED READINGS, WHICH ARE ATTACHED.

2. PROVIDE WRITTEN RESPONSES TO THE QUESTIONS POSED BELOW.

• Your response via BlackBoard Assignments should have the following format and follow the rules indicated below:

 Single spaced.
 In Arial 12 font.
 Your response should be in a separate Microsoft Document attached to and submitted through Blackboard Assignment: CASE STUDY 1.
 Each section of the response should correspond to one of the Questions below – 1.A., 1.B., 2.A., 2.B., 3.A., AND 3.B. WRITE 1 SHORT PARAGRAPH FOR EACH RESPONSE.
 In your responses, without using too many sentences, use the attached documents to give your specific answer to each question.
 If you have made and posted more than one response on Blackboard, I will read, grade, and respond to your most recent response by day and date.

QUESTIONS – PROVIDE A WRITTEN RESPONSE:

RESPOND TO QUESTIONS 1, 2, AND 3, EACH OF WHICH HAS A PART A. AND PART B.

QUESTION 1: How is Consumer Directed Health Insurance Supposed to Address the Problems of Moral Hazard? – READINGS 1, 1.A. and 2.

(Using Federally Qualified Consumer Directed Health Insurance Plans as an example):

PART A.: What are the BASIC FEATURES of these high deductible health insurance plans that are supposed to encourage health plan members to make better treatment choices, and to reduce the likelihood of moral hazard?

PART B.: How are these BASIC FEATURES supposed to affect a health plan member’s choice of health care goods and services – how are they supposed to encourage and support better choices and interactions with doctors, resulting in less expensive treatments, use of lower intensity treatments, and wiser use of specialty consultations and medical imaging?

QUESTION 2: Consumer Directed Health Plans: How are they expected to work VERSUS how they actually work? READING 3.

HINT: YOUR ANSWER TO PART A. BELOW SHOULD BUILD ON YOUR ANSWER TO QUESTION 1 – THEY ARE RELATED TO EACH OTHER.

PART A.: How are enrollees in Consumer Directed Health Plans expected to act by using different kinds of provider price and quality of care information, and being aware of their cost sharing responsibilities, when they purchase health care goods and services?

PART. B.: Using one (1) example from Reading 3 – what is the evidence that people in Consumer Directed Health Plans do NOT act as the literature predicts they will when they purchase health care goods and services? Briefly describe TWO (2) KEY FINDINGS.

QUESTION 3: What are the potential problems of High Deductible Consumer Directed Health Insurance in terms of patient access to necessary Personal Health Care Services? READING 4 and READING 5.

PART A.: How might High Deductible Health Plans discourage plan members from receiving Personal Health Care Services that they need, especially during the current pandemic GIVE TWO (2) EXAMPLES.

PART. B.: Indicate ONE (1) WAY in which Consumer Directed Health Plans might be changed to solve this problem.

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