3050.1.4 : Financial Status of Healthcare Organizations
Evaluate the financial condition of healthcare organizations.
Millions of consumers are enrolled in a managed care organization (MCO) model, and the numbers are expected to increase over the years. In order to control healthcare cost, employers have moved to managed care health plans as an alternative to fee-for-service plans. In the fee-for-service model, providers charge a fee for each service or procedure delivered to the patient. Managed care, however, provides a range of healthcare products and services to consumers in an effort to keep the lowest possible cost and to help patients avoid serious health problems.
You are the chief financial officer (CFO) of a nonprofit organization, Seamus Company, and have been asked to analyze the company’s health insurance plans for any cost-saving measures. You have also been thinking of innovative ways to help reduce cost, such as leveraging resources through healthcare partnerships. Healthcare coverage is the sole principal employee-related expenditure for most employers (aside from salaries). Employers are shifting the healthcare cost to their employees by encouraging them to think more about health-related expenses and behavior. Employers increasingly offer incentives to remove spouses from employee plans. Employers may charge workers extra if a covered spouse has access to other insurance, or they may pay bonuses when spouses are not on the company policy.
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.