Consumer-Driven Healthcare

[D.W.]

Health insurance plans are becoming more challenging to perfectly accommodate policy orders. Because of the consistent rise in healthcare costs, consumers are exploring all of their options. The consumer-based or consumer driven health plans are offered as an alternative to the standard health care policies. This option holds both positive and negative aspects of coverage an payment benefits.

Traditional healthcare coverage usually consists of higher premium payments from month to month and the money that the consumer contributes may not equal the amount used for medical necessities. Consumer directed health care plans are designed to encourage policy holders to save money for their health care needs and receive tax incentives.
High deductible health care plans have a cap on the yearly amount an individual or family can spend out of pocket for expenses. The consumer-based health plans are engaging more younger adults through allowing them flexibility in making decisions from whether to use brand name or generic drugs to rationing their health care needs.

The federal government consists of the regulators and policymakers who set the guidelines for health care in this nation. The healthcare policies today vary which can be viewed as a positive impact on consumer costs. There are more options available for health care coverage. Due to the Affordable Care Act, millions of people are one eligible for coverage through the government. Consumers do not have to solely rely on private industry coverage.
The consistent trend with government regulations and policies is that there is always a chance of an increase in the pricing. The consumer can never control the pricing fluctuation as much as they can try to control their spending. Also, the trend negatively affects the lower income class more than the middle and upper class consumers.

In conclusion, I think consumer-based health care is a positive step in the right direction. Consumers want to now that they have multiple options that can result in receiving quality health care. I think that value based care would enhance the purpose of consumer-based health care coverages by providing quality care to beneficiaries without the excessive cost to either party.
Providing value based health care can reduce the reoccurring hospital or doctors visits and in essence reduce the yearly high cost of health care premiums, co-payments and deductibles to all social classes.


References:

Rodeck, D. (2017). How Do Consumer Driven Health Plans Compare to Traditional Insurance?. Retrieved from https://thebenefitsguide.com/consumer-driven-health-plans-compare-traditional-insurance/

Beaton, T. (2017). What are the Pros and Cons of Consumer Directed Health Plans?. Retrieved from https://healthpayerintelligence.com...os-and-cons-of-consumer-directed-health-plans

Anthem Blue Cross. (2018). How Do Consumer-Driven Health Plans Compare to Traditional Insurance?. Retrieved from https://www.anthem.com/ca/blog/health-insurance-basics/consumer-driven-health-plans/

Rook, D. (2015). The Pros and Cons of Consumer-Driven Healthcare. Retrieved from https://www.griffinbenefits.com/employeebenefitsblog/consumer-driven-healthcare-cdhc-cdhp

Chambers, D.; Collins, C. A. (2016). How Do Federal Regulations Affect Consumer Prices? An Analysis of the Regressive Effects of Regulation. Retrieved from https://www.mercatus.org/publicatio...prices-analysis-regressive-effects-regulation

Rouse, M. (2018). Value-Based Healthcare. Retrieved from https://searchhealthit.techtarget.com/definition/value-based-healthcare

 

[Moore]

Consumer based healthcare allows employees to have low premiums, high deductibles and savings accounts. This type of healthcare plan lowers the cost for the employers, encourages employees make better decisions regarding the care the need, and allow all employees access to healthcare insurance. “When consumer- driven healthcare was introduced in the early 2000’s, it was wildly unsuccessful” (Rook, 2015). Its purpose was to allow employees to get care for what they need, and allow a more tailored approach to choosing care, however it did not overall positively affect the employees, in a financial way. The consumer-based healthcare plans were great for healthy people that rarely went to the doctor but left the sick or elderly with a lot of expenses.


According to Hall, “Health Insurance is one of the most heavily regulated industries in the United States. Some states allow only standardized plans, while others offer both standardized and more personalized options. States also get the option whether to include Healthcare savings accounts with high deductible health plans. Despite what the state decides, all states are in favor of reducing the amount of uninsured people. States have also helped with coverage by providing affordable care through programs such as CHIP, and Medicaid. According to Hess et al “Through Medicaid and SCHIP, 41 states covered children in families with incomes that are 200 percent or more of the federal poverty level, far exceeding federal requirements;” (Hess, Schwartz, Rosenthal, Snyder, &Weil, 2008). The State also can create guaranteed policies, where anyone applying for healthcare cannot be denied an offer based on their current health, and employment type. States are also able to limit premiums that may be charged to groups that pose a higher health risk. Some states require that employed citizens require private health insurance, and unemployed people are required to have health insurance as well.


States also collect data regarding health insurance coverage. They can collect household or employer data from surveys, with this data they are able to plan and create new policies. This information helps the state identify and monitor underinsured areas and medical concerns in any given area. States play a major role in consumer cost in healthcare, by offering programs, collecting data, and creating policies.


Hall, M. A., & Jost, T. S. (2005). The Role of State Regulation in Consumer-Driven Health Care. Retrieved November 19, 2019, from https://scholarlycommons.law.wlu.edu/cgi/viewcontent.cgi?article=1040&context=wlufac.


Hess, C., Schwartz, S., Rosenthal, J., Snyder, A., & Weil, A. (2008, April). STATES’ ROLES IN SHAPING HIGH PERFORMANCE HEALTH SYSTEMS . Retrieved November 1, 2019, from

https://www.commonwealthfund.org/si...statesrolesshapinghighperfhltsys_1115_pdf.pdf.


Rook, D. (2015, November 6). The Pros and Cons of Consumer-Driven Healthcare. Retrieved November 19, 2019, from https://www.griffinbenefits.com/employeebenefitsblog/consumer-driven-healthcare-cdhc-cdhp.