Mini-Case Study: Health Plan Implementation
As an employer, I would educate the employees of Riley about the plan alongside the financial opportunities as well as risks. The education can focus on helping the employees make the right decisions through explanations that would enable them to perceive possible risks, understand financial responsibilities, and help them compare various health plans. Multiple methods can be used to communicate with the employees during the education, including; emails, power points, webcasts, infographics, group meetings, and brochures.
Where employees want to keep previous insurance, I would initiate side-by-side comparisons can be used to highlight differences between high deductable plans and other plans that the employer offer and are available for the employees. The information could include the various cost definitions, including premiums, deductibles, maximums that come out of the pocket. Education should entail the advantages and disadvantages of the different plans for various demographic. Importantly, during training, real-life examples, and fictional possibilities using real-life scenarios would be considered for the employees to imagine themselves in different situations. Lastly, the employees would be provided with resources, which help in determining scenarios for care costs, especially price estimators. The tools can help employees see the differences in charges between various healthcare providers.
High deductible health plans encourage increased health insurance coverage because of tax incentives, which enable employees to offset some part of the cost of coverage due to a reduction of taxes on savings (Davis, Doty & Ho, n.d). Secondly, premiums for high deductibles can be lower than premiums in comprehensive health plans. Some individuals might opt for a higher deductible despite high out-of-pocket expenses compared to detailed drawings, due to primary interest in protecting assets and seeking assurance that they would not become bankrupt in cases of outrageous medical expenditures (Davis et al., n.d). Indeed, Lave et al. (2011) affirm that a high deductible helps in health savings as well as less out-of-pocket payments.
The disadvantage of a high deductible plan is that it disproportionately affects individuals as well as families with low incomes because of insufficient assets that cannot meet the requirements stipulated for out-of-pocket pays (Dolan, 2016). Therefore, enrolled individuals from areas with high poverty rates as well as low education have reduced visits to emergency departments by between 25 and 30% in a period of two years (Dolan, 2016).
My opinion is that a high deductible plan would mostly be beneficial for employees who earn higher. For employees with lower incomes, the high premiums would be prohibitive and limit many from accessing critical care services.
References
Davis, K., Doty, M.M., & Ho, A. (n.d). How high is too high? Implications of high-deductible health plans. Retrieved from https://www.issuelab.org/resources/9739/9739.pdf
Dolan, R. (2016). High-Deductible Health Plans. As high-deductible health plans become increasingly prevalent in both group and individual markets, it remains to be seen how they will affect health care access and outcomes. Health Policy Brief, 1-5. Retrieved from https://www.healthaffairs.org/do/10.1377/hpb20160204.950878/full/healthpolicybrief_152.pdf
Lave, J.R., Men, A., Day, B.T., Wang, W., & Zhang, Y. (2011). High-deductible health plans. Health Research and Educational Trust. DOI: 10.1111/j.1475-6773.2010.01