How portability and creditable coverage affect cost control

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Reference no: EM132316326 , Length: word count:550

Purchasing and Contracting Health Plan Options Worksheet -

Complete Parts A and B of this worksheet.

Part A -

Reference: Ch. 8 of Medical Insurance: A Revenue Cycle Process Approach (7th ed.).

Compare cost control strategies of employer-sponsored health plans (when employers buy from insurance companies) to self-funded health plans (when employers cover costs of benefits).

Complete the table below.


Employer-Sponsored Health Plans

Self-Funded Health Plans

General Comparison



Riders



Enrollment Periods



Provider Networks



Third-Party Administrators



Write a 50- to 150-word response that discusses how portability and creditable coverage affect cost control within group health plans.

Part B -

Refer to Ch. 8 of Medical Insurance: A Revenue Cycle Process Approach (7th ed.).

Write a 150- to 350-word response to each of the following questions. Be clear and concise, use complete sentences, and explain your answers using specific examples.

1. How do participation contracts represent financial opportunities for providers?

2. What are positive and negative ramifications of discounted fee-for-service arrangements?

Cite any outside sources. For additional information on how to properly cite your sources, utilize the Reference and Citation Generator resource.

Reference no: EM132316326

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