Economic Issues Simulation Paper
The economic issues simulation refers to the use of managed care firms that wish to supply health insurance to companies and individuals. The managed care firms incur costs in providing health care services to enrollees, but earn profits or revenue from providing health insurance. In this paper we will discuss the economic issues simulation which focuses on the planning and decisions made by a health maintenance organization (HMO). HMOs can choose to provide or deny coverage to companies and individuals in order to maximize revenues and reduce risks to the organization (University of Phoenix, 2004).
About the Company
Castor Collins Health Plans (CCHP) is a regional HMO that was founded in 1999 (University of Phoenix, 2004). Castor Collins Health Plans was originated in the state of Pantome (University of Phoenix, 2004). The HMO of Castor Collins Health Plans provides health insurance and health care services to enrollees (University of Phoenix, 2004). CCHP does so as part of its statewide network of physicians and facilities (University of Phoenix, 2004). CCHP uses a capitation model to pay its network of providers who care for the current 100,000 enrollees throughout the state (University of Phoenix, 2004). While CCHP has 100,000 enrollees they are still seeking more applicants and enrollees. As the Vice President (VP) of Strategy and Financial Planning at Castor Collins, it is my job to interact with new clients and formulate health plans that will suit their needs (University of Phoenix, 2004). VP of Castor Collins is also needed to price plans and set insurance premiums (University of Phoenix, 2004). As VP of CCHP I work alongside a few colleagues including Helen Feuerman, Dr. Jonathan Wilkes, and Adam Hunter (University of Phoenix, 2004). Together we are setting out to make a decision about our newest possible enrollees.
A decision must be made in regard to the newest interested...