Economic Issues For Hmo Case Study

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Economic Issues for HMOs Dana Carter HCS/440 December 7, 2010 Tom Flora, PhD Economic Issues for HMOs This simulation looks at providing health care insurance coverage from the standpoint of a health maintenance organization (HMO). The obligation of Castor Collins is to provide health care for potential members of two companies, Constructit Construction and E-Editor. Castor Collins had to decide about quality of health care at a price that covers premiums and potential earnings from the plans both companies can purchase. Castor Collins also had to decide if insuring both companies would be optimal in the HMO and would they have to deny coverage based on a risk and utilization assessment. Insurance Plans The simulation…show more content…
|550 men versus 450 women. Men are greater |760 men versus 840 women. Women are | | |within company |greater within company | |2. |32% of workers have a large amount of |95% of the company sits at a desk for long| | |physical activity associated with their job|periods of time throughout the day | |3. |Highest average age is 26-42 |Highest average age is 35-54 | |Major health care risks of the employee | | | |population | | | |1. |Obesity |Obesity…show more content…
The jobs are sedentary, in that an employee sits long hours at a computer. The health profile of E-Editors state that 95% of the employees who work have been sedentary in similar work in other organizations. The risk for vision and stress-related injuries are high in the 95% of employees who have worked on computers for the majority of working life. A sedentary work life causes changes in eating habits, which causes obesity, diabetes, hypertension, high cholesterol and other ailments that could become a risk factor to insuring the company. The risk of insuring this company is pre-existing conditions and
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