Healthcare Delivery Case Study Essay

Healthcare Delivery Case Study Essay

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Healthcare Delivery Case Study Essay

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HEALTHCARE DELIVERY CASE STUDY ESSAY

A Preferred Provider Organization (PPO) plan is affordable in my region since one pays low monthly premiums. This plan does have deductibles, and it uses a network which is optimized for our region. It is an all-in-one coverage plan which may also include built-in coverage of prescription drugs. One pays less if he/she uses doctors and hospitals which are in the network of the plan.

A low annual deductible is paid when one uses the Preferred Provider Organization (PPO) plan. The deductible amount is $10. The coinsurance of a PPO plan is also very affordable as it requires the patient to pay 10 % of the total amount (Gold et al, 2015). Participants of a PPO plan are allowed to see doctor facilities in their networks without the referral. They can also choose specialists without necessarily having to consult the primary care physicians.

A Part D (Prescription Drug) is most suitable for healthcare coverage of the hypothetical obesity patient. This plan ensures that the patient gets bonus drugs in addition to the total formulary drugs. The patient can order drugs through mail if he/she uses this plan. The initial coverage limit for this plan is designed such that the plan covers for more costs than the patient. Brand-name drugs also have a discount of 75 % (Heiss et al, 2012).

The Part D policy also suits the obesity patient since he/she will be charged a low monthly premium of $100. Blue Cross Blue Shield does not cancel a prescription drug plan. Enrolling in a part D prescription drug plan will ensure that the obesity patient gets additional benefits to his/her initial Medicare coverage (Heiss et al, 2012). The part D plan offered by Blue Cross Blue Shield allows users to switch to low-cost medications.

The obesity patient can use over-the-counter drugs since he/she has already been diagnosed with the condition. These over-the-counter drugs are more affordable and a part D plan will allow for the patient to switch to the medication (Miller et al, 2014). The plan also charges small amounts of money to patients taking drugs for a longer period. An obesity patient is very likely to take drugs for a longer period such as a 30-day supply. This plan will allow him/her to save his/her money.

Prescriptions can be filled at various pharmacies which are to be used by the obesity patient. These ensure that the plan fully covers him/her through the pharmacies at which prescriptions were filled. The part D plan by Blue Cross Blue Shield charges lower costs for those who use the preferred pharmacies for that network (Safran et al, 2015). Identifying the preferred pharmacies for this network also helps to save a lot of money.

Higher discount rates are given when one uses a membership card in the part D plan. These are given on the prescription drugs bought. There are additional programs which collaborate with Blue Cross Blue Shield in order to help customers pay for the expenses of prescription drugs (Safran et al, 2015). Several programs are available in my region, and they help those with a part D plan very often. One can also apply for the extra help program.

A part D plan also offers all the prescription drugs needed by a patient. This guarantees the obesity patient adequate drug supply all the time. A patient can also get prescription drugs and pay at a later date. In addition to this, there is no interest charged for such credit payments.

REFERENCES

Gold et al (2015). A national survey of the arrangements managed-care plans makes with physicians. New England Journal of Medicine, 333(25), 1678-1683.

Heiss et al (2012). Mind the gap! Consumer perceptions and choices of Medicare Part D prescription drug plans. In Research findings in the economics of aging (pp. 413-481). University of Chicago Press.

Miller et al (2014). Managed care plan performance since 1980: a literature analysis. Jama, 271(19), 1512-1519.

Safran et al (2015). Prescription Drug Coverage and seniors: Findings from A 2003 National Survey: Where do things stand on the eve of implementing the new Medicare Part D benefit? Health Affairs, 24(Suppl1), W5-152.

Healthcare Delivery Case Study Essay

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