Health insurance and managed care systems

Health Insurance and Managed Care

The purpose of this paper is to develop a game that will make it much easier and fun to not only understand, but also remember the major types of managed care plans together with their characteristics. The game is quite simple and can be played by pretty much every individual as it is applicable in understanding other concepts. The game requires two individuals or more to play, however, if one is alone, it is still applicable.

To begin with, one of the essential requirements of the game includes having paper slots in which the content being discussed is written. In this case, taking into account that there are four types of managed care plans, there will be four main slots. This will include, Health Maintenance Organization (HMO), Point of service (POS), Preferred Provider Organization (PPO), and High Deductible Plans (HDP) (ASD, 1992). The other requirement will be having cards as many as possibly, displaying the characteristics of the four types of managed care plans. This can include all the characteristics or as few as possible.

In this case, For High Deductible Plan (HDP), the slots for playing will include the following characteristics:

1. Employers and health plans shifting more payment responsibility to the plan member

2. The insurance benefits incorporated in this plan only work when the patient has conclusively paid the bill.

3. Purchased plans of this case bought after March 2010 provide free preventive services, even if the deductible has not been met by the client.

For Preferred Provider Organization (PPO), the slots will include:

1. This arrangement allows the patient to pay less within the network as compared to seeking medical attention outside the network

2. This plan allows patients to refer themselves to core providers outside the network at a deductable coinsurance fee based on higher charges

3. This kind of managed care plan is very much comparable to a fee-for-service situation (AAP, 2015).

Therefore, when the game starts, the two players play a thumb war. Basically, this is thumb wrestling and winning implies pinning the thumb of the opponent. The main objective of this inceptive part of the game is to win this competition as much as possible as it gives you all the more chances. Whichever individual that gets to win, gets to select whether he or she wants to draw the four main slots or the several other slots in which one of them displays the characteristics of four types of managed care plans. For instance, if the first player who wins selects types of managed care plan, he or she has to state a characteristic of the plan that is correct. On the other hand, if he or she states characteristics, the opponent has to select one random characteristic slot and read it aloud. In turn, the first opponent has to state the managed care plan in which that characteristic that has been read aloud belongs to. Every time an individual gets it right, then he or she gets a point. The game continues this way until all the characteristic slots have been selected or answered. Whoever racks up the most points is the eventual winner of the game. This game will be quite beneficial in understanding and remembering all four types of managed care plans as well as their characteristics. The game can be played by several individuals and can be fun. If there are more than two players, the reigning winner battles the next opponent on the thumb war to see who gets to select the first slot.