Matrix: Health Insurance

Topics: Health care, Medicine, Health economics Pages: 5 (537 words) Published: May 29, 2013
University of Phoenix Material

Health Insurance Matrix

As you learn about health care delivery in the United States, it is important to understand the various models of health insurance to develop a working knowledge as you progress through the course. The following matrix is designed to help you develop that knowledge and assist you in understanding how health care is financed and how health insurance influences patients and providers as important foundational information for your role as a future health care worker. Fill in the following matrix. Each box must contain responses between 50 and 100 words using complete sentences.

Include APA citations for the content you provide.

| |Origin: When was the |What kind of payment |Who pays for care? |What is the access |How does the model affect patients? |How does the model affect providers? | | |model first used? |system is used, such | |structure, such as |Include pros and cons. |Include pros and cons. | | | |as prospective, | |gatekeeper, open-access, | | | | | |retrospective, or | |and so forth? | | | | | |concurrent? | | | | | |Indemnity | |Indemnity insurance |With traditional | |Indemnity plans give patients control| | | | |often runs on a |Indemnity insurance | |of their healthcare. They are allowed| | | | |retrospective payment |plans, patients commit | |to see any provider and do not | | | | |system, which is |to paying physicians | |require referrals to visit a | | | | |basically, a case by |and hospitals for each | |specialist. The down-side to having | | | | |case method of |individual service | |an indemnity plan is the longer, or | | | | |payment. Reviews for |rendered. Once a | |more frequently a service is | | | | |payment may only be |patient has received | |utilized, the higher the cost. This | | | | |submitted once the |care, an itemized bill | |may seem like an incentive for | | | | |service has been |will be submitted to | |providers, yet is a disincentive for | | | | |provided to the |the insurance company | |patients paying upfront | | | | |patients (Austin & |and reimbursement is |...

References: Austin, A., & Wetle, V. (2012). The United States health care system, combining business, health, and delivery. (2nd ed.). Upper Saddle River, NJ: Pearson Education.
Barsukiewicz, C. K., Raffel, M. W., & Raffel, N. K. (2010). The U.S. health system: Origins and functions. (6th ed.). Mason, OH: Cengage Learning.

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