Economics In Healthcare

Part I

Consider the four health plans below with an eye to choosing one to offer to the company’s employees. Assume that the health plans and their annual per employee premiums are as follows:

Health Plan Premium, Individual Premium, Family

Aetna Health $4,555                           $11,428

MetroPlus $4,267                           $10,540

Empire        $4,217                           $10,767

Oxford        $6,029                           $13,417

The employer will pay 80% of the premium for individual coverage, and the employee will pay the remaining 20% as well as the entire additional premium for family coverage. (The premiums listed above, while realistic in magnitude, are hypothetical and computed solely for the purpose of this project.) All of the plans are managed care plans. Assume that the benefit package is the same across all plans, so there is no difference between them in what services are covered.

In addition to the above data, click here (https://www.health.ny.gov/health_care/managed_care/reports/quality_performance_improvement.htm#link3) to access the latest report for ‘Health Plan Comparison in New York State’. Review the online report and incorporate relevant information into your evaluation.

You can view the various categories of measures on which health plans are rated (e.g., Access to Care, Adult Living with Illness, etc.). Click each link for a summary chart that presents the performance (usually as a percentage score) of each plan in the group on the relevant measures and how each plan compares to regional and statewide scores.

Provide an analysis that outlines the plan you selected and why. Generally, you would select the plan with the highest score, but if you chose a plan with a lower score, explain why. Include the following elements in your analysis:

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