Wellness Initiatives Corp (WIC) has the potential to provide grouped insurance coverage for Fairdeal Hotels. WIC managed care covers health financing, insurance, case management on service delivery, and payments. WIC policies are a function of a centralized policy point where possible gaps in coverage are adequately addressed. WIC seeks to mediate effects of under-services that arise due to economies of scale subject to the presence of uninsured population and policy have driven under-service subject to patients with terminal illness like HIV/AIDS, dementia, diabetes, or pulmonary disorders.
The grouped insurance policies are tenable through the employer. The policies satisfy states’ authority and affiliated hospitals have sufficient resources. The insured can be airlifted to facilities near his family. WIC policies are comprehensive for the insured that have ongoing treatment. Under our policies, the insured is entitled to quality medical care at affiliated medical facilities at their states of destinations and can be flown for referral services for specialized treatment. This policy satisfies the cost control test for safety and effectiveness in that it meets employee choices to do away with private insurance plans that individuals may require to top-up medical cost deficits that may occur following exceeded medical care limits.
The policy makes payments for all medical costs incurred which motivate employees and reduce staff turnover if the employer covers her staff. WIC initiated this step because it would seem unreasonable when lawmakers cut down specific medical services from inclusion in a medically managed program. Our policy accounts for scenarios where there may result in tighter price control mechanisms on doctors and hospices. This has witnessed improvement on our loyalty program from many companies and has seen many employees terminating their private insurance plans (Cutler & Sheiner, 1997).
WIC has policies that oversee servicing of insured in nursing homes to ensure they get the best-managed care. This measure ensures WIC takes a preventive stance towards the sustainable health of our clientele. WIC is at the center of ensuring our clientele base is not exposed to risks of inflated medical care at an age when they are not able to meet their medical expenses. In that light, WIC is at the forefront to ensure employees get value for their retirement plans and protect them from elevated costs of healthcare that come with old age. WIC is at the core of planned central managed care to ensure ‘our clients cut down on their personal and corporate spending on healthcare and are not subject to price controls that negatively affect management’ (Chernew, 1995a:146).
WIC understands that insured may over-use healthcare services more when they know it is not them that they are servicing the medical bills. The insured are exposed to insecurity subject to doubt that they may be exposed to medical situations that may have adverse effects on the liquidity of their capital (Chernew, 1995b:197). The managed care approach of WIC recognizes that corporate bundled payments can sustain medical care for its staff during their service and after retirement.
WIC policies are functions of ‘supply and demand strategies’ that have been balanced to ensure our clients get the ‘best premium support’ mechanisms that are standardized to meet their medical care requirements. The policies are a function of income level and determined ‘expense level’ and don’t affect employee other ‘personal future financial planning’. This is in the understanding that employees often fail to secure insurance even when they can afford them. Our mission statement is to ensure WIC doesn’t fall victim to excess expenditure and supports informed choices on preventive care. A preventive approach to medical risks ensures WIC attains effective cost control while still maintaining sustainable curative care.
WIC recognizes that although the concept of an all-payer system rule may lead to a transfer of costs instead of reducing costs, it has the potential of making corporate entities view the system as forcing providers to charge private payers but the WIC system envisions a healthcare environment where corporate and the governments have equal opportunities to the sustainable realization of managed care as a function of broadened cost control strategy (Cutler & Sheiner, 1997).
In the long term, WIC projections foresee a situation where challenges that have direct relationships with price discrimination are managed sustainably (Chernew, 1995b:206). WIC reduces the variant where insurers pay for medical services and this translates into a better system for payment for the healthcare providers who suffer burdens of attending to persons who have no access to insurance facilities (Chernew, 1995b:198).
WIC has set standard procedures which is a function of a simplified billing system. In this regard, WIC ensures managed care cost variation across different facilities is standardized for the WIC insured. WIC-affiliated hospital facilities experience decreased administrative expenses because WIC maintains its billing system (Chernew, 1995a:151). This measure was put forth to eliminate different insurers’ disparate rules. Through these standardization measures, WIC has created an avenue for transparency to its insured, that, now get the opportunity to determine the economic value added from their previous or current insurers. Taking control of your costs is therefore a WIC pillar of strength and operational strategy (Chernew, 1995a:149).
WIC work plan incorporates public and private insurance plans. WIC integrated this aspect from concerns that public plans have the potential to use their purchasing power to provide alternatively less expensive insurance coverage which would have a long-term effect of putting private practicing entities out of business. In incorporating this measure, WIC understands legislators can protect the insurance industry by creating lope-holes that may weaken the public insurance plan. WIC partners with public and private practice to strengthen capacity to control costs by enforcing sustainable all-payer system regulatory reform (Hacker, 2008:45).
As partners in business, WIC recognizes that it cannot set prices for managed care (Shi & Singh, 2008:59) but it exerts control on the use of the services. To serve the corporate society, WIC takes its stance of applying pressure on employer reimbursement. An employer cannot fail us. We do this because as a business, WIC is committed to ensuring its health plans have bargaining power. It is this reputation that we protect.
References
Shi, L., & Singh, D. A., (2008). Essentials of the U.S. Health Care System, Canada: Jones & Bartlett Publishers, p.56-64.
Chernew, M.E. (1995b). HMO use of diagnostic tests: A review of the evidence, Medical care research, and review, 52(2):196-222.
Chernew, M.E., (1995a). The impact of Non-IPA HMOs on the number of Hospitals and capacity, Inquiry, 32(2): 143-154.
Cutler, D.M., & Sheiner, L. (1997). Managed care and the growth of medical expenditures, NBER working paper number 6140.
Hacker, J.S. (2008). The case for public plan choice in national health reform: key to cost control and quality coverage. Berkeley: University of California, Berkeley, p.45.