HCM 301 CSU Module 6 Equity and Equality in Health Insurance Coverage Discussion – Description
review the descriptions of the major payment/reimbursement methodologies that healthcare organizations use:
Fee-for-service
Reasonable cost or cost-based reimbursement
Reasonable charge or charge-based reimbursement
Prospective payment.
Discussion: What is the difference between Equity in health insurance coverage and Equality in health insurance coverage?
Discuss your personal experience with medical insurance coverage. Which payment methodology does your insurance provider use? In your opinion, is your insurance sufficient to cover your healthcare needs? Are different methodologies better for different types of claims?
Discussion Requirements:
Be sure to post an initial, substantive response by Thursday at 11:59 p.m. MST and respond to two or more peers with substantive responses by Sunday at 11:59 p.m. MST. A substantive initial post answers the question presented completely and/or asks a thoughtful question pertaining to the topic. Substantive peer responses ask thoughtful questions pertaining to the topic and/or answer a question (in detail) posted by another student. Support your statements with logic and at least one credible reference. Post your initial response early and check back often to continue the discussion. Be sure to respond to your peers’ and instructor’s posts, as well. peer responses:
Good Evening Everyone,
For this week’s discussion we are asked to reflect on the descriptions of the major payment/reimbursement methodologies that healthcare organizations use such as fee-for-service. The difference between Equity and equality in health insurance coverage; equity means that everyone is provided with the same opportunity to be healthy and receive healthcare. Equality is equal treatment and available health care services for everyone.
Reflecting on my own experience with medical insurance coverage, my insurance provider uses fee-for-service payment methodology. In my opinion my insurance provider is mostly sufficient to cover my healthcare needs; but in some aspects they charge way to much for some of those needs such as giving birth to my son. But if it was not for me being in a hospital and having access to emergency services I might not be alive today because I almost went septic during my delivery and they were able to save my life thankfully. I don’t think there are different methodologies that work better for different types of claims I think fee-for-service is a valuable way to process claims.
Systemic racism current discussion came to light in 2020 when all of the protests started fighting against the poor care that some races are given just based on appearance. I found a really great article that talks about this issue and really helps you understand what needs to change in our healthcare system. “Racism is associated with poorer mental and physical health outcomes and negative patient experiences in the health care system.”(Sexton et al., 2021).
-Courtney Wilkerson
References:
Sexton, S. M., Richardson, C. R., Schrager, S. B., Bowman, M. A., Hickner, J., Morley, C. P., Mott, T. F., Pimlott, N., Saultz, J. W., & Weiss, B. D. (2021, January 1). Systemic racism and Health Disparities. The College of Family Physicians of Canada. https://www.cfp.ca/content/67/1/13.shortLinks to an external site.
CDC. (2020). Health Equality, Health Equity & Health barriers. Floridahealth.gov. https://collier.floridahealth.gov/programs-and-ser…
Second
Daniele Baughman
7:41amJun 22 at 7:41am
Manage Discussion Entry
Hello Fellow classmates and Professor Felker,
According to (Florida Department of Health, 2017) health equity is known as the availability of healthcare while taking into account the factors that affect health. These factors can be things such as housing or transportation, Health equity is achieved once no one is left out because of their circumstances, it also acknowledges that not every person starts the same or needs the same things to obtain the similar results. The (Florida Department of Health, 2017) States that health equality is the equal treatment and the availability of health services for all people, while promoting fairness. It works only if everyone starts the same and needs the same things. (Florida Department of Health, 2017) My current insurance provider is Aetna Better Health of West Virginia, and its payment methodology is fee-for-service. I have pretty much not had a problem with my insurance coverage and for the most part it sufficiently covers my healthcare needs, the only problem that I have had was I had a miscarriage this in march of this year and had to get medical care, I was told everything would be covered for it along with the birth control that I got after it by both my healthcare provider and insurance provider, then at the beginning of this month I got an outrageous medical bill for it.
Florida Department of Health. (2017, November 3). Health Equality, Health Equity & Health barriers. Health Equality, Health Equity & Health Barriers . https://collier.floridahealth.gov/programs-and-ser…
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