ipl-logo

What Is The Difference Between Cigna HMO And Heritage California ACO?

582 Words3 Pages

Compare and Contrast CIGNA HMO and Heritage California ACO from the lens of the consumer
Introduction
In the US, there are many health insurance plans designed to meet different individual needs with various advantages and disadvantages of their own. This research paper, focuses on the two different health plan models those are Cigna HMO and Heritage California ACO. Health Maintenance organization (HMO) is basically a type of health plan that limits the freedom of choice of the provider, as the coverage is given to patients who take care from the physicians who contact with the HMO and its main focus is on the prevention and wellness (Wedig, 2013). ACO health plans basically focuses on the care coordination, promote prevention and wellness, …show more content…

They have 14.5 million global medical customers, 1.2 million Medicare prescription drug Customers; 459,000 Medicare Advantage Customers; 59,000 Medicaid Customers (Cigna Facts, 2014). Cigna offers health insurance populations like young adults and students, employers insurance, Medicare patients and international insurance. Whereas, Heritage California ACO model has patient’s benefits like continuity of care, follow-ups and personal attention after any diagnosis or procedures and increased awareness. Moreover, patients have access to expert coordinated care which where only available to managed care patients in the past. Heritage Provider Network provides high quality and cost effective healthcare to more than 700000 individuals. Heritage California ACO focuses on the population with chronic illness, Medicare & Medicaid beneficiaries and other individuals, this is voluntary. From the above observation, I think Cigna HMO has many services serving different population at affordable rates and have successful results in the maintaining the quality of care, accessibility and

Show More
Related
274 Words | 2 Pages

The Patient Protection and Affordable Care Act (ACA) approved the use of Accountable Care Organizations (ACOs) to provide protection, value of care and reduce health care costs in Medicare. The ACO program is a charitable program which began on January 1, 2012. An ACO represents a group of providers and suppliers of services such as hospitals, physicians, and those involved in patient care. These individuals have agreed to work together to coordinate care for the patients they serve under the original Medicare. The objective of an ACO is to provide continuous, high quality care for Medicare beneficiaries, simultaneously improve quality and lower costs.

Read More
663 Words | 3 Pages

Megan McCardle and Claudia Chaufan have brought many different opinions about healthcare reform. In “Liberals Are Wrong: Free Market Health Care is Possible" by Megan McCardle, she has argued that is not available for people to purchase the right and needed healthcare. Besides that, Claudia Chaufan has stated that people can purchase their own healthcare plans and also mentioned about the single-payer plan. Although having some shared ideas about health insurances, each of the authors had their significant concepts. Based on “Ken Arrow’s critique of healthcare markets”, Megan McCardle has indicated her opposition against him.

Read More
451 Words | 2 Pages

" Part 2: Discuss the history of why HMOs were developed and if they met those goals as intended. Health Maintenance Organization Plans - HMO Plans for short - are a type of managed care program. The idea behind managed care programs is that maintaining good health will be achieved by preventing disease and providing quality care. By maintaining good health, it is believed that escalating health care costs can be controlled. “When HMO Plans were first introduced, members paid a fixed, prepaid monthly premium in exchange for health care from a contracted network of providers.

Read More
1295 Words | 6 Pages

In fact, according to Kaiser Foundation (2018), as of 2017, there are almost 12 million health plan members, estimated 209,000 employees, 21, 275 physicians, 54,000 nurses, 39 medical centers, and more than 700 medical facilities. The main objective of Kaiser Permanente is to provide affordable and best-quality health care services, as well as to improve the health of the communities they serve. This healthcare provider is one of the trusted partners in total health which collaborate with the people in the community in order to help them in creating and thriving communities which can be considered among the healthiest in the entire nation. In line with the aforementioned information, the Kaiser Permanente is one of the medical branches that provide quality healthcare in the entire nation, as well as the Coastal and Olympic region and Puget Sound. Also, it is one of the service providers that has survived enormous and huge competition from other healthcare providers located in the entire nation, United States of

Read More
74 Words | 1 Pages

The current health care system is complex and constantly changing. The health care reform have been an ongoing debate since the establishment of Medicare and Medicaid and will continue in the future of the PPACA. In addition, the implementation of the PPACA will face more challenge as it relate to laws and the economics. So although, the PPACA have made some progress, it also have years of work to overcome some of the

Read More
426 Words | 2 Pages

CVS Health is one of the many competitors in the pharmacy retail industry with a focus on retail stores and health clinics within their stores. Currently ranked #10 on the Fortune 500 list (Fortune), CVS Health has over 7,800 retail drugstores throughout the states and Puerto Rico as well as in Brazil, 1000 Minute Clinics, and over 1.7 billion prescriptions filled/managed annually with over 217,000 employees (CVS Health). CVS Health has one of the most successful loyalty programs in all of the U.S. The ExtraCare loyalty program has over 70 million card members. The loyalty program is so effective in the sense that it is tailored to the individuals based on their purchase history.

Read More
1683 Words | 7 Pages

Both Medicare ACO programs need the ACOs to inform the payee that they are participating the ACOs, and the ACOs will be responsible for reducing the cost for these beneficiaries. A significant difference from traditional HMO, however, Medicare patients can still see any physician they want to see without a referral. Whereas many private managed care plans force patients to choose a primary care provider (PCP), (Shafrin,2011). The shared savings features of ACOs and integration of care, discussed above, provide incentives to keep unnecessary utilization down, and could, therefore, lower costs (Barnes et

Read More
109 Words | 1 Pages

Social contracts in America have been molded around public policy through the years. Public policy is influenced by the citizens of America and the countries stability. Social contracts like the Affordable Care Act (ACA) conveys a political message that the government is establishing a social contract with the citizens of America. The ACA established a social contract with physicians and hospitals by mandating rules and regulations. However, both social contracts have flaws that can hinder physician and patient relationship, care, and cost.

Read More
535 Words | 3 Pages

Prior to the implementation of the Affordable Care Act (ACA), few people anticipated employer-provided health care would disappear as a major player in the United State healthcare arena. However, ACA adoption and has put more than 169 million employees at risk for losing their workplace coverage. Several studies indicate employer-based coverage will decline rapidly over the next decade as the traditional US system is displaced by the healthcare exchange system. While consumers grapple with finding affordable coverage options and providers adjust to the new norms, there is another wrinkle in the mix. In January, Health and Human Services (HHS) Secretary Sylvia M. Burwell announced the agency's push toward value-based and alternative reimbursement models.

Read More
991 Words | 4 Pages

The affordable care act presented the United States with the most extensive overhaul since the passage of Medicare and Medicaid in the 1960’s. The act was a response to staggering statistics on the price of healthcare and the resulting uninsured rate within the United States. The affordable care act uses Individual Mandate and Health Insurance Exchanges to combat major factors causing high insurance cost and low insured rates. As with most reform, the public has not been one hundred percent unified on the potential effectiveness of the Affordable Care Act.

Read More
1897 Words | 8 Pages

Before the Affordable Care Act, Health Care in the United States was obtained in multiple ways. Approximately 33% of Americans received their health care from Medicare which is Health Care for the elderly, Medicaid which is Health Care for the poor, Tricare, and VA. Privately provided Health Care accounted for 50% of Americans, and 16% of Americans were uninsured. 16% equates to about 50 million people. Two major problems faced in the American health care system before the Affordable Care Act, 16% of the population was uninsured and health care costs were rising rapidly.

Read More
684 Words | 3 Pages

Costa Rica has a system called CAJA (Costarricense de Seguro Social) this is a Universal system that allows citizens and permanent residents to have 100% coverage for medicine,

Read More
523 Words | 3 Pages

There have been some major changes over the past few years within the health insurance industry. There has been increasing demand for health insurance even through the market has reached its maturity. Cost increase throughout the market, companies need to change to maintain profitability. The legal landscape, increasing cost of health care, and a sinking within the market have changed the environment that Health Insurance Company operates. The legal changes within the United States have reformed the health insurance industry.

Read More
1437 Words | 6 Pages

The expansion of Medicaid through the implementation of the Affordable Care Act (ACA) has initiated many states to try innovative ideas to improve their Medicaid programs. Many states, like Minnesota, had started the reform process prior to the passage of the ACA with the purpose of improving the quality of care for Medicaid beneficiaries and to utilize a more cost-effective system to provide Medicaid benefits. One of the innovative ideas that states like Minnesota is implementing is the use of accountable care organizations (ACOs). This paper will explore ACOs by studying the reforms within the Minnesota Medicaid program. Background Medicaid was originally established by the government to provide medical services and payment for individuals

Read More
741 Words | 3 Pages

The United States is the only Western nation that does not authorize free health services to its people. The cost of healthcare to the uninsured is beyond prohibitive, and insurance plans are far more captivated with profit costs, rather

Read More

More about What Is The Difference Between Cigna HMO And Heritage California ACO?

Related Topics

Open Document