| Health Maintenance Organization (HMO) | Preferred Provider Organization (PPO) | Point of Service (POS) | |
| Advantages |
1. Clients have chief care doctor and can build sustaining relations with them. 2. There are no deductibles and is cheap, thus saving on finances (Health Insure, 2019). 3. Suitable for children, young adults and older adults (Managed Care Digest Series, 2016) 4. Suitable for low income earners |
1. Highly flexible in picking a doctor as well as other providers of health care. 2. Specialists can see patients without the need of being referred (Health Insure, 2019). 3. Incentives for older adults |
1. Low co-pays with no deductibles. 2. There is flexibility in coverage (Kokemuller, 2017). |
| Disadvantages |
1. Has numerous rules and doctors are limited to the number of patients. 2. It is discriminative in terms of preexisting conditions among people (Health Insure, 2019). 3. More focused on low income earners than middle and high income earners |
1. PPOs co-payment compared to HMOs are higher. 2. Members of PPO plan have to pay a certain deductible before benefits of coverage begin (Health Insure, 2019). |
1. Obstacles are complex (referrals are a requirement, among other things). 2. High costs, which are out-of-network and wasted premiums (Kokemuller, 2017). 3. Does not favor low income earners and older adults |
Explain the impact media and social networking have on consumers when choosing the most appropriate managed care health insurance plans. Consider the positive and negative impacts .
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In the present day world, it is hard to bypass the current technology and all that it brings on board. Social media and media have several impacts on the consumers when it comes to picking the most suitable healthcare insurance plans. For instance, through social media and media healthcare consumers tend to have an easy time sharing and receiving information, promote healthcare behaviors, debate healthcare issues within the practice, interact with others including students, patients, colleagues, and caregivers among others (Taylor et al., 2016). Besides, it encourages and improves the outcomes of healthcare, increases the level of individual awareness of discoveries and news, educates and motivates patients, gives the community health information thereby improving community well-being programs. All the same despite the great impact, there are also several risks which come with it. For example, social media and media tend to put health care professionals as well as patients at great risk through professional image disruption, patient privacy breaches, and the desecration of personal-professional borders (Ventola, 2014).
Discuss how branding, marketing, and communication influence a consumer’s choice when considering an appropriate managed care health insurance plan. Consider positive and negative influence.
Branding refers to the distinctive crafting of commodities which depict the values of a firm. Equally, marketing refers to the processes of promoting the commodities of the firm. Almost every firm in the world employs marketing techniques to campaign for their commodities for the purposes of promoting them to create awareness throughout the market to lure and preserve the unwavering customers.
Every brand is similar to the other, and the only difference is how strong and appealing it is to the consumer simply because it would play a very critical part in attracting consumers to the company thus insurers compete competitively with other health. Also, it would ensure that customers do not look elsewhere for services (Taylor et al., 2016). On the other hand, marketing plays a significant role in creating awareness to the consumers and building desire in the consumer’s hearts. Strong branding and marketing in addition to communication tend to play a major role in consumers on what to consider before choosing their desired health insurance plan. For example, in a significant manner, the consumer would be able compare their finances and desires as well as the prices and characteristics of particular insurance plans thus choose the suitable plan for themselves.
However, considering the insignificant side, the consumer may fail to understand due to the unclear message which may end up causing confusion thus misleading an individual. As for this reason, it is of great value to always consider maintaining good marketing and brand systems as well as communication for consumer outreach enhancement (Beaton, 2017).
Explain how communication and education to consumers differs by generations when marketing managed care health insurance plans.
Across the many generations, one thing has been clear all through, the differences and the desires of each generation. When it comes to how communication and education to consumers differs by generations when marketing managed care health insurance plans, it is no different.
Consider why it is important to communicate and educate differently between generations.
Just like across every generation the preferences differ in a unique manner (fashion, music, and way of life among others). Similarly, when it comes to communication and education to consumers, the differences tend to be open and clear. For instance, millennial clients have a preference for “strong provider connection,” the baby boomers have a preference for extra multifaceted needs patient engagement, and physician guidance which is ample is the preference for silent generation (Heath, 2016).
References
Beaton, T. (2017, July 31). Effective Steps for Health Insurance Marketing, Consumer Engagement. Health Payer Intelligence . Retrieved from https://healthpayerintelligence.com/news/effective-steps-for-health-insurance-marketing-consumer-engagement
Health Insure. (2019). PPO vs HMO . Retrieved from http://www.healthinsure.org/ppo-vs-hmo/
Heath, S. (2016, March 29). Understanding Generational Differences in Patient Engagement. Patient Management . Retrieved from https://patientengagementhit.com/news/understanding-generational-differences-in-patient-engagement
Kokemuller, N. (2017, July 27). The Advantages & Disadvantages of POS Insurance. Pocket Sense . Retrieved from https://pocketsense.com/advantages-disadvantages-pos-insurance-7277214.html
Managed Care Digest Series. (2016). HMO-PPO Digest 2016. 30th Edition. Parsippany, NJ.: A Sanofi Company
Taylor, E. A. et al. (2016). Consumer Decisionmaking in the Health Care Marketplace . RAND Corporation. https://doi.org/10.7249/RR1567
Ventola C. L. (2014). Social media and health care professionals: benefits, risks, and best practices. Pharmacy and Therapeutics: a peer-reviewed journal for formulary management, 39 (7), 491–520.
