Financing and Structuring Health Care Essay

3082 Words Aug 1st, 2011 13 Pages
Financing and Structuring Health Care 1

Financing and Structuring Health Care
Lisa Martin Strayer University Professor Tataw July 18, 2011

Financing and Structuring Health Care 2

1. Indentify and describe the three main types of health insurances in the U.S. The main 3

types are the commercial health insurance industry, Blue cross and Blue shield plans and

Health Maintenance Organizations. With the commercial health
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These

plans focused attention no insurance for hospital costs, and offering medical insurance

protection for physician services. Since the Blues have merged their services they are

Financing and Structuring Health Care 3

now known as the single insurance entity in a state. And if you notice each state has its

own BC/BS.(e.g.) Blue Cross and Blue Shield of Ohio, which have their own type of

benefits that they offer. This occurred because of the segregation that took place back in

the 1980s which has led to 64 Blue Cross and Blue Shield organizations operating in all

50 states and U.S. territories. Recently the Blue plans have been aggressively

coordinating resources of individual plans in order to compete effectively with large

national commercial insurance companies, especially in obtaining the business of

employers that operate in more than one state. We call that the “home” plan which is

where the operation center of the company is held. For example, my husband works for

Bank of America which is based out of North Carolina, he used to have Blue Cross and

Blue Shield of North Carolina with a unique id# when he had services rendered here in

Virginia, the claims would go through Anthem BC/BS as the “host” plan. The two plans

would communicate with one

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