Humana Organizational Impact and Recommendation
Additionally, Humana provides care plans for some state-programs such as Puerto Rico, Medicare and lastly, TRICARE. The stakeholders in this organization distributes the risks among different people while ensuring that they are able to acquire great profits in the long run The revenues from Humana can be broken down into the retail insurance segment, healthcare profits and employer group insurance profits (Shynkevich & Belatreche, 2015, July). The retail insurance attributes to the biggest segment of the profits in Humana and includes: state Medicaid programs, drugs prescribed in Medicare programs, Personal commercial plans, health insurance plans for specified individuals and Medicare advantages (MA). The membership of Humana consists of people enrolled in healthcare plans as well as those who have been enrolled in healthcare programs (Shynkevich & Belatreche, 2015, July). Members in Humana have continued to grow over the years according to my analysis.
Based on price, the various health plans can be categorized into: Bronze, Gold, Silver and Platinum. These categories have been established on the level of expenses catered for. Bronze covers 60%, Gold covers 80%, Silver covers 70% and lastly Platinum covers 90%. The percentages are directly proportional to the price of each of the healthcare plans. The price of bronze and silver is relatively lower in Humana than in other insurance bodies such as Cigna. Humana is faced with three main risks: The underwriting risk which is born from managed care administrations and occurs in scenarios where the expenses and claim of a given health plan exceed the total premiums. The managed care administrations examine the health plans and award the right amount of premium. It is also hard to embrace price discrimination among customers and hence in the long run Humana remains prone to this risk.
Demand theory and Financial Statements The link existing between demand of goods and services provided by a given organization and the price of their products is presented in the demand theory (Palea, 2015). The shareholders and the investors in any organization use the financial statements presented in their decisions. Lastly, investors in Humana are also components of the market behavior and their existence in given time frames affect the assets, capital and distribution of income which are usually used in the financial statements. Economic Legislative Changes Legislative Changes During my research, I identified two cases where customers have complained about the services provided by Humana (Kelly, 2016). This has then triggered establishment of laws to help protect the interests of customers and reduce chances of exploitation. First, bodies have been formed to administer the operations of organizations such as Humana.
Secondly, clearer policy guidelines and policies have been set to make sure that the parties on both ends are well informed. During my research, I managed to talk to Bruce D. Thousand, who confirmed to be how dynamic the operations of Humana are. It is an organization which grows every day in attempt to cater for the legal changes while improving the value of their services. Potential Disparities Humana is enhancing its operations every day to match the developed Acts. Consequently, Humana has further coped with the changes by: establishing clinical capabilities to assist customers when away from the doctors, partnering with other risk partners and adopting the new technology. G. Paying medicare advantage plans: To level or tilt the playing field. Journal of Health Economics. Kelly, A. S. Shynkevich, Y.
McGinnity, T. M. Coleman, S. Belatreche, A.
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