Essay Sample on Financial Status of Healthcare Organizations

Introduction

Managed Care Organization (MCO) is an effectively managed process of providing healthcare services through a collective and accomplished care health plan. MCO has been introduced in institutions to ensure that quality healthcare services to people associated with a given institution. Specific network and specific services and products are defined in the care plan to improve the care process. Every institution is picking up the trend of MCO to ensure that quality healthcare is offered to employees. As a Chief Financial Officer (CFO), performing an analysis on the company's health insurance for its employees is a paramount task that should be geared towards increasing service benefits using cost-saving measures (Cannon, 2012). In Seamus Company, developing strategies such as integrating Medicaid as an external partnership in the MCO plan, aligning the MCO with Seamus objectives and healthcare institutions functionalities and involving employees, healthcare practitioners and firm's managers in the model will help in the efficient implementation of MCO in the company.

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Fiscally Sustainable Strategies for the MCO Model

Moving from free-for service model to MCO model in health insurance provision in Seamus Company will require systematic and fiscal sustainable strategies. The strategies include integrating Medicaid as an external partnership in the MCO plan, aligning the MCO with Seamus objectives and healthcare institutions functionalities and involving employees, healthcare practitioners and firm's managers in the model (Shepherd, 2007). As a CFO, developing a plan that will incorporate the three strategies will help in minimizing costs and improve fiscal management in Seamus Company.

Plan to Carry Out the Strategies

Cost-Saving Measures

The plan for MCO model implementation under the three strategies will be implemented using external partnerships, stakeholder incorporation and incorporating Seamus and healthcare institution's parameters. These measures will ensure costs are saved during the implementation and utilization of the model.

Integrating Medicaid as an external partnership in the MCO plan is a strategy that will involve using Medicaid in smoothening the firm's MCO. The fact that the MCO model is a new health insurance model in Seamus will help the company in using Medicaid as a guide (Scott, Gazmararian, Williams, & Baker, 2002). Because Medicaid has already invested in MCO, the company will save costs in trying out the model and evaluating its effectiveness.

Aligning the MCO with Seamus objectives and healthcare institutions functionalities is a strategy that will ensure that the company's management readily accepts the model. Seamus objectives are to ensure employee's paramount performance by motivating them. The model will, therefore, serve two purposes; motivate employees and facilitate an improved health insurance plan (Cannon, 2012). Aligning the model with healthcare institutions' functionalities will reduce costs interventions to adjust the model to work with the healthcare facilities. Therefore, costs will be saved through ensuring the plan is as per the organization's expectations and healthcare institution's effective conditions.

By involving employees, healthcare practitioners and firm's managers in the model is a strategy that will enhance cost saving by incorporating favorable terms for each party to implement the MCO model. A neutral ground that will save costs both in health insurance and the implementation process will be chosen through stakeholder involvement.

Tax Deductible Considerations

Implementing the MCO model through governmental agencies such as Medicaid is an effective way to ensure that tax deductions are incorporated. Public health insurance plans are exempted from taxes. Therefore, the Medicaid strategy is the most effective strategy in the plan for ensuring paramount tax deductions.

Other Tax Advantages

Confirming to government regulations on concentrating on personal health in the MCO model plan will increase tax advantages. The MCO plan should still incorporate measures such as tax guidelines for employees who have agreed to health insurance plans. The USA government offers subsidies to institutions to cater to employee insurance (Cannon, 2012). The subsidies will help in outweighing the tax obligations that the company is subjected to.

Fiscal Management Improvements

Implementation of MCO model through considering the firm's objectives and centralizing health insurance financial resources is a plan that will improve fiscal management in the company. Financial objectives of Seamus are to ensure the company spends less on health insurance plans but also keep every employee under the covers (Shepherd, 2007). Consideration of the firm's financial objectives will improve fiscal management by enhancing the centralized management of health insurance financial resources.

Financial Management Principles for the Plan

Accountability and improve financial management efficiency are the two financial management principles of Seamus Company that will support the MCO model implementation plan. Accountability will hold every individual to be responsible for his or her health hence concentrating on an individual's health rather than the family's health. Costs will be saved due to concentration on an employee's health (Cannon, 2012). The centralization of health insurance financial resources under the MCO model will be supported by improved financial efficiency in the firm where health insurance will become more beneficial to employees.

How the Strategies Reduce Costs of Company's Health Insurance Plans?

The strategies adopted by Seamus in implementing the MCO model pan are geared towards reduction of costs. Primarily, the strategies will improve healthcare follow-up for every employee thus act as prevention measures, which will reduce costs that would have been used in treatment (Scott et al., 2002). As well, the strategies will reduce costs by acquiring assistance from external partnerships such as Medicaid who will guarantee cheap healthcare insurance policies.

Analysis of Increased Service Benefits

Health Utilization Risk Strategy

Aligning the MCO model with the company's objectives and healthcare institutions' functionalities is a strategy that will increase service benefits through health utilization risk strategy. The strategy will ensure that every employee is insured for health programs thus cover any health inconveniences that may occur (Beach, 2019). Employees will, therefore, be at a reduced risk of diseases thus improving their performance at work.

Financial Benefits of Implementation of Increased Service Benefits

Seamus objectives have always been to operate at the most effective financial grounds. Aligning the MCO model with the company's objectives will ensure that the company gains financial benefits such as reduced operating costs and reduced taxes.

Potential Financial Drawbacks of the Implementation of Increased Service Benefits

Aligning the MCO model to healthcare institutions' functionalities offer benefits of the improved corporation between Seamus and the healthcare institutions but pose a financial drawback (Shepherd, 2007). Seamus will be dependent on healthcare institutions' health insurance terms, which may end up being financially inconvenient for Seamus.

Benefits to Seamus on Increased Usage of Service Benefits

The service benefits that implementation of MCO model in Seamus allows the company to enjoy a wide range of benefits. Cost savings in health insurance of employees ensure that the company benefits from healthy financial growth and stability (Cannon, 2012). Additionally, the coverage and quality provision of healthcare services ensures that health utilization strategy is put in place thus increasing employees' efficiency at work. In return, the company will benefit from employees' improved productivity.

Analysis of External Healthcare Partnerships and Financial Benefits

Financial Benefits from External Healthcare Partnerships

External partnerships such as Medicaid or healthcare institutions in Seamus' MCO model will be a great boost towards the company's financial management. External partnerships will ensure that costs are shared in the MCO health insurance plan. For instance, Medicaid will offer subsidized health insurance policies that saving costs for the company (Paasche-Orlow, Schillinger, Greene, & Wagner, 2006). Also, healthcare provision institutions will offer reduced healthcare prices for the company's employees thus reduce costs and improve the financial performance of Seamus Company.

Financial Drawbacks from External Healthcare Partnerships

The major financial drawback that external healthcare partnerships would offer to Seamus MCO model is the uncertainty of reliability of partners. Financial drawbacks on the partners' end will affect the company adversely (Shepherd, 2007). The limiting factor of this drawback is that the uncertainty is beyond the company's control. Thus, it will create financial insecurities in the company.

Is the Partnership Beneficial?

Despite the limitation that external partnerships offer to Seamus, the partnerships are highly beneficial to the company. The partnerships will improve the quality of the MCO model. For instance, a partnership of the company with Medicaid will help the company benefit from subsidization of health insurance plans under MCO and incorporate every employee in the health insurance plan (Paasche-Orlow et al., 2006). Also, the partnership will ensure MCO's success through specialization of Medicaid in health insurance services. Medicaid will guarantee quality healthcare coverage under MCO thus ensuring that the company's MCO model is highly efficient (Shepherd, 2007). External partnerships will largely benefit Seamus Company through reducing healthcare illiteracy. Employees will become more alert on health insurance policies thus improving the efficiency of MCO model in Seamus Company (Beach, 2019). External partnerships are, therefore, largely beneficial since they will support, both financially and strategically, the MCO model implementation process.

References

Beach, M. (2019). The Intersection of Health Literacy, Cultural-competency, and Patient-centeredness for Quality Improvement. [online] Wgu.yourlearningportal.com. Available at: https://wgu.yourlearningportal.com/wgu/resources/courses/wgu_courses/hcm/hcm_bachelors/C428_HCM3110_finance/resources/The_Intersection_of_Health_for_Quality_Improvement.pdf [Accessed 28 Jan. 2019].

Cannon, H. (2012). Looking at CER from the Managed Care Organization Perspective. Journal of Managed Care Pharmacy, 18(4 Supp A), S13-S16.

Paasche-Orlow, M., Schillinger, D., Greene, S., & Wagner, E. (2006). How health care systems can begin to address the challenge of limited literacy. Journal of General Internal Medicine, [online] 21(8), pp.884-887. Available at: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1525-1497.2006.00544.x [Accessed 28 Jan. 2019].

Scott, T., Gazmararian, J., Williams, M., & Baker, D. (2002). Health Literacy and Preventive Health Care Use Among Medicare Enrollees in a Managed Care Organization. Medical Care, 40(5), 395-404.

Shepherd, M. (2007). Unprecedented Opportunities for Managed Care Organizations and Community Pharmacies to Work Together. Journal of Managed Care Pharmacy, 13(5), 426-428.