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create a handout to educate employees on how health insurance impacts preventative care.
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Benefits and Requirements of Insurance (105 points)
You have been asked by your private employer to create a handout to educate employees on how health
insurance impacts preventative care.
Be sure to include the following information:
• Covered preventative measures;
• Frequency of preventative care allowed;
• How utilization changes based on health insurance coverage;
• The impact of preventative care on the individual, organization. and nation; and
• Figures, examples, and statistics supporting your findings.
Your assignment should meet the following structural requirements.
• Two-page handout, not including the cover sheet and reference page.
• Include headings titled “Covered Preventative Care” and “Utilization”.
• Be sure to include an informational paragraph under each heading and a citation to the resource
utilized.
• Formatted according to APA and Saudi Electronic University writing standards.
• Provide support for your statements with in-text citations from a minimum of five scholarly articles.
Two of these sources may be from the class readings, textbook, or lectures, but two must be
external. The Saudi Digital Library is a good place to find these references.
Live Session
Module 5
HCM563
Healthcare Insurance
Instructor Name
Module 5 Learning Outcomes
1. Evaluate the preventative and cost benefits of health insurance for Saudi nationals,
expatriates, and the country.
2. Compare and contrast healthcare costs with the health insurance benefits received
globally.
3. Demonstrate health access and utilization rates with insured versus uninsured
individuals in Saudi Arabia.
4. Create a demonstrative tool illustrating the positive aspects of health insurance.
HCM563: Healthcare Insurance
Preventative Care
(Source: https://pixabay.com/photos/doctor-doctor-s-office-stethoscope-3464761/)
HCM563: Healthcare Insurance
Chronic Disease Care and
Outcomes
● Increased coverage positively impacts those with chronic disease
● Examples include:
○ Improved rates of diabetes diagnosis
○ Increased cancer screenings
● Having to borrow for medical care
● 11.1% of individuals reported borrowing for medical reasons
HCM563: Healthcare Insurance
Financial Protection and the Role
of Insurance
(Source: https://pixabay.com/photos/money-profit-finance-business-2696228/)
HCM/563 Healthcare Insurance
The Concepts of Risk Pools
(Source: https://pixabay.com/photos/risk-word-letters-boggle-game-1945683/)
HCM563: Healthcare Insurance
Risk Pools
►If your group is large enough, then it spreads those with greater health risks to
those healthier individuals (Sickness funds & Private health insurance
►The greater the risk pool, the more stable healthcare premiums will become
►Risk pools do not necessarily mean the premiums will be lower
►The average health of the pool determines whether premiums will be higher or
lower
►Premiums tend to be recalculated annually to account for the health of the risk
pool
►Mandatory insurance, like that in Saudi Arabia, grows the risk pool, as
individuals are required to have health insurance
HCM563: Healthcare Insurance
Adverse Selection
(Source: https://pixabay.com/photos/doors-choices-choose-open-decision-1767563/)
HCM563: Healthcare Insurance
Access to Care
►Access improves health outcomes
►Health insurance can help individuals gain entry into the medical system
►A barrier to healthcare is the high cost of services
►With health insurance, a small copay is usually due
►Under some plans, preventative care is free
HCM563: Healthcare Insurance
Barriers to Dental Health
►Most insurance policies don’t cover dental health
►A study found that Saudi Arabians usually visit a dentist for emergency
treatment and not for preventative care
►Cost, shortage of dentists, difficulty in getting appointment, no need for
treatment, and fear of dentists were the main perceived barriers to access to
dental care
►The study showed that income was the biggest factor to whether Saudis visited
the dentist
►How could health insurance aid in this problem?
Course Code and Title
Well-Being and Self-Reported
Health
(Source: https://pixabay.com/illustrations/age-youth-contrast-old-young-2808492/)
HCM563: Healthcare Insurance
Emergency Departments and
Health Insurance
►Overcrowding of EDs is a reality across the globe
►Long wait times to see primary care providers result in more individuals seeking
care in EDs
►Overcrowded EDs have negative consequences
►Health insurance opening up the private sector could reduce ED usage
HCM563: Healthcare Insurance
Summary
►Health insurance can improve access and utilization of care
►Health insurance helps to insulate individuals and countries
from growing costs of healthcare.
►Breaking down barriers to healthcare will help individuals
achieve better quality of life.
HCM563: Healthcare Insurance
Module 5 Assignment
Requirements
►Assignment
►You have been asked by your private employer to
create a handout to educate employees on how health
insurance impacts preventative care.
►Be sure to include the following information:
Covered preventative measures;
Frequency of preventative care allowed;
How utilization changes based on health insurance
The impact of preventative care on the individual,
and nation; and
HCM563: Healthcare Insurance
coverage;
organization
Figures, examples and statistics supporting your findings.
Creating a Brochure or Handout
►Office has brochure templates.
►https://templates.office.com/en-us/business-tri-fold-brochure-tm00001002
►There is also a tutorial here: https://design.tutsplus.com/tutorials/how-todesign-a-handout-template-in-adobe-indesign–cms-32162
HCM563: Healthcare Insurance
References
► Ahangar, A., Ahmadi, A. M., Mozayani, A. H., & Dizaji, S. F. (2018). The role of risk-sharing mechanisms in finance
health care and towards universal health coverage in low-and middle-income countries of World Health
Organization regions. Journal of Preventive Medicine and Public Health, 51(1), 59.
► Almutlaqah, M. A., Baseer, M. A., Ingle, N. A., Assery, M. K., & Al Khadhari, M. A. (2018). Factors affecting access to
oral health care among adults in Abha City, Saudi Arabia. Journal of International Society of Preventive & Community
Dentistry, 8(5), 431-438.
► American Academy of Actuaries. (n.d.). Risk pooling: How health insurance in the individual market works. Retrieved
from https://www.actuary.org/content/risk-pooling-how-health-insurance-individual-market-works-0
► Erlangga, D., Suhrcke, M., Ali, S., & Bloor, K. (2019). The impact of public health insurance on health care utilisation,
financial protection and health status in low-and middle-income countries: A systematic review. PloS one, 14(8).
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0219731
► Dawoud, S. O., Ahmad, A. M. K., Alsharqi, O. Z., & Al-Raddadi, R. M. (2016). Utilization of the emergency department
and predicting factors associated with its use at the Saudi Ministry of Health General Hospitals. Global Journal of
Health Science, 8(1), 90.
► Office of Disease Prevention and Health Promotion. (2017). Access to healthcare.
https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services
► Sommers, B. D., Gawande, A. A., & Baicker, K. (2017). Health insurance coverage and health—What the recent
evidence tells us. The New England Journal of Medicine, 2017; 377:586-593. DOI: 10.1056/NEJMsb1706645
HCM563: Healthcare Insurance
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