HBF Video Business Case - Research Paper Example

HBF VIDEO BUSINESS CASE REPORT Name Course Date Executive Summary The purpose of this research paper/report is to explore and examine the issue regarding HBF in its operations, as health insurer, in the midst of a potential increase in costs by the private hospitals in the contemporary society. From this perspective, there is a need for the HBF to adopt and implement appropriate mechanisms in the course of curbing the menace while protecting the rights and welfare of the stakeholders or consumers. According to the findings of the assessment, the issue of the case was how the HBF could respond to the request, which would affect and influence HBF members ultimately through an increase in the premium costs. The eminent cause of this issue is the difference in opinions on the factors driving business was the main cause of the issue regarding the health insurer and the hospital in their pursuit of competitive advantage and sustainability. From this illustration, the health insurer (HBF) would like to keep the premiums at the minimum because consumers desire to experience consistent premiums rather than increasing costs regarding their health insurance costs. On the other hand, the private hospital focuses on maximizing their profit levels and revenues, thus, the desire to increase their daily bed rates. In the course of overcoming this issue, the report recommends implementation of two valuable solutions. In the first instance, there is a need for the relevant stakeholders and practitioners to engage in the renegotiation of the cap to limiting the tendency by the private hospitals to set an awkward precedent. Secondly, HBF should consider hiring legal practitioners in attempts to restore and maintain the trust of the target audiences on matters of credibility and effective management of the finances. Issue Health insurer tends to face several challenges, and one of them is to keep the premium to the minimum since consumers do not like seeing a consistent increase in the premiums. Nevertheless, health insurers are not the price setters for the benefits paid out. Health insurance focuses on executing their mechanisms and approaches to facilitate covering hospital costs. HBF tends to engage in the consistent negotiation with healthcare facilities and hospitals to keep the premium down to the minimum. In most cases, the hospital would like to engage in increasing prices as much as possible while health insurer (HBF) would like to keep it at a minimum. This creates the platform for the issue in which HBF could not agree on a rate with Ramsey. The institution sought to increase its daily bed rate ratio to a higher rate, which HBF believed was unjustifiable. According to HBF, the action would send an awkward precedent. From this perspective, the issue of the case was how the HBF could respond to the request, which would affect and influence HBF members ultimately through an increase in the premium costs. Cause From the case report, it is valuable to note that the hospital (Ramsey) was under increased pressure to achieve or accomplish better returns for the shareholders to increase their share prices and dividends, thus, the platform to pursue the highest increase of the daily bed rate. On the other hand, HBF did demonstrate an interest into looking after the members with the intention of ensuring that the target audiences do not pay a large sum of the premium for their insurance programs. From this illustration, the difference in opinions on the factors driving business was the main cause of the issue regarding the health insurer and the hospital in their pursuit of competitive advantage and sustainability. Alternatives Alternatives Ethics Customer Cost Evaluation Customer Short-term Low-1; High-10 Low-1; High-10 Low-1; High-10 Low-1; High-10 Roll over and pay the increase 1 1 10 10 Seek Legal Assistance 9 10 2 2 Long-Term Renegotiate the Cap 9 10 1 1 Roll over and Pay the Increase One of the alternatives in the course of dealing with the issue in this case study is to accept the proposal by the private hospital to increase the daily bed rate, which would translate to an increase in the premiums by the HBF. In this context, the HBF will have the obligation to increase the cost of premiums to the target audiences or customer/stakeholders, which might have diverse implications. The cause of the issue was the difference in perception regarding factors driving the business. Evidently, HBF might decide to play to the tune of the private hospital to increase its daily bed rates to enormous financial costs, which are unjustifiable in agreement with the perception of the health insurer. From the table assessment, the alternative will demonstrate unethical attitude by the health insurer while increasing the cost of premiums to the consumers, thus, exploitation of the welfare of the target audiences. Seek Legal Assistance Secondly, the HBF might focus on the adoption or outsource the legal assistance in the industry to handle the approach by the private hospital to engage in an enormous or unjustifiable increase to the daily bed rates. In this context, the legal practitioners would have the obligation to argue on the issue of credibility, awkward precedent, and ineffective financial management practices by the private hospital. From the tabular assessment, the approach will prove to highly ethical in the course of addressing the needs of the consumers. Similarly, legal assistance will facilitate quality approach towards the reduction of the costs of premium by the consumers. From a consumer perspective, the evaluation will reveal quality implications on their welfare, thus, the opportunity to oversee capping of the premiums by the health insurers in addressing the demands and expectations of the stakeholders in the healthcare industry. Additionally, the legal assistance in the healthcare industry will focus on the prevention of the potential awkward precedent in agreement with the unjustifiable increase in the daily bed rates by the private hospital. Renegotiate the Cap From the statement mentioned above, the cause of the issue was the diversity in the perception of the factors driving business entities. In the case of HBF, factors such as credibility, prevention of awkward precedent, and financial management are vital in the improvement of the condition of the business entity. On the other hand, private hospitals focus on maximization of the revenues at the end of each financial period. From this illustration, private hospitals engage in practices, which will increase their profit levels or revenues at all cost while health insurers aim at keeping the premiums at a minimum in agreement with the demands and expectations of the consumers. From this illustration, renegotiation of the cap will prove to be ethical in regards to the needs and expectations of the consumers. Similarly, the approach will contribute to the enormous improvement and protection of the welfare of the target audiences in the health care sector. Decision Criteria/Evidence-based Analysis Setting awkward Precedent The decision by the HBF to roll over and pay the substantive and unjustifiable increase in the daily bed rates by the private hospital tends to have diverse implications. At first glance, the approach will enable HBF and private hospitals to maximize their revenues through an increase in the volume of the premiums. On the other hand, there will be negative implications such as setting an awkward precedent for other private hospitals to engage in raising or increasing their charges in pursuit of maximum revenues and profit levels at the end of each fiscal period. Eventually, the alternative might have adverse implications for the HBF’s stakeholders, consumers through increased premiums. Retaining Customer Trust In the first instance, integration of this alternative will have diverse implications on the operations of the health insurers and private hospitals in pursuit of their goals and targets in the market and industry of operation. From a positive perspective, the approach would prevent generation of awkward precedent by preventing the private hospital to increase its rates to unjustifiable figures1. Secondly, seeking the legal assistance on the issue will be vital in enabling the target audience or consumers to maintain their trust and belief on the service providers in the health insurance sector. Nevertheless, HBF will have to incur increased costs to substantiate the legal assistance in the industry. Cost-efficiency The third alternative (Renegotiate the Cap) in this context would be setting up a negotiating team between the health insurer and the private hospitals on the platform to determine the most appropriate cap illustrating the maximum private hospitals can increase their rates. The alternative will demonstrate cost-efficiency perspective or mechanism by HBF to pursue its goal. For instance, HBF focuses on retaining premiums at the minimum because consumers do not like seeing the consistent increase in the premium levels. Categorically, renegotiation of the cap will be vital in preventing future actions of similar nature, thus, prevention of the awkward precedent by the private hospitals in pursuit of their financial gains2. Recommended Solutions From the above illustrations, this report suggests three critical solutions in the course of determining how HBF reacts towards protection of the consumers from the unjustifiable increase in the daily bed rates by the private hospital. These suggested solutions include rolling and paying the increase, renegotiating the cap, and seeking the legal assistance in the industry. Accordingly, HBF should focus on adopting and implementing the final two solutions while avoiding the first suggestion because of its implications of working with the target audiences. Firstly, there is a need for HBF, as the health insurer, to organize a meeting of the shareholders and stakeholders in the course of determining the most appropriate cap. The stakeholders and shareholders will have the obligation to set the ceiling in which the private hospitals cannot increase their rates in the delivery of quality services and products in agreement with the demands and expectations of the consumers. The meeting will be valuable in the course of setting the objectives for the practitioners in the healthcare sector, thus, prevention of awkward precedent, improvement of credibility, and effective financial management in the achievement of the goals and targets at the end of each fiscal period. Secondly, there is a need for the HBF to consider hiring the services of legal practitioners in the health insurance market. The approach proves to be valuable in restoring the trust of the consumers on the service providers in the health insurance industry. From this perspective, consumers do not like to see increases in their insurance premiums3. Evidently, the approach will be essential in overcoming increase potential cost of their insurance contributions. Categorically, implementation of the approach will be valuable in the course of ensuring that private hospitals adhere to the rules and regulations in the process of increasing their rates. Implementation and Implications Implementation of these solutions indicates that HBF aims at protecting the needs and expectations of the target audiences. These solutions focus on enabling the institution to maintain the premium at a minimum in spite of not being the price setters in the industry. From this perspective, implementation of these solutions will require right or effective budgeting and ideal management skills in pursuit of quality outcomes or results4. In the first instance, the renegotiation of the cap among the stakeholders and shareholders will have enormous implications on the efficiency in the delivery of quality products and services from the cost perspective. The health insurer will be able to keep the premiums at the minimum while watching the actions by the private hospitals seeking to maximize their revenues and profit levels at the end of each financial period5. Similarly, the approach will ensure that the private hospitals adhere to the set ceiling while seeking to maximize their products and services rather than doing so to the extent of achieving unjustifiable rates. Additionally, implementation of such solutions will protect the interests of the consumers while improving credibility and appropriate financial management by the target audiences and service providers (Ferrier and Julie 339)6. Implementation of the proposed and recommended solutions will be ideal in the maximization of the revenues of the service providers and healthcare practitioners while reducing the intent to exploitation the target audiences in the market and industry of operation. The realization of effective and efficiency in the health insurance sector will be ideal in enabling consumers and service providers to achieve the goals and targets at the end of the fiscal period. Bibliography Einav, Liran, and Jonathan Levin. "Managed Competition in Health Insurance." Journal of the European Economic Association 13, no. 6 (2015): 998-1021. Ferrier, Gary D., and Julie S. Trivitt. "Incorporating quality into the measurement of hospital efficiency: a double DEA approach." Journal of Productivity Analysis 40, no. 3 (2013): 337-355. Newhouse, Joseph P. "Reimbursing health plans and health providers: efficiency in production versus selection." Journal of economic literature 34, no. 3 (1996): 1236-1263. Shipman, Scott A., and Christine A. Sinsky. "Expanding primary care capacity by reducing waste and improving the efficiency of care." Health Affairs 32, no. 11 (2013): 1990-1997. Wouters, Olivier J., et al. "Medical savings accounts: assessing their impact on efficiency, equity, and financial protection in health care." Health Economics, Policy and Law (2016): 1-15. Yang, Charles C. "Health Care Reform, Efficiency of Health Insurers, and Optimal Health Insurance Markets." North American Actuarial Journal 18, no. 4 (2014): 478-500. Read More

From this perspective, the issue of the case was how the HBF could respond to the request, which would affect and influence HBF members ultimately through an increase in the premium costs. Cause From the case report, it is valuable to note that the hospital (Ramsey) was under increased pressure to achieve or accomplish better returns for the shareholders to increase their share prices and dividends, thus, the platform to pursue the highest increase of the daily bed rate. On the other hand, HBF did demonstrate an interest into looking after the members with the intention of ensuring that the target audiences do not pay a large sum of the premium for their insurance programs.

From this illustration, the difference in opinions on the factors driving business was the main cause of the issue regarding the health insurer and the hospital in their pursuit of competitive advantage and sustainability. Alternatives Alternatives Ethics Customer Cost Evaluation Customer Short-term Low-1; High-10 Low-1; High-10 Low-1; High-10 Low-1; High-10 Roll over and pay the increase 1 1 10 10 Seek Legal Assistance 9 10 2 2 Long-Term Renegotiate the Cap 9 10 1 1 Roll over and Pay the Increase One of the alternatives in the course of dealing with the issue in this case study is to accept the proposal by the private hospital to increase the daily bed rate, which would translate to an increase in the premiums by the HBF.

In this context, the HBF will have the obligation to increase the cost of premiums to the target audiences or customer/stakeholders, which might have diverse implications. The cause of the issue was the difference in perception regarding factors driving the business. Evidently, HBF might decide to play to the tune of the private hospital to increase its daily bed rates to enormous financial costs, which are unjustifiable in agreement with the perception of the health insurer. From the table assessment, the alternative will demonstrate unethical attitude by the health insurer while increasing the cost of premiums to the consumers, thus, exploitation of the welfare of the target audiences.

Seek Legal Assistance Secondly, the HBF might focus on the adoption or outsource the legal assistance in the industry to handle the approach by the private hospital to engage in an enormous or unjustifiable increase to the daily bed rates. In this context, the legal practitioners would have the obligation to argue on the issue of credibility, awkward precedent, and ineffective financial management practices by the private hospital. From the tabular assessment, the approach will prove to highly ethical in the course of addressing the needs of the consumers.

Similarly, legal assistance will facilitate quality approach towards the reduction of the costs of premium by the consumers. From a consumer perspective, the evaluation will reveal quality implications on their welfare, thus, the opportunity to oversee capping of the premiums by the health insurers in addressing the demands and expectations of the stakeholders in the healthcare industry. Additionally, the legal assistance in the healthcare industry will focus on the prevention of the potential awkward precedent in agreement with the unjustifiable increase in the daily bed rates by the private hospital.

Renegotiate the Cap From the statement mentioned above, the cause of the issue was the diversity in the perception of the factors driving business entities. In the case of HBF, factors such as credibility, prevention of awkward precedent, and financial management are vital in the improvement of the condition of the business entity. On the other hand, private hospitals focus on maximization of the revenues at the end of each financial period. From this illustration, private hospitals engage in practices, which will increase their profit levels or revenues at all cost while health insurers aim at keeping the premiums at a minimum in agreement with the demands and expectations of the consumers.

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