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- H applied for a individual major medical policy. When H filed a claim within the first year of coverage and the underwriter noticed that the H's age on the claim form was different than what was listed on the application. The insurer will take which of the following actions regarding H's claim? A: Deny the claim and refund premiums B: Deny the claim, cancel the policy and keep all premiums C: Pay the claim in full and keep the policy as is D: Adjust the claim benefit amount to the insured's correct ageSelect and analyze 1 determinant of health within the concept of its impact to the U.S. healthcare system. Describe the healthcare demand and supply as it relates to your chosen determinant. What will be your recommendation on how to reduce or eliminate this determinant? Ensure that you integrate economic terms, frameworks, and models throughout your review..What are some of the metrics economists use to measure health outcomes?
- What is an actuarially fair insurance policy?Table 1 Injurer Victim Care Injurer Care Victim Prob of Accident Care Cost Care Cost WyX, p(x1,x,) None None 15% None Care 12% Care None 10% Care Care 3 2 6% a) Is this a situation of unilateral precaution or bilateral precaution? Assume that the harm caused by each accident (denoted by A in class) is equal to 2. b) Given the information in Table 1, fill in the values in the empty cells of Table 2 Table 2: Injurer care Victim's care Expected harm from Total expected social accident costs p(x,Xu)A None None None Care Care None Care CareThe impact of changing economic realities (not just Covid related) in the healthcare setting. Consider the customer perspective, organizational perspective, and provider perspective. Looking at the three perspectives, make recommendations for improvement.
- what does non-stationarity mean ?For Pancreas Transplant, DRG code is 010. For DRG 010, Medicare pays fixed amountof $21,313.50. Outlier threshold for Medicare is $25,800. (a) John admitted hospital A for pancreas transplant. The charges for John’s treatment was 128,000. Cost to charge ratio for Hospital A was 0.10. How much payment hospital A would get from Medicare?Suppose Jay has been experiencing back pain and that there are two options for back pain: Treatment Regimen Total Cost Pain Reduction Do nothing $0 0 units Cortisone injections $600 30 units Another treatment is discovered. It costs $700 and reduces pain by 25 units. Should he choose the new treatment?
- What impact does AI have in healthcare and how does it play a factor in the economy? Please provide the explanation in detail and source of information.NO CHATGPT. In the US, private health insurance is usually purchased by groups rather than individuals. For example, most people are insured through their employer or their spouse’s employer. Which type of distortion does the insurance company need to worry about with individuals purchasing insurance versus groups? Why is group insurance preferable for the employer? Why is this preferable for the individual?Which of he following provisions of an individual Accident and Heallh policy allows for nonpayment of premiums in lhe event of the insured's total disability? A.Grace Period B.Elimination Period C.Waiver of Premium D.Return of Premium
