Private Insurance – Group Contract Insurance HMOs provide comprehensive services across the continuum of care and they make money by keeping people healthy. Prepaid group health plans emphasize health promotion since they provide health care services at a preset cost. By keeping people healthy, HMOs avoid lengthy hospitalizations and costly services.
The Medicare Program Medicare is the largest health care insurer in the U.S. It is designed to assist: –People 65 and older –People of any age with end-stage renal disease –People eligible for Social Security disability payment programs for more than 2 years –Qualified railroad retirement beneficiaries and merchant seamen
The High Cost of Health Care Health care inflation is well established and the level of health care activity is expected to grow as a result of various factors including: –An aging population –Increased demand –Continuing advances in medicine
Nutrition as a Component of Health Care Reform Cost-Effectiveness (continued) –Effective nutrition therapy can produce economic benefits as a result of altered food habits and risk factors. –Practice guidelines or protocols that clearly specify appropriate care and acceptable limits of care for each disease state or condition are important to enhance the quality, efficiency, and effectiveness of the health care system.
Medical Nutrition Therapy Providing Return on Investment Oxford Health Plan –Saved $10 for every $1 spent on nutrition counseling for at-risk elderly patients The Lewin Group –8.6% reduction in hospital utilization for patients with CVD –16.9% reduction in physician visits for patients with CVD –9.5% reduction in hospital utilization for diabetes patients –23.5% reduction in physician visits for diabetes patients