please help with final submission of project. below is what i have so far and the attached is what im suppose to have. 1. Why did America's earliest health insurance companies start out there? What were the first motivating elements? Describe the US's early development of health insurance. - Lack of Access to Healthcare: Before the widespread availability of health insurance, access to healthcare was limited for many Americans, especially those in lower-income groups. Medical care was often expensive, and individuals had to pay for it out of pocket, which could lead to financial hardship in the event of illness or injury.

2. Explain the theory of insurance, by specifically addressing the degree of risk aversion, the size of the potential loss, and the "wealth effect". - Risk aversion refers to the tendency of individuals to prefer certainty over uncertainty when it comes to financial outcomes. In other words, people are generally willing to pay a premium (insurance premium) to avoid the uncertainty and potential financial hardship associated with a loss.

3. What is meant by the "HMO Effect" versus "Favorable Selection" in managed care? Describe the evidence of an HMO Effect, and the evidence of Favorable Selection. -The HMO Effect refers to the hypothesis that individuals who enroll in HMOs or similar managed care plans tend to use healthcare services more efficiently and cost-effectively than those with traditional fee-for-service insurance.

4. What are deductibles? Why are they so important in US health insurance models? How do changes in deductibles impact utilization and clinical decision-making. -Deductibles are predetermined costs associated with insurance policies that the insured person must pay before the insurance provider pays any claims. Because they are fixed costs that must be paid before insurance companies can pay out benefits, they are crucial to US health insurance models. If your deductible is low, your premium will be high, and vice versa.

5. Discuss the Utilization Management function in managed care, including Preadmission Certification and Concurrent Review of services. -Cost Sharing: Deductibles are a form of cost sharing between the insurance company and the policyholder. They require individuals to bear some of the initial healthcare expenses, which can help control insurance premiums and overall healthcare costs.

6. Discuss the emerging role of Disease Management (DM) and Intensive Case Management in American managed care. How does DM actually work? -Disease Management; Definition: DM is a proactive and systematic approach to managing the care of individuals with chronic diseases or conditions, such as diabetes, heart disease, asthma, or chronic obstructive pulmonary disease (COPD). The goal is to optimize patient outcomes while controlling costs.

8. Describe the commonly used approaches to "underwriting" for healthcare services. -Individual Assessment: In medical underwriting, insurance companies assess the health status and medical history of individual applicants. This process typically involves reviewing medical records, conducting medical exams, and evaluating pre-existing conditions. 9. Do hospitals actually have "monopoly power" today? Why or why not? -Market Concentration: Hospital markets vary in terms of concentration. In some regions, there may be a single dominant hospital system or a small number of large healthcare providers that effectively control the market. This concentration can lead to market power and potentially result in higher prices and reduced competition.

10. Explain risk adjustment in the Affordable Care Act. How well does this approach work in your view? -Risk Adjustment Formula: To address this, the ACA introduced a risk adjustment program. Under this program, insurers submit data on the health status of their enrollees. The federal government uses a risk adjustment formula to assess the relative health risk of each plan's enrollees. Plans that enroll sicker individuals receive payments from plans that enroll healthier individuals.

References Alpha51 Inc. (n.d.). Your Source For Benefits. Retrieved November 24, 2019, from https://www.groupbenefits.ca/group-insurance/renewal-analysis/underwriting-methods. Morrisey, M. A. (2014). Health Insurance Second Edition. Chicago, IL: Health Administration Press Semanskee, A., Claxton, G., & Levitt, L. (2016, October 5). Explaining Health Care Reform: Risk Adjustment, Reinsurance, and Risk Corridors. Retrieved November 24, 2019, from https://www.kff.org/health-reform/issue-brief/explaining-health-care-reform-riskadjustment-reinsurance-and-risk-corridors/.

Objectives This HSM420 Course Project provides you with an opportunity to select one important health insurance, managed care, or healthcare reform challenge (or problem to solve), analyze it in greater depth in a written format, and summarize it in a presentation. Paper: The paper will critically analyze the issues related to your topic within the context of the current healthcare environment, and will also consider future directions n U.S. medical care. Web references, books, and professional journal articles should be considered as references. And don't overlook the Devry Online Library as an important source of information for your paper! Pay particular attention to the accurate citation of research sources and be sure to cite sources as you go, or inserting them later will be extremely difficult and time consuming Guidelines Your paper should be 7-10 pages in length (excluding cover and references pages), with 12-point Times font, double-spaced with one inch margins, running head, and page numbers - all in accordance with APA formatting. Include a cover page, table of contents, introduction, body of the report, summary/conclusion, and references page. Even though this is not a scientific writing assignment, and is mostly creative in nature, references are still very important. At least six authoritative outside references are required. These should be listed on the last page, titled References. Appropriate citations are required. All Devry University policies are in effect, including the plagiarism policy. Papers are due during Week 7 of this course. Any questions about this paper may be discussed in the weekly Q & A Discussion topic. Possible Course Topics Pros and Cons of Managed Care in America Challenges in Managing Health Maintenance Organizations (HMOS) Challenges in Managing Preferred Provider Organizations (PPOs) Problems in Network Contracting for Managed Care Legal Issues Associated With Managed Care Contracting Challenges in Utilization and Case Management in Managed Care Approaches to Disease Management in Managed Care Managing Quality Improvement in Managed Care Achieving Effective Marketing and Sales in Managed Care Achieving and Maintaining Accreditation in Managed Care Preventing Fraud and Abuse in Managed Care Complying With State and Federal Regulation of Managed Care Problems in Medicare Managed Care Problems in Medicaid Managed Care Effective Information Systems in Managed Care Challenges in Patient Relations for Managed Care Challenges in Provider Relations for Managed Care The COVID-19 crisis of 2020 and Managed Care NOTE: Other topics related to course content and COs are acceptable, but only as approved in advance by your professor.Milestones The Course Project is worth 370 points (150 for the Course Project topic and Course Project outline, 50 for the Peer Review and 170 for the final Course Project) Topic and Outline (Week 2): 150 points It is expected that you will provide a focused topic, including a statement of the key challenges or problems currently associated with the topic in America. It is expected that the outline be submitted in a formal outline format as demonstrated below. Your outline should show enough detail to demonstrate that you have begun thinking about the organization of your paper and the research required into the topic. After your outline, please submit a listing of the sources you have already identified for your paper. I. Each Roman numeral should be a main section of the paper. A. Subpoint d to the Subpoint 1. Details of Subpoint B. Subpoint Peer Review Discussion (Week 5): 50 Points (An additional Discussion Board for week 5) You will attach your final -draft- paper to a discussion posting in Week 5. Please make sure to do this prior to Wednesday of Week 5. You will then find two other projects to review in the Week 5 Peer Review Discussion and submit your critiques in a discussion post. Final Paper (Week 7): 170 points It is expected that the final version of your Paper will be 7-10 pages in length (excluding cover page, references page, and any appendices), with 6-8 sources identified. APA in-text citation is required in addition to listing all of your sources on a works cited page at the end of the document. Your grade will be affected if you do not cite or identify your sources correctly. Sections of Your Project Your final paper must include the following sections in addition to a cover page and table of contents. It may also include other sections if you deem it necessary and appropriate. I. Introduction Il. Background Ill. Define the Challenges and Problems Associated With Your Topic IV. Review of the Literature V. Challenges/Problems Analysis VI. Recommend Solutions VII. Implementation of Solutions VIII. Justification IX. Summary and Conclusion X. Works Cited Your presentation must summarize your paper in a professional manner that would be appropriate to present to a Board of Directors. Best Practices The following are the best practices in preparing this paper.Best Practices The following are the best practices in preparing this paper. 1. Cover Page-Include who you prepared the paper for, who prepared it, and the date. 2. Table of Contents-List the main ideas and section of your paper and the pages in which they are located. The illustrations should be included separately. 3. Introduction-Use a header on your paper. This will indicate you are introducing your paper. The purpose of an introduction or opening: 1. Introduce the subject and why the subject is important 2. Preview the main ideas and the order in which they will be covered. 3. Establish a tone of the document. Include in the introduction a reason for the audience to read the paper. Also, include an overview of what you are going to cover in your paper and the importance of the material. (This should include or introduce the questions you are asked to answer on each assignment.) Body of Your Report-Use a header titled with the name of your project. Example: "The Development of Hotel X-A World Class Resort." Then proceed to break out the main ideas. State the main ideas, state major points in each idea, and provide evidence. Break out each main idea you will use in the body of your paper. Show some type of division, such as separate sections that are labeled; separate groups of paragraphs; or headers. You would include the information you found during your research and investigation. Sections for the HSM420 Course Project are as follows. Background Define the Challenges and problems associated with your topic Review of the literature Challenges/problems analysis . Recommended solutions Implementation of solutions * Justification Summary and Conclusion-Summarizing is similar to paraphrasing but presents the gist of the material in fewer words than the original. An effective summary identifies the main ideas and major support points from the body of your report Minor details are left out. Summarize the benefits of the ideas and how they affect the industry. Work Cited-Use the citation format as specified in the Syllabus. Additional hints on preparing the best possible project are below. 1. Apply a three-step process of writing: plan, write, and complete. 2. Prepare an outline of your research paper before you go forward. 3. Complete a first draft, and then go back to edit, evaluate, and make any changes required. 4. Use visual communication to further clarify and support the written part of your report. You could use example graphs, diagrams, photographs, flowcharts, maps, drawings, animation, video clips, pictograms, tables, and Gantt charts