0To prepare for this Discussion: Review the materials on critical reading strategies and on the MEAL plan for paragraphs.Read the provided article in the Learning Resources, taking note of where the a

       Employers with more than 50 employees are not eligible to provide coverage for their employees through the Small Business Health Options Program (SHOP, n.d.). An employer with 50 or more employees is expected to provide coverage (SHOP, n.d.). Coverage will need to be a cost effective option for all with additional coverages or options for those with chronic issues. The Affordable Care Act states that individuals are expected to have coverage or face a tax penalty (SHOP, n.d.)

        The tribe I currently work for practices this for insurance coverage. The insurance policy includes relatively competitive options with a standard deductibles. American Indian populations historically have a rate of diabetes within the population per capita. The tribe had to find a viable option for those with chronic diabetes. The route the tribe took was to find additional providers for this population that specialize in specific coverages for the chronically ill. The cost of coverage has not increased substantially within the past few years. There are different tiers of coverage and the options provided suit the diversity of the employee base. There is little “cost sharing” for high value treatments as described by Baicker and Levy (2015). 

        A higher deductible/ lower premium tier for the “healthy” group would be a viable option. Financial incentives for this group would also decrease cost to individuals. This would prevent adverse reaction from occurring, because it would encourage healthier lifestyle and prevent this population from declining coverage. At the same time financial incentives would encourage those who are considered a “moral hazard” to improve lifestyle. 
                                                               

                                                                     References

Baiker, K., & Levy, H. (2015). Cost sharing as a tool to driver higher-value care. JAMA Internal

        Medicine, 175 (2), 399-400.

Getzen, T. (2015). Health economics for the healthcare administrator (Laureate custom edition). 

        New York: Wiley.

Sommers, B. D., Musco, T., Finegold, K., Gunja, M. Z., Burke, A., & McDowell, A. M. (2014). Health

         reform and changes in health insurance coverage in 2014. Waltham, MA: New England Journal  

         of Medicine.

Small Business Health Options Program (SHOP). (n.d.). Http://www.healthcare.gov/employers