Employee health care options

1
Employee health care options

• Karen Pinkonsly,
• Joanna Zahn,
• Steve Arendt,
• Jorge Lopez,
• Laura Golightly

2
BACKGROUND

• UIUC competes for faculty
• Health care insurance is one of most popular
  benefits offered
• Options
• Quality Care Health Plan (QCHP)
• Health Alliance HMO
• Personal Cares HMO

3
PRINCIPAL-AGENT CONTRACTS

• UIUC- Quality Health Care Plan
• UIUC- HMO Health Alliance
• UIUC- HMO Personal Care
• UIUC- Employees
• Employees- Doctors
• Employees- Chosen Health Plan
• Employees- UIUC
• Doctors- Chosen HMOs
• Doctors- Quality Health Care Plan

4
PRINCIPAL UIUCAGENT Health Care Plan

• Principals Interest
• Agents Interest
• Expected behavior of agent if contract is
  incomplete
• Possibility that expected behavior would not be
  taken
• Control system employed to reduce such
  possibility, if any

5
PRINCIPAL UIUCAGENT Health Care Plan

• P high quality, low price
• A make profit, provide quality service
• HCP is expected to perform services if it has
  received compensation
• Incomplete?
• HCP unlikely
• HMOs more likely
• Control System
• HMOs list of preferred providers

6
PRINCIPAL EmployeeAGENT Health Care Plan

• Principals Interest
• Agents Interest
• Expected behavior of agent if contract is
  incomplete
• Possibility that expected behavior would not be
  taken
• Control system employed to reduce such
  possibility, if any

7
PRINCIPAL EmployeeAGENT Health Care Plan

• P high quality, low cost per visit, access to
  specialist
• A profit, provide quality service
• HCP expects to be paid if preformed services
• Incomplete?
• Unlikely HCP would not bill patients
• Control System
• Computer database to show unpaid clients

8
PRINCIPAL Health Care PlanAGENT Doctors

• Principals Interest
• Agents Interest
• Expected behavior of agent if contract is
  incomplete
• Possibility that expected behavior would not be
  taken
• Control system employed to reduce such
  possibility, if any

9
PRINCIPAL Health Care PlanAGENT Doctors

• P large network of doctors
• A pay for services
• Incomplete
• HCP QHCP does not provide payment, unlikely
• HMO doctor hasnt seen patient, unlikely
• Control Systems
• Incentive pools, utilization review, goal
  congruency

10
PRINCIPAL EmployeeAGENT UIUC

• Principals Interest
• Agents Interest
• Expected behavior of agent if contract is
  incomplete
• Possibility that expected behavior would not be
  taken
• Control system employed to reduce such
  possibility, if any

11
PRINCIPAL EmployeeAGENT UIUC

• P high quality health care
• A obtain high quality employees
• Incomplete if
• payment is taken out of paycheck UIUC does not
  pay HCP
• employee does not teach
• Control System
• Labor contracts

12

• Questions?