Healthcare Clinic Case Study: Analysis & Coverage Solutions

This case study examines a nonprofit healthcare clinic in a metropolitan area, focusing on its transition from a volunteer-based free clinic to a fee-charging operation and the challenges it faces regarding health insurance coverage for both its employees and patients. Initially founded by retired healthcare professionals to serve a low-income community, the clinic now grapples with issues such as providing health insurance benefits to its employees and addressing the lack of coverage among its patients. The analysis includes a discussion of the pros and cons of health insurance coverage, available types of coverage, and cost considerations, proposing solutions like Affordable Care Insurance, Free Universal Health Care, and Primary Care Membership. It also explores alternative options to expensive health covers, such as Medical Cost-Sharing Programs and Health Saving Accounts, and strategies for educating the community about available options. The study further touches on the clinic's eligibility for federal grants, considering its initial nonprofit status versus its current operational model.

I Summary of clinic at Metropolitan area.
Metropolitan Area had advert pervert where community member could not afford basic
health. Health Practioners (retired experts and well-wishers) in that Area came up with a
proposal of forming no profitable health care clinic to treat their people, a Suggestion of each
member to contribute $10,000 was made and they managed to raise $100,000.The collected
amount was used to facilitate the running of the clinic. They managed to set up a clinic in one of
unused build of the church. Health facility in the area donated unused tools to help in the
operation of non- profitable clinic, other members agreed to work for free and to be donors. The
main objective of the clinic was to give back to the community despite of their financial status.
Majority of people living in the area were youth with young families, no, permanent job and
no health covers .The elderly moved to the community because accommodation was affordable.
Majorities of members in community are uninsured and undocumented and some were able to
pay for health services and others were not. After a decade of operation a number of changes
took place, the founders of organization stepped down for the youths to take up responsibility of
the clinic. Initially services were for free but only little cost was made, due to increases of
expenditures the clinic started charging the patient. A group of new employees were recruited as
part timers to tackle the increase number of patients.Dispite new management running the clinic
and charging patients they faced various challenges unlike previous management which was
appreciated by community.

II Analysis of Clinic in Metropolitan Area and proposing solution to problems.
Pro and cons of coverage.
Pros
According to Howell (2017) explained that have advantages to patients using it and health
cover instill confident to patients using it because they seem to be safe. Health Covers helps
patients to access quality medical service at affordable cost, this helps to improve quality of
treatment at clinic. Due to flexibility of covers customization can be done to make them
affordable by removing extra offers which patients do not require. Cover makes patients
comfortable because they know in case of any illness or emergency insurance cover will
handle it.
When new management took over to run the clinic community members, new management
started charging community due to increase of charge the option a community can use to get
quality health care is Medical cover. Medical cover helps family to be relieved when it comes to
expensive treatment of critical diseases like cancer which need expensive treatment. Health care
cover encourages patients to save for their treatment in advance by making monthly or yearly
contribution of small amount they have. This is a solution and very applicable to area like
metropolitan where people do not have art of save what they get is hand to mouth.
Cons
According to Jernigan (2017) explained that covers has got its negative side which involves
with the cost of pay in the long run it becomes expensive. Health covers are expensive because
patients have to pay for them expensively through the year this limits poor people to afford
it.The covers terms are difficult to understand this makes it confusing. Cheap covers are only
limited to some specific services this makes it of no use.Techical terms of medical cover are
difficult to understand if someone is not educated. Majority of people living in metropolitan
are poor and unemployed this makes them not to afford basic education so their understanding
about medical cover and technical terms of cover like pool and premium can be so hard for
them. Another con is most insurance companies do not full cover(100%) for insured services
for example when someone is ill they incur a lot of expenses laboratory tests, scanning and x
ray .This expenses sometime health insurance company pay.

Cover available for clinic to use.
According to Niemann (2018) explained that there are many covers available to choose the
best depends with the service cover offers.
Affordable Care Insurance
This type of health insurance covers basic health for people who cannot managed other covers.
Employer-Based Insurance.
This covers targets employed people and the company or organization they work in mostly offers
for them
Free Universal Health Care.
This cover is mostly offered by government to its citizens.
Preferred Provider Organization (PPO).
This plan enable workers to choose a medical expert or clinic to treat them and payment is made
before using services. Patients can use this plan because it requires a small pay when seeking
medical care.
Exclusive Provider Organization (EPOs).
This cover mostly employees in an organization and not outside.
Health maintenance organizations (HMO).
Organization come together give medical service to patients who are insured this policy can be
of help to the area in case study because expert formed an organization to offer medical care.
Point-of-service (POS).
It provides services of both Preferred Provider Organization and Health maintenance
organizations.
The cost option, amount to pay or works to do cost sharing and employee’s amount to paid.
According to data extracted from the ValuePlenguin website, LendingTree (2019) stated that
HMO, POS and PPO annual premium is $2, 764, $2,928 and $3,019 respectively. General the
cost of cover depends on the type of cover someone takes and what someone earns. The Cost
will be determined according what employee earns and standard of living poor will pay less and
rich more. Rich should pay some cover for poor ones to share cost.

Most important cover Option for clinic to use.
Affordable Care Insurance. This can be a good option to the poor community because it
enables then to access basic health care by paying little amount.
Free Universal Health Care is best option because a state can decide to provide cover for all
its citizens. According to Ireland (2018) explained that free universal health care is good but has
its advantages because some service are not insured. Most people in the area are poor so
employment covers or plans are not encouraged it this case.
Preferred Provider Organization (PPO).It will enable poor people to choose expert they can
afford to pay for their services.
Health maintenance organizations and Point-of-service (POS) are import plans for
organization to select.

III Board of members’ Decisions:
According to Neeman (2018) explained that there are some measures or alternatives taken for
the expensive health covers.
Primary Care Membership. It is concerns about members of a community coming to get to
contribute towards a cover.
Medical Cost-Sharing Program. It is where clinic managers enable poor patients to pay what they
can afford and clinic management can take care of other costs.
Medical Services Discount Card Offers some medical services at discount and issuing patient
with discount card to enable them access those services
Health saving account. It is good to encourage patients to save for their health.
Pros and cons of option cover.
Pros.
Patients uses this options when they want to save some money to avoid yearly payment of
covers.
It is cheap option of being insured because some cost are paid.
Cons
They make someone dependent and lazy, patients do not work hard to cover themselves
Medical Cost-Sharing Program is not best because it encourages someone not to work hard.
Assisting patient to learn option to be used unsteady covers.
Sensation of patient about option they can use unsteady of expensive medical cover by telling
them importance and available option for them to understand and make use of them.
The clinic can organize a free medical camp and use that as opportunity to educate community
about option of medical cover.
Making adverts to local Television stations, Radios and newspaper can be importance to
community because they can access information you are to inform them. Clinic can make
billboards and distribute fliers within metropolitan area.

How to qualify for Federal grants.
Initially while old management was operating the Clinic .It could be afford to apply for
federal grants because it had qualification for grant. The Clinic started as non-profitable
organization to help poor people in the community who cannot afford basic health care this is
one of the requirement for a clinic to get federal grant. The church donated building and initial
tools to start a clinic were donated by other health facilities in the area grant can be given also
basing on this. Health experts is the area volunteered to work for free at the clinic.
After getting new management taking over to get Federal grants might be difficult because new
management started charging community members. According to Rural health information Hub
website (2019) states that organization to qualify for grant organization should not be for making
profits.

Reference.
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