Description
This course will review the drivers of healthcare cost and solutions that have been proposed to address cost, quality and value of health care. Many point blame for high costs on payment models that pay healthcare providers for every service they provide to patients, essentially paying more for volume and service intensity. This is called a Fee for Service (FFS) payment model. Some solutions, arguably the more sustainable solutions, are the combined strategies of new payment models, care management, insurance plan designs, consumer engagement tools, and technology.
Knowledge
- Identify the drivers and trends of healthcare spending from the perspective of various stakeholders.
- Critically assess the impact of strategic and financial approaches that have been put in place by the ACA and the various modifications.
- Evaluate how healthcare payment models currently work and the new direction that value-based payment is taking.
- Identify how financial and non-financial metrics can be appropriately combined to improve a healthcare stakeholders’ value proposition.
Outline
- Current Healthcare Spend and Trend
- Course Introduction
- Introduction to Module 1
- What's the Fuss? Part 1
- What's the Fuss? Part 2
- Stakeholders
- Healthcare Differs from Other Transactions
- Sources of Funds
- Uses of Funds
- Healthcare Spend
- Healthcare Trend
- Article Intro: "Cost Conundrum"
- Consumer Perspective: Person-on-the-Street Interview: Cathy
- Consumer Perspective: Person-on-the-Street Interview: Keith
- The Cost Conundrum
- Check Your Knowledge
- Check Your Knowledge
- Week 1 Quiz (Graded)
- I Thought we were done with this: Insurance Markets
- Week 2 Introduction
- How Does Insurance Work?
- Risk Pooling
- Selection Impact on Risk Pools and Premium Costs
- Background on U.S. Health Insurance
- Affordable Care Act
- Access to Insurance
- Interview with Mark Guanya: Part 1
- Medicare Changes
- Insurance Sources
- Benefits
- Article Introduction: "The Bitter Pill"
- The Bitter Pill
- Check Your Knowledge
- Check Your Knowledge
- Week 2 Quiz (Graded)
- Value-Based Payment Models
- Week 3 Introduction
- Contractual Reforms to Address Cost and Trend
- Managed Care
- Article Introduction: Dealing with Medical Practice Variations
- Fee-for-Service Payment Models
- Bundled Payments
- Healthcare Differences
- Medical Homes
- Capitation or Salary
- Reference Pricing and the Consumer
- What Drives Results?
- Interview with Mark Guanya: Part 2
- Dealing with Medical Practice Variations: A Proposal for Action
- CMS Vignettes
- Check Your Knowledge
- Check Your Knowledge
- Week 3 Quiz (Graded)
- Evolving Integrated Models: Putting It All Together
- Week 4 Introduction
- Congestive Heart Failure (CHF)
- Article Introduction
- Spine Care
- Bundles
- Article Introduction
- Iora Health
- Course Summary
- Overkill: An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?
- The Last Company You Would Expect is Reinventing Health Benefits
- Check Your Knowledge
- Check Your Knowledge
Summary of User Reviews
This course on healthcare payment models has received positive reviews for its comprehensive coverage and practical applications. Users have found it helpful for understanding the complexities of healthcare financing and payment systems.Key Aspect Users Liked About This Course
Comprehensive coverage of healthcare payment modelsPros from User Reviews
- In-depth exploration of payment models and their impact on healthcare systems
- Real-world examples and case studies for practical application
- Engaging and knowledgeable instructors
- Access to supplementary resources and materials
- Interactive assignments and quizzes for active learning
Cons from User Reviews
- Content can be dense and technical at times
- Limited discussion of global healthcare systems
- Some users found the course pace to be slow
- More focus on policy implications than individual practice
- Course may not be suitable for those with limited healthcare background
Rina Vertes
4.5 Raiting
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