开始时间: 12/21/2023 持续时间: 未知
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所在平台: Coursera |
课程主页: https://www.coursera.org/learn/healthcare-payment-models
课程评论：没有评论
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. Using that information we will explore various situations, showcasing coordinated care and payment strategies that can be implemented to improve patient health and the cost of delivery of healthcare services. By the end of this course, the learner should be able to: 1. Identify the drivers and trends of healthcare spending from the perspective of various stakeholders, including medical providers, insurers, government and private purchasers and payments 2. Critically assess the impact of strategic and financial approaches that have been put in place by the ACA and the various modifications. 3. Evaluate how healthcare payment models currently work and the new direction that value-based payment is taking. 4.Identify how financial and non-financial metrics can be appropriately combined to improve a healthcare stakeholders’ value proposition.
Name:Current Healthcare Spend and Trend
Description:This week's focus will be on understanding the various stakeholders in healthcare. We will review the "math" surrounding healthcare costs and how it can fluctuate. Healthcare drivers will be reviewed to identify trends. As you move through the weekly material, I encourage you to think about the impact that the drivers have on the delivery of the healthcare services.
Name:I Thought we were done with this: Insurance Markets
Description:This week we will describe the various elements which underline health insurance within the United States. For example, third party payment structures and risk pooling, to name a few. This week we will focus some time on the Affordable Care Act (ACA) which is a very complex piece of legislation. Special attention will be made on provisions of the ACA that impact insurance markets, financing, healthcare costs, and payment models.
Name:Value-Based Payment Models
Description:This week will continue to "follow the money". We will focus much of our attention on the shortcomings of a Fee-for-Service payment model. Our attention will shift to alternative payment models that have been implemented, allowing for certain comparisons to be made. Lastly, we will review some results that have been achieved because of the new payment models. This week I will leave you by asking, If we know that the Fee-for-Service payment model is dysfunctional, why is it continuously used?
Name:Evolving Integrated Models: Putting It All Together
Description:This week we shift our focus from reviewing current payment models and strategies to applying some of the models and concepts to "real-world" scenarios. We will use fictitious examples, as well as published articles to bring together all of the concepts. As with most things, there is not one single answer to solving the healthcare cost, quality, and value problems. I encourage you to think "outside of the box" and as always, "follow the money!"
本课程将回顾医疗保健成本的驱动因素以及为解决医疗保健的成本、质量和价值而提出的解决方案。许多人将高成本归咎于医疗保健提供者为他们向患者提供的每项服务支付费用的支付模式，本质上是为数量和服务强度支付更多费用。这称为服务费 (FFS) 支付模式。一些解决方案，可以说是更可持续的解决方案，是新支付模式、护理管理、保险计划设计、消费者参与工具和技术的综合策略。我们将利用这些信息探索各种情况，展示可以实施的协调护理和支付策略，以改善患者健康和医疗保健服务的交付成本。在本课程结束时，学习者应该能够： 1. 从各种利益相关者的角度确定医疗支出的驱动因素和趋势，包括医疗提供者、保险公司、政府和私人购买者和支付 2. 批判性地评估医疗支出的影响ACA 实施的战略和财务方法以及各种修改。 3. 评估医疗支付模式目前的运作方式以及基于价值的支付的新方向。 4.确定如何适当地结合财务和非财务指标，以改善医疗保健利益相关者的价值主张。
