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Population Health

Alternative Payment Models

Jeroen Struijs

The way we currently pay our care providers lead to suboptimal outcomes and unnecessary spending. Consequently, we fail to maximize the value of our health care services. We need to change provider payment models in order to keep health care systems financial sustainability. Doing nothing is not an option. But the question is, how do we do it?

During this course, we will discuss the rationale for payment reforms and dive into the key design elements of Alternative Payment Models (APMs) and how they change care provider incentives. You will learn about a roadmap to design and implement APMs on your own. You will learn about behavioural economics and human behaviour which are essential to advance the design and implementation of APMs. After the course you can apply your sharpened skills to lead change in health care via innovative payment models in order to increase value of health care services.

This course is targeted at a variety of professionals in the healthcare sector in order to realise a common language. Are you a provider, board member, working at a public or private payer or researcher working in the health sector, this course is relevant for you!

This Course is part of the to-be-developed Leiden University master program Population Health Management. If you wish to find out more about this program see the last reading of this Course!

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What's inside

Syllabus

Welcome to Alternative Payment Models

Welcome to the course Alternative Payment models! You’re joining thousands of learners currently enrolled in the course. I'm excited to have you in class and look forward to your contributions to the learning community. To begin, I recommend taking a few minutes to explore the course site. Review the material we’ll cover each week, and preview the assignments you’ll need to complete to pass the course. Click Discussions to see forums where you can discuss the course material with fellow students taking the class. If you have questions about course content, please post them in the forums to get help from others in the course community. For technical problems with the Coursera platform, visit the Learner Help Center. Good luck as you get started, and I hope you enjoy the course!

Why do we need payment reforms?

Why do we need payment reforms? In this module you will learn why payment reforms are useful to increase value of health care services and what the conceptual considerations behind alternative payment models are in general. Moreover, we will back you up with some empirical evidence that providers do respond to changes in financial incentives; both in desired and undesired ways....

What is an Alternative Payment Model?

What is an Alternative Payment Model? In this module we take a closer look at the most prominent APMs; pay for performance, shared savings models, bundled payment and capitation. We will look at the incentives that are linked with each APM-type and the way by which they shift financial accountability.

How to implement Alternative Payment Models?

How to design and implement an APM? In this module you will learn about the roadmap for designing and implementing APMs. You will take a more indepth dive in the six steps of the roadmap. You will gain essential knowledge for designing and implementing APMs yourself!

The role of behavioural economics within APMs

APMs aim to change provider behaviour. Understanding human behaviour is therefore essential. In this module, you will learn about the universal lessons of behavioural economics relevant for designing and implementing APMs, like loss aversion, hyperbolic discounting and nudging. Good luck with your final week!

Good to know

Know what's good

, what to watch for

, and possible dealbreakers

Develops understanding of payment models so as to influence provider behavior using economics and incentives

Explores different types of payment models and their impact on care provider incentives

Provides a roadmap for designing and implementing payment model innovations

Uses case studies and empirical evidence to illustrate core concepts and models

Examines the role of behavioural economics in designing incentive-based payment models

Taught by experienced practitioners in the healthcare sector

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Reviews summary

Apm healthcare models course

Learners say this course provides an insightful introduction to Alternative Payment Models (APM) in healthcare and is well laid out and engaging. Some reviewers say that while the course is helpful, it could benefit from an improved introduction and more real-world examples. Behavioral economics helps to understand APM design and most students gave the course a very positive rating.

Students enjoyed the engaging assignments and clear presentation of the material.

"Very interesting course..."

"A very good introduction to APM"

"Very well laid out course, this is extremely helpful..."

Students said the course was insightful and useful in their work designing APMs.

"Extremely helpful"

"Good theoretical framework on how to approach this problem"

"A good course to be familiar with the new payment models."

Some students said the course would benefit from more real-world examples and a clearer introduction.

"Not very clear for the introduction part."

"Would like more real world example."

"Very interesting course but in really needs a proper introductory overview of the definitions that will be used throughout the course."

Activities

Be better prepared before your course. Deepen your understanding during and after it. Supplement your coursework and achieve mastery of the topics covered in Population Health: Alternative Payment Models with these activities:

Read and synthesize 'Redefining Health Care' by Michael Porter

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Gain insights into the challenges and opportunities in transforming healthcare delivery by understanding the underlying principles outlined in this foundational book.

View The Politics Industry: How Political Innovation... on Amazon

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Read the book 'Redefining Health Care'
Summarize the key takeaways
Apply the concepts to your own work in healthcare

Review key concepts of health care economics

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Solidify your understanding of the principles that drive healthcare economics to help understand the functions of the different entities within the health care system.

Browse courses on Health Care Economics

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Read textbook chapters on health care economics
Attend a seminar on healthcare economics
Review relevant articles on healthcare economics

Attend a conference or webinar on APMs

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Network with professionals in the field and stay abreast of the latest developments in APMs by attending relevant events.

Browse courses on Alternative Payment Models

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Identify relevant conferences or webinars
Register for the event
Attend the event and participate in discussions

Four other activities

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Explore simulating APMs using the APM Toolkit

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Gain hands-on experience in simulating different APM structures to see their effects on provider incentives and health care outcomes.

Browse courses on Alternative Payment Models

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Follow the online tutorials to install and use the APM Toolkit
Identify a specific APM you are interested in simulating
Input the parameters of the APM into the Toolkit
Run the simulation and analyze the results

Analyze data on the impact of APMs

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Develop your analytical skills by examining real-world data to understand how APMs affect various aspects of healthcare.

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Gather data on APM implementation
Clean and prepare the data
Analyze the data using appropriate statistical methods
Interpret the results and draw conclusions

Develop a case study on the implementation of an APM

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Apply your knowledge to a real-world scenario by developing a detailed plan for implementing an APM in a specific healthcare setting.

Browse courses on Case study

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Choose a healthcare setting
Research different APMs
Develop a detailed implementation plan
Write a case study report

Design and propose an innovative APM

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Synthesize your learning by developing a novel APM that addresses a specific healthcare need or challenge.

Browse courses on Alternative Payment Models

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Identify a healthcare need or challenge
Research existing APMs
Design a new APM
Develop a proposal for your APM

Career center

Learners who complete Population Health: Alternative Payment Models will develop knowledge and skills that may be useful to these careers:

Health Policy Analyst

The goal of Health Policy Analysts is to improve the quality of healthcare services provided to patients. To achieve this goal, they work with a variety of stakeholders, including healthcare providers, patients, and policymakers. Alternative Payment Models are a key tool for improving the efficiency and effectiveness of healthcare delivery, and Health Policy Analysts who are familiar with APMs will be well-positioned to develop and implement policies that improve patient care. This course provides a comprehensive overview of APMs, including their history, rationale, and design elements. It will also discuss how behavioral economics can be used to improve the design and implementation of APMs. This knowledge will be invaluable to students who aspire to work as Health Policy Analysts.

See salaries and explore the career path for Health Policy Analyst

Healthcare Consultant

Healthcare Consultants help healthcare organizations improve their performance. They do this by providing advice on a variety of topics, including strategy, operations, and finance. Alternative Payment Models are a major trend in healthcare, and Healthcare Consultants who are familiar with APMs will be able to provide their clients with valuable advice on how to implement them successfully. An understanding of APMs will help you better understand the challenges and opportunities facing healthcare organizations, and will allow you to propose innovative solutions that can help improve patient care and reduce costs.

See salaries and explore the career path for Healthcare Consultant

Healthcare Data Analyst

Healthcare Data Analysts use data to improve the quality and efficiency of healthcare services. They work with a variety of data sources, including claims data, electronic health records, and patient surveys. Alternative Payment Models are generating a lot of new data, and Healthcare Data Analysts who are familiar with APMs will be well-positioned to analyze this data and identify trends that can improve patient care. The Population Health course will provide you with the skills you need to analyze healthcare data and use it to improve patient care.

See salaries and explore the career path for Healthcare Data Analyst

Healthcare Policy Analyst

Healthcare Policy Analysts develop and analyze policies that affect the healthcare system. They work with a variety of stakeholders, including policymakers, healthcare providers, and patients. Alternative Payment Models are a major area of focus for Healthcare Policy Analysts, and those who are familiar with APMs will be well-positioned to develop policies that improve patient care and reduce costs. This course will introduce you to various APM designs and provide you with the tools you need to analyze their pros and cons.

See salaries and explore the career path for Healthcare Policy Analyst

Healthcare Financial Manager

Healthcare Financial Managers oversee the financial operations of healthcare organizations. They are responsible for budgeting, forecasting, and financial planning. Alternative Payment Models are having a significant impact on the financial performance of healthcare organizations, and Healthcare Financial Managers who are familiar with APMs will be well-positioned to lead their organizations through this transition. This course will give you the foundational knowledge of APMs you need to thrive as a Healthcare Financial Manager.

See salaries and explore the career path for Healthcare Financial Manager

Health Economist

Health Economists use economic principles to analyze healthcare issues. They work with a variety of stakeholders, including policymakers, healthcare providers, and patients. Alternative Payment Models are a major area of research for Health Economists, and those who are familiar with APMs will be well-positioned to contribute to the development of policies that improve patient care and reduce costs. This course will provide you with the economic tools you need to analyze healthcare issues and develop evidence-based recommendations.

See salaries and explore the career path for Health Economist

Healthcare Research Analyst

Healthcare Research Analysts conduct research on a variety of healthcare topics, including the effectiveness of different treatments, the impact of healthcare policies, and the patient experience. Alternative Payment Models are a major area of research for Healthcare Research Analysts, and those who are familiar with APMs will be well-positioned to conduct research that can improve patient care and reduce costs. This course will provide you with the research methods you need to conduct healthcare research and disseminate your findings.

See salaries and explore the career path for Healthcare Research Analyst

Healthcare Administrator

Healthcare Administrators oversee the day-to-day operations of healthcare organizations. They are responsible for a variety of tasks, including managing staff, developing policies, and ensuring that the organization is compliant with all applicable laws and regulations. Alternative Payment Models are changing the way that healthcare organizations are managed, and Healthcare Administrators who are familiar with APMs will be well-positioned to lead their organizations through this transition. The course will provide you with the knowledge you need to design a roadmap for implementing APMs in your organization.

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Healthcare Operations Manager

Healthcare Operations Managers oversee the day-to-day operations of healthcare organizations. They are responsible for a variety of tasks, including managing staff, developing policies, and ensuring that the organization is compliant with all applicable laws and regulations. Alternative Payment Models are changing the way that healthcare organizations are managed, and Healthcare Operations Managers who are familiar with APMs will be well-positioned to lead their organizations through this transition. This course will give you the foundational knowledge of APMs you need to thrive as a Healthcare Operations Manager.

See salaries and explore the career path for Healthcare Operations Manager

Health Educator

Health Educators teach people about health and how to make healthy choices. They work with a variety of populations, including children, adults, and seniors. Alternative Payment Models are increasingly being used to reward providers for improving the health of their patients, and Health Educators who are familiar with APMs will be well-positioned to help their patients achieve their health goals. This course will provide you with the knowledge you need to educate patients about APMs and help them make informed decisions about their healthcare.

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Health Insurance Analyst

Health Insurance Analysts work with health insurance companies to develop and implement policies. They analyze data to identify trends and patterns, and they make recommendations on how to improve the efficiency and effectiveness of health insurance programs. Alternative Payment Models are a major area of focus for Health Insurance Analysts, and those who are familiar with APMs will be well-positioned to help their companies develop and implement successful programs. This course will provide you with the knowledge you need to analyze health insurance data and make recommendations on how to improve the efficiency and effectiveness of health insurance programs.

See salaries and explore the career path for Health Insurance Analyst

Health Information Manager

Health Information Managers oversee the management of health information. They are responsible for ensuring that health information is accurate, complete, and secure. Alternative Payment Models are generating a lot of new health data, and Health Information Managers who are familiar with APMs will be well-positioned to manage this data and ensure that it is used to improve patient care. This course will give you the knowledge you need to manage health information and ensure that it is used to improve patient care.

See salaries and explore the career path for Health Information Manager

Healthcare Quality Manager

Healthcare Quality Managers oversee the quality of healthcare services provided to patients. They work with a variety of stakeholders, including healthcare providers, patients, and policymakers. Alternative Payment Models are increasingly being used to reward providers for improving the quality of care they provide, and Healthcare Quality Managers who are familiar with APMs will be well-positioned to help their organizations achieve success under these new payment models. This course will provide you with the knowledge you need to measure and improve the quality of healthcare services.

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Healthcare Risk Manager

Healthcare Risk Managers identify and manage risks to the health of patients and the financial health of healthcare organizations. Alternative Payment Models are changing the way that healthcare organizations are paid for their services, and Healthcare Risk Managers who are familiar with APMs will be well-positioned to help their organizations manage the risks associated with these new payment models. This course will provide you with the knowledge you need to identify and manage healthcare risks.

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Healthcare Compliance Officer

Healthcare Compliance Officers ensure that healthcare organizations comply with all applicable laws and regulations. Alternative Payment Models are complex and evolving, and Healthcare Compliance Officers who are familiar with APMs will be well-positioned to help their organizations comply with all applicable laws and regulations. This course will provide you with the knowledge you need to ensure that your organization is compliant with all applicable healthcare laws and regulations.

See salaries and explore the career path for Healthcare Compliance Officer

Reading list

We've selected 14 books that we think will supplement your learning. Use these to develop background knowledge, enrich your coursework, and gain a deeper understanding of the topics covered in Population Health: Alternative Payment Models.

The Innovator's Dilemma, with a New Foreword

Save

Provides insight into the ways that new technologies can disrupt the healthcare industry, and the ways that legacy companies can respond to these new technologies.

The Innovator's Dilemma, with a New Foreword: When...

Hardcover

The Innovator's Dilemma, with a New Foreword: When...

Audio CD

The Innovator's Dilemma, with a New Foreword: When...

Kindle Edition

Redefining Health Care

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Michael Porter argues that the only way to improve healthcare for the long term is to implement value-based health care delivery and payment. In other words, he argues that the only way out of our current, unsustainable system is to move toward outcomes-based care.

Redefining Health Care: Creating Value-Based...

Hardcover

Redefining Health Care: Creating Value-based...

Kindle Edition

How to Become Famous

Save

Discusses the ways that behavioral psychology can be used to inform public policy and the design of public programs, with an eye towards increasing the impact and scale of these programs.

Population Health

Alternative Payment Models

What's inside

Syllabus

Good to know

Save this course

Reviews summary

Apm healthcare models course

Activities

Career center

Reading list

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