Medicaid Policy & Politics from Coursera

Medicaid is a government program that pays for the healthcare of low-income Americans. In this course, we discuss how the federal government, individual states, and private systems interact to fund, regulate, and deliver healthcare under this system. We establish a basic history and structure under the law, and give a general overview of funding, trends, similarities and differences between states, and some states' attempts to integrate social determinants of health into healthcare. It ends with a more detailed look at the Arizona Healthcare Cost Containment System as an example of one state Medicaid program.

We start at the most basic level, but build upon it to provide a solid overview of the most important aspects of Medicaid policy. This course should be accessible and relevant to anyone new to Medicaid, regardless of whether you have no prior exposure to policy or are a lawyer or seasoned policy analyst.

Our target audience includes: policy advisors, lawyers, advocates, legislators, employees of Medicaid agencies, employees of nonprofits and MCOs, and students.

What's inside

Syllabus

Medicaid and the Government

This first module focuses on how Medicaid fits into government systems, a basic overview of Medicaid, and the historical context. We start with some basics you may already be familiar with, but quickly build upon them as a foundation for understanding where policy decisions are made.

Delivery Systems & Managed Care

Kirin and Asha discuss healthcare delivery systems, focusing on managed care – a delivery system in which third party managed care organizations (MCOs) coordinate care for members and the state Medicaid agency pays MCOs rather than paying providers directly.

State Plans

Kirin and Asha discuss state plans, which are the blueprints for establishing all important details about how a state structures and administers its Medicaid program. We also talk about how state plans can be amended and circumstances under which a state can request permission to "break the rules" using a waiver.

Social Determinants of Health (SDoH)

Kirin and Asha talk about how state Medicaid programs are increasingly going beyond providing traditional healthcare services and adding programs and services that improve member health through things like healthy housing, reliable transportation, and nutritious food.

Medicaid Finance

In this module, Kirin and Asha discuss how the federal contribution to Medicaid funding is calculated, how state budgets work, and what policy arguments are made with regard to Medicaid spending and structure.

Medicaid in Arizona (optional)

Kirin and Asha visit a single state in more depth. Part I gives an overview of the Arizona Healthcare Cost Containment System (AHCCCS), including: the history, structure of the agency, its influence on national trends, the benefits provided, costs, and the dual eligible population. In part II, special guest Markay Adams explains how the tribal healthcare system intersects with Medicaid in Arizona.

Good to know

Know what's good

, what to watch for

, and possible dealbreakers

Introduces participants to the foundational principles of government healthcare programs for low-income individuals

Provides an outline of the interrelationship between government entities, states, and private systems in financing, managing, and delivering healthcare through Medicaid

Covers crucial aspects of Medicaid policy, including funding models, historical context, and the implementation of social determinants of health

Provides a tailored deep dive into the Arizona Healthcare Cost Containment System as an example of a state-level Medicaid program

Suitable for a range of audiences, including policy advisors, lawyers, legislators, nonprofit employees, and students

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 Medicaid Policy & Politics with these activities:

Create a State Medicaid Comparison Chart

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Develop a comprehensive chart that compares the key features of Medicaid programs across multiple states, highlighting similarities and differences.

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Research and gather data on Medicaid programs in different states
Choose relevant categories for comparison, such as eligibility criteria, benefits, and funding sources
Create a table or chart to organize the data and facilitate comparison
Analyze and identify key trends and differences among the states

Explore Resources on Medicaid Managed Care

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Review authoritative sources and tutorials to gain a deeper understanding of Medicaid managed care models and their impact on healthcare delivery.

Browse courses on Healthcare Delivery Systems

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Identify reputable websites and organizations that provide information on Medicaid managed care
Read articles, watch videos, and participate in online discussions to learn about different managed care models
Analyze the advantages and disadvantages of managed care in the context of Medicaid

Analyze Medicaid Case Studies

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Examine real-world Medicaid cases to develop an understanding of how the program operates in different situations and to identify challenges and opportunities.

Browse courses on Healthcare Policy

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Review and analyze case studies provided in the course materials
Identify the key issues and challenges faced in each case
Develop recommendations for addressing the challenges and improving outcomes

Three other activities

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Show all six activities

Attend a Medicaid Policy Workshop

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Participate in workshops led by experts to gain in-depth knowledge and insights on specific Medicaid policy issues or trends.

Browse courses on Healthcare Policy

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Research and identify upcoming Medicaid policy workshops or conferences
Register and attend the workshop, actively participating in discussions and Q&A sessions
Network with other attendees, including policymakers, advocates, and healthcare professionals

Design a Proposal for Medicaid Policy Improvement

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Develop a well-researched and evidence-based proposal that outlines specific policy changes to improve the effectiveness of Medicaid programs.

Browse courses on Healthcare Policy

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Research best practices and innovative approaches in Medicaid policy
Identify areas where Medicaid programs can be improved
Develop and articulate specific policy recommendations, supported by evidence and analysis
Create a comprehensive proposal that includes a rationale, implementation plan, and expected outcomes

Support a Medicaid Advocacy Organization

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Engage with organizations that advocate for Medicaid beneficiaries to gain practical insights into the challenges and opportunities facing the program.

Browse courses on Healthcare Policy

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Identify and contact Medicaid advocacy organizations in your area
Offer your assistance with activities such as outreach, research, or advocacy campaigns
Attend meetings and events to learn about current Medicaid policy issues

Career center

Learners who complete Medicaid Policy & Politics will develop knowledge and skills that may be useful to these careers:

State Medicaid Director

State Medicaid Directors oversee the administration of the Medicaid program in their respective states. This course will help you build a foundation in Medicaid policy, as you will learn about the history, structure, and funding of Medicaid, as well as the role of state governments in administering the program. This knowledge will be invaluable to you as a State Medicaid Director, as you will be responsible for ensuring that the program is implemented in a way that meets the needs of low-income individuals in your state.

See salaries and explore the career path for State Medicaid Director

Health Policy Analyst

Health Policy Analysts research, analyze, and interpret government healthcare policies to assess their effectiveness and impact. This course will help you build a foundation in Medicaid policy, which is a major component of the US healthcare system. You will learn about the history, structure, and funding of Medicaid, as well as the role of state governments in administering the program. This knowledge will be invaluable to you as a Health Policy Analyst, as you will need to be familiar with the healthcare policy landscape in order to make informed recommendations.

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Healthcare Consultant

Healthcare Consultants provide advice and guidance to healthcare organizations on a variety of issues, including policy, strategy, and operations. This course will help you develop the knowledge and skills you need to be successful in this role, as you will learn about the Medicaid program, which is a major player in the US healthcare system. You will also gain an understanding of the healthcare delivery system, managed care, and the role of social determinants of health.

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Healthcare Lobbyist

Healthcare Lobbyists represent the interests of healthcare organizations before government agencies and elected officials. This course will help you build a foundation in Medicaid policy, which is a major component of the US healthcare system. You will learn about the history, structure, and funding of Medicaid, as well as the role of state governments in administering the program. This knowledge will be invaluable to you as a Healthcare Lobbyist, as you will need to be able to advocate for your clients' interests in a complex and ever-changing policy environment.

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Policy Analyst

Policy Analysts research, analyze, and interpret government policies to assess their effectiveness and impact. This course will help you build a foundation in Medicaid policy, which is a major component of the US healthcare system. You will learn about the history, structure, and funding of Medicaid, as well as the role of state governments in administering the program. This knowledge will be invaluable to you as a Policy Analyst, as you will need to be familiar with the healthcare policy landscape in order to make informed recommendations.

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Healthcare Manager

Healthcare Managers plan, direct, and coordinate the delivery of healthcare services in a variety of settings, including hospitals, clinics, and long-term care facilities. This course will help you develop the knowledge and skills you need to be successful in this role, as you will learn about the Medicaid program, which is a major payer for healthcare services in the US. You will also gain an understanding of the healthcare delivery system, managed care, and the role of social determinants of health.

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Public Health Educator

Public Health Educators develop and implement educational programs to promote health and prevent disease in communities. This course will help you develop the knowledge and skills you need to be successful in this role, as you will learn about the Medicaid program, which is a major payer for healthcare services for low-income individuals. You will also gain an understanding of the healthcare delivery system, managed care, and the role of social determinants of health.

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Public Health Researcher

Public Health Researchers conduct research to identify and address health problems in communities. This course will help you develop the knowledge and skills you need to be successful in this role, as you will learn about the Medicaid program, which is a major payer for healthcare services for low-income individuals. You will also gain an understanding of the healthcare delivery system, managed care, and the role of social determinants of health.

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Social Worker

Social Workers provide support and guidance to individuals and families who are facing challenges, including poverty, illness, and mental health issues. This course will help you develop the knowledge and skills you need to be successful in this role, as you will learn about the Medicaid program, which is a major payer for healthcare services for low-income individuals. You will also gain an understanding of the healthcare delivery system, managed care, and the role of social determinants of health.

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Medical Writer

Medical Writers create and edit written materials for a variety of audiences, including patients, healthcare professionals, and the general public. This course will help you develop the knowledge and skills you need to be successful in this role, as you will learn about the Medicaid program, which is a major component of the US healthcare system. You will also gain an understanding of the healthcare delivery system, managed care, and the role of social determinants of health.

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Data Analyst

Data Analysts collect, analyze, and interpret data to identify trends and patterns. This course may be useful to you as a Data Analyst, as you will gain an understanding of the Medicaid program, which is a major payer for healthcare services for low-income individuals. This knowledge will be helpful to you when working with clients who are enrolled in Medicaid or who provide services to Medicaid beneficiaries.

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Accountant

Accountants prepare and maintain financial records, prepare tax returns, and provide financial advice to individuals and businesses. This course may be useful to you as an Accountant, as you will gain an understanding of the Medicaid program, which is a major payer for healthcare services for low-income individuals. This knowledge will be helpful to you when working with clients who are enrolled in Medicaid or who provide services to Medicaid beneficiaries.

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Business Analyst

Business Analysts analyze business processes and systems to identify areas for improvement. This course may be useful to you as a Business Analyst, as you will gain an understanding of the Medicaid program, which is a major payer for healthcare services for low-income individuals. This knowledge will be helpful to you when working with clients who are enrolled in Medicaid or who provide services to Medicaid beneficiaries.

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Attorney

Attorneys represent clients in legal matters and advise them on their legal rights and responsibilities. This course may be useful to you as an Attorney, as you will gain an understanding of the Medicaid program, which is a major payer for healthcare services for low-income individuals. This knowledge will be helpful to you when working with clients who are enrolled in Medicaid or who provide services to Medicaid beneficiaries.

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Actuary

Actuaries use mathematical and statistical techniques to assess risk and uncertainty. This course may be useful to you as an Actuary, as you will gain an understanding of the Medicaid program, which is a major payer for healthcare services for low-income individuals. This knowledge will be helpful to you when working with clients who are enrolled in Medicaid or who provide services to Medicaid beneficiaries.

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