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Gary Young

This course is best suited for individuals currently in the healthcare sector, as a provider, payer, or administrator. Individuals pursuing a career change to the healthcare sector may also be interested in this course.

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This course is best suited for individuals currently in the healthcare sector, as a provider, payer, or administrator. Individuals pursuing a career change to the healthcare sector may also be interested in this course.

This course is the continuation of An Overview of the U.S. Healthcare System course . If you have not yet taken the introductory course, it is recommend that you complete that course prior to this course. The foundational knowledge from the introduction is carried through in this deeper dive into learning about how the U.S. Healthcare System operates.

This course provides an insight into the payment architecture, cost and value of prescription drugs, spending, outcomes, and social accountability of the American Healthcare System. Throughout this course, you will be given the opportunity to evaluate your understanding through engagement in course discussions, application of course concepts to course assignments, and through completion of content quizzes along the way.

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Syllabus

Payment Architecture for Healthcare Services
In this module, we will discuss the basic mechanics of paying for volume and how it affects physician payment. Looking ahead, in the U.S., traditional payment approaches for healthcare providers, such as fee-for-service and per diem payments, are being slowly phased out due to concerns about excessive and unnecessary utilization of healthcare services contributing to rising healthcare costs. Additionally, the US healthcare system is undergoing a slow shift from paying providers for volume to paying them for value, which means they are rewarded or penalized based on their quality of care and efficiency.In this module we will explore these traditional payment arrangements as well as the new methods and developments. We will examine the benefits and drawbacks to the different methods and how they affect provider performance.
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Diffusion of Pricing and Prescription Medications
In this module, we will now focus our attention on the diffusion of pricing and prescription medications in the U.S. Prescription drugs account for over 10% of total healthcare spending in the U.S. and are increasingly important for managing chronic conditions. However, the regulatory process for approving new drugs has long been a source of controversy, with stakeholders contending it is inefficient and contributes to rising drug costs. To better understand these issues, we will explore how drugs are developed and regulated.We will also continue on in our exploration of initiatives addressing the cost and value of prescription drugs in this module. Rising drug costs have been a major concern for both the private and public sectors, with initiatives ranging from value-based contracts to federal and state laws aimed at negotiating drug prices and limiting out-of-pocket expenses for patients. While the impact of many of these initiatives is yet to be evaluated, the hope is that they will ultimately result in affordable access to prescription drugs for all Americans.
Comparative Analysis of Healthcare Systems Around the World
Healthcare financing and delivery vary across the globe, with different approaches to public and private sector involvement, as well as universal health coverage. The U.S. has a mixed model with both public and private sector involvement, but lacks universal coverage, while other countries rely predominantly on either the public-or private-sector with varying levels of out-of-pocket spending. In this module, we will explore the key differences between the U.S. healthcare system and the healthcare systems of other countries. We will examine the advantages and disadvantages of various healthcare systems models and evaluate the performances of these systems. How do you feel currently about your quality of care? Perhaps learning about different models of healthcare delivery around the world will give you a new perspective.
Social Accountability for Healthcare Delivery
In this module, we will examine the tax-exempt status of nonprofit hospitals in the U.S., which generate millions in annual revenue but are exempt from paying income, property, and sales taxes. We will also discuss the qualifications that allow these hospitals to enjoy this favorable tax treatment, and the community benefits they are expected to provide in return. Nonprofit hospitals in the U.S. face a unique challenge of providing community benefits while also competing in a highly competitive market for healthcare services. However, research has found that charitable spending can be a source of competitive advantage, leading to increased customer loyalty and financial benefits. We will reflect on the tax exemptions and community benefits as well as the social accountability for healthcare delivery more in this module.

Good to know

Know what's good
, what to watch for
, and possible dealbreakers
Examines healthcare delivery and financing in the United States, a topic highly relevant to those in the industry
Taught by Gary Young, an expert in healthcare economics and policy
Develops an understanding of the U.S. healthcare system's payment architecture, cost, and value of prescription drugs, spending, and outcomes
Analyzes the diffusion of pricing and prescription medications in the U.S., a critical topic for healthcare providers and policymakers
Compares healthcare systems around the world, providing a broader perspective on healthcare delivery models
Emphasizes the social accountability of healthcare delivery, particularly for nonprofit hospitals

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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 Understanding the U.S. Healthcare Landscape with these activities:
Review Key Concepts from Previous Healthcare Courses
Strengthen your foundation in healthcare concepts to enhance understanding of advanced topics.
Browse courses on Medical Terminology
Show steps
  • Review notes and materials from previous healthcare courses.
  • Focus on core concepts such as anatomy, physiology, and medical terminology.
Review 'Healthcare Finance and Economics' by Sloan and Smith
Review key concepts of healthcare finance and economics to strengthen foundational understanding.
View Melania on Amazon
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  • Read chapters 1-4 of the book.
  • Summarize the main points of each chapter.
  • Create a mind map connecting the key concepts.
Revisit health insurance basics
Refresh your memory on insurance concepts to enhance your understanding of the course material.
Browse courses on Insurance Coverage
Show steps
  • Review terminology and definitions related to health insurance.
  • Explore different types of health insurance plans.
  • Understand the role of deductibles, co-pays, and premiums.
Five other activities
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Show all eight activities
Engage in Online Discussions with Peers
Connect with fellow healthcare professionals and share insights and experiences.
Browse courses on Collaborative Learning
Show steps
  • Join online discussion forums or groups related to the course.
  • Participate in ongoing discussions and ask questions to enhance understanding.
Explore Online Modules on Healthcare Payment Architecture
Enhance your understanding of payment mechanisms and their impact on healthcare delivery.
Show steps
  • Identify reputable websites or online platforms offering tutorials on healthcare payment architecture.
  • Watch videos or read materials on fee-for-service, capitation, and bundled payments.
Conduct a Comparative Analysis of Healthcare Systems
Develop a deeper understanding of global healthcare approaches and identify potential improvements for the U.S. system.
Show steps
  • Select 2-3 countries to compare, focusing on their healthcare delivery models and financing structures.
  • Gather data on key healthcare indicators (e.g., cost, access, quality).
  • Analyze the data to identify similarities, differences, and areas for improvement.
  • Present findings in a written report or infographic.
Prepare a Presentation on Social Accountability in Healthcare
Develop a comprehensive understanding of stakeholders' roles and responsibilities in healthcare delivery.
Show steps
  • Research the concept of social accountability and its application in healthcare.
  • Identify the key stakeholder groups in the healthcare system.
  • Prepare a presentation outlining the roles, responsibilities, and communication strategies for effective stakeholder engagement.
Develop an Infographic on Nonprofit Hospital Tax Exemptions
Convey the complexities of nonprofit hospital tax exemptions and their impact on healthcare delivery.
Show steps
  • Gather data on tax exemptions and community benefits provided by nonprofit hospitals.
  • Create a visual representation of the findings, highlighting key statistics and trends.
  • Share your infographic with relevant stakeholders.

Career center

Learners who complete Understanding the U.S. Healthcare Landscape will develop knowledge and skills that may be useful to these careers:
Quality Improvement Specialist
A Quality Improvement Specialist plans, implements, and evaluates quality improvement programs in healthcare settings. This course would be helpful for someone in this role by providing them with a deep understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, outcomes, and social accountability. This understanding would be essential for someone who wants to plan, implement, and evaluate quality improvement programs in healthcare settings.
Pharmacist
A Pharmacist dispenses medications and provides advice on their use. This course would be helpful for someone in this role by providing them with a deep understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, outcomes, and social accountability. This understanding would be essential for someone who wants to dispense medications and provide advice on their use.
Physician
A Physician provides medical care to patients. This course would be helpful for someone in this role by providing them with a deep understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, outcomes, and social accountability. This understanding would be essential for someone who wants to provide medical care to patients.
Hospital Administrator
A Hospital Administrator plans, directs, and coordinates the operations of a hospital or other healthcare facility. This course would be helpful for someone in this role by providing them with a deep understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, outcomes, and social accountability. This understanding would be essential for someone who wants to plan, direct, and coordinate the operations of a hospital or other healthcare facility.
Health Policy Analyst
A Health Policy Analyst researches and analyzes healthcare policies, and develops recommendations for changes to healthcare policy. This course would help someone in this role by providing them with a deep understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, outcomes, and social accountability. This understanding would be essential for someone who wants to make recommendations for changes to healthcare policy.
Regulatory Affairs Specialist
A Regulatory Affairs Specialist ensures that a company's products and services comply with government regulations. This course would be helpful for someone in this role by providing them with a deep understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, outcomes, and social accountability. This understanding would be essential for someone who wants to ensure that a company's products and services comply with government regulations.
Policy Analyst
A Policy Analyst researches and analyzes public policies, and develops recommendations for changes to public policy. This course would be helpful for someone in this role by providing them with a deep understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, outcomes, and social accountability. This understanding would be essential for someone who wants to research and analyze public policies, and develop recommendations for changes to public policy.
Medical Writer
A Medical Writer writes and edits medical and scientific content, such as journal articles, patient education materials, and marketing materials. This course would be helpful for someone in this role by providing them with a deep understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, outcomes, and social accountability. This understanding would be essential for someone who wants to write and edit medical and scientific content.
Public Health Educator
A Public Health Educator develops and implements educational programs to promote health and prevent disease. This course would be helpful for someone in this role by providing them with a deep understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, outcomes, and social accountability. This understanding would be essential for someone who wants to develop and implement educational programs to promote health and prevent disease.
Healthcare Consultant
A Healthcare Consultant provides advice and guidance to healthcare organizations on a variety of issues, including strategy, operations, and finance. This course would be helpful for someone in this role by providing them with a broad understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, outcomes, and social accountability. This understanding would be essential for someone who wants to provide advice and guidance to healthcare organizations.
Systems Analyst
A Systems Analyst designs and implements computer systems. This course may be useful for someone in this role by providing them with a basic understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, and outcomes. This understanding would be helpful for someone who wants to design and implement computer systems.
Insurance Underwriter
An Insurance Underwriter assesses and evaluates risk in order to determine whether to issue an insurance policy. This course may be useful for someone in this role by providing them with a basic understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, and outcomes. This understanding would be helpful for someone who wants to assess and evaluate risk in order to determine whether to issue an insurance policy.
Social Worker
A Social Worker provides social services to individuals, families, and communities. This course may be useful for someone in this role by providing them with a basic understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, and outcomes. This understanding would be helpful for someone who wants to provide social services to individuals, families, and communities.
Research Analyst
A Research Analyst conducts research and analyzes data to provide insights and recommendations to clients. This course may be useful for someone in this role by providing them with a basic understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, and outcomes. This understanding would be helpful for someone who wants to conduct research and analyze data to provide insights and recommendations to clients.
Statistician
A Statistician collects, analyzes, and interprets data. This course may be useful for someone in this role by providing them with a basic understanding of the U.S. healthcare system, including its payment architecture, cost and value of prescription drugs, spending, and outcomes. This understanding would be helpful for someone who wants to collect, analyze, and interpret data.

Reading list

We've selected six 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 Understanding the U.S. Healthcare Landscape.
Provides a framework for understanding value-based healthcare and offers strategies for implementing value-based initiatives. It valuable resource for healthcare professionals and policymakers who are interested in improving the quality and efficiency of healthcare.
Provides an overview of the social determinants of health and explores the relationship between social factors and health outcomes. It valuable resource for understanding the role of social factors in shaping health and well-being.
Provides a comparative analysis of healthcare systems around the world and explores the different approaches to healthcare financing and delivery. It valuable resource for understanding the strengths and weaknesses of different healthcare systems.
Provides a critical analysis of the U.S. healthcare system and offers a vision for a more equitable and sustainable system. It valuable resource for understanding the challenges facing the healthcare system and for developing solutions to improve the system.
Provides a practical guide to value-based payments in healthcare. It valuable resource for healthcare providers who are interested in implementing value-based initiatives.
Provides a guide to the U.S. healthcare system for consumers. It valuable resource for individuals who are interested in understanding their health insurance options and making informed decisions about their healthcare.

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