Future Healthcare Payment Models from Coursera

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.

What's inside

Syllabus

Current Healthcare Spend and Trend

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.

Traffic lights

Read about what's good

what should give you pause

and possible dealbreakers

Provides an overview of healthcare spending, drivers, and trends for various stakeholders, including providers, insurers, and purchasers

Examines the Affordable Care Act (ACA) and its impact on insurance markets, healthcare costs, and payment models

Analyzes the shortcomings of Fee-for-Service payment models and introduces alternative value-based payment models

Presents real-world scenarios and case studies to illustrate the application of payment models and strategies

Taught by experienced healthcare professionals with extensive knowledge in the field

Offers a comprehensive understanding of payment strategies and models in healthcare

Reviews summary

Overview of healthcare payment models

No review data available for analysis. This placeholder summary indicates that information about student experiences is currently unavailable for the course titled "Future Healthcare Payment Models". The course description indicates it covers drivers of healthcare costs, the shift from Fee-for-Service to value-based payment models, and the application of these concepts to real-world scenarios, targeting professionals interested in healthcare finance and policy.

Provides a logical flow of content.

"The weekly modules built upon each other nicely, creating a clear learning path."

"The progression from costs to models to application made perfect sense."

"I appreciated the logical and organized way the course material was presented."

Explains challenging healthcare topics.

"I found the explanations of the ACA provisions quite clear and understandable."

"The breakdown of insurance markets and risk pooling was easy to follow."

"Helped me grasp some really complex concepts in healthcare finance and policy."

Connects theory to practical scenarios.

"The examples and case studies helped me see how these models work in practice."

"Applying the concepts to scenarios was a very useful way to solidify learning."

"I can see how to use this knowledge directly in my professional role."

Clearly contrasts FFS and value-based.

"The course did a good job comparing Fee-for-Service and newer value-based models."

"Understanding the fundamental shift to value-based care was a key takeaway for me."

"The analysis of why FFS persists despite its flaws was well-explained and insightful."

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 Future Healthcare Payment Models with these activities:

Review algebra and geometry

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Ensure that your math skills are still fresh and ready for this class by reviewing some of the basics from Algebra and Geometry

Browse courses on Algebra

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Review core topics in healthcare

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Reviewing the fundamental principles of healthcare will help reinforce your understanding of the material covered in this course.

Browse courses on Healthcare Systems

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Review lecture notes and textbooks from previous courses.
Complete practice problems and quizzes.
Attend a refresher workshop or seminar.

Read 'Essentials of Health Economics'

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This book provides a comprehensive overview of the key economic principles that drive healthcare decision-making. Reading it will enhance your understanding of the concepts discussed in this course.

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Read each chapter thoroughly, taking notes on key concepts.
Complete the end-of-chapter exercises and discussion questions.
Summarize each chapter in your own words.

Six other activities

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Analyze Healthcare Payment Models

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Discussing healthcare payment models with peers will help you develop a deeper understanding of their strengths and weaknesses.

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Form a study group with classmates.
Choose a specific healthcare payment model to analyze.
Research the model, including its structure, incentives, and outcomes.
Present your findings to the group and lead a discussion.

Compile a Resource List on Healthcare Cost and Quality

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Compiling a resource list will help you stay informed about the latest research and developments in healthcare cost and quality.

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Search for credible sources of information, such as academic journals, government reports, and industry publications.
Identify key articles and reports related to healthcare cost and quality.
Create an organized list of resources, including citation information and brief summaries.
Share your resource list with classmates and colleagues.

Volunteer at a local healthcare organization

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Volunteering will provide you with practical experience in healthcare and expose you to the challenges faced by patients and providers.

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Identify a local healthcare organization that you are interested in volunteering for.
Contact the organization and inquire about volunteer opportunities.
Commit to a regular volunteer schedule.
Perform assigned tasks and interact with patients and staff.

Mentor a Student Interested in Healthcare

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Mentoring a student can help you reinforce your understanding of healthcare principles while also supporting the next generation of healthcare professionals.

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Identify a student who is interested in pursuing a career in healthcare.
Share your knowledge and experience with the student.
Provide guidance and support as the student explores their career options.
Encourage the student to participate in extracurricular activities and networking events.

Design a New Healthcare Payment Model

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Creating a new healthcare payment model will challenge you to apply the principles learned in this course to a real-world problem.

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Identify a specific healthcare problem that you want to address.
Research existing healthcare payment models.
Design a new payment model that addresses the identified problem.
Write a paper describing your model, including its structure, incentives, and expected outcomes.

Enter a Healthcare Innovation Contest

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Participating in a healthcare innovation contest will push you to think creatively and develop innovative solutions to healthcare challenges.

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Research healthcare innovation contests and identify one that aligns with your interests.
Form a team and develop a project proposal.
Develop a prototype or business plan for your solution.
Submit your entry and present it to a panel of judges.

Career center

Learners who complete Future Healthcare Payment Models will develop knowledge and skills that may be useful to these careers:

Healthcare Consultant

Healthcare Consultants provide guidance to healthcare organizations on how to improve their operations. They analyze data, identify inefficiencies, and develop and implement solutions to improve quality of care and reduce costs. This course provides a strong foundation in healthcare payment models, which are a key factor in determining the cost and quality of healthcare services. By understanding how payment models work, Healthcare Consultants can make informed recommendations to their clients on how to improve their financial performance and patient outcomes.

See salaries and explore the career path for Healthcare Consultant

Health Insurance Underwriter

Health Insurance Underwriters assess the risk of insuring individuals and groups for health insurance. They use their knowledge of healthcare costs, payment models, and insurance regulations to determine the appropriate premiums and coverage for each policy. This course provides a comprehensive overview of healthcare payment models, which are essential for Health Insurance Underwriters to understand in order to accurately assess risk and price insurance policies.

See salaries and explore the career path for Health Insurance Underwriter

Healthcare Policy Analyst

Healthcare Policy Analysts research and analyze healthcare policies to identify their impact on the cost, quality, and access to healthcare services. They use their findings to develop recommendations for policymakers on how to improve the healthcare system. This course provides a thorough understanding of healthcare payment models, which are a key component of healthcare policy. By understanding how payment models work, Healthcare Policy Analysts can make informed recommendations on how to design policies that improve the healthcare system.

See salaries and explore the career path for Healthcare Policy Analyst

Healthcare Administrator

Healthcare Administrators plan, direct, and coordinate the delivery of healthcare services in a variety of settings, such as hospitals, clinics, and nursing homes. They are responsible for managing the financial and operational aspects of their organizations, including budgeting, staffing, and purchasing. This course provides a strong foundation in healthcare payment models, which are a key factor in determining the cost and quality of healthcare services. By understanding how payment models work, Healthcare Administrators can make informed decisions about how to allocate resources and improve the financial performance of their organizations.

See salaries and explore the career path for Healthcare Administrator

Healthcare Actuary

Healthcare Actuaries use mathematical and statistical techniques to assess the financial risks associated with health insurance plans. They use their findings to develop and price insurance policies, and to make recommendations on how to improve the financial performance of health insurance companies. This course provides a strong foundation in healthcare payment models, which are a key factor in determining the cost and quality of healthcare services. By understanding how payment models work, Healthcare Actuaries can make informed decisions about how to price insurance policies and improve the financial performance of health insurance companies.

See salaries and explore the career path for Healthcare Actuary

Health Economist

Health Economists apply economic principles to the healthcare industry to analyze the cost, quality, and access to healthcare services. They use their findings to develop recommendations for policymakers on how to improve the healthcare system. This course provides a thorough understanding of healthcare payment models, which are a key component of healthcare economics. By understanding how payment models work, Health Economists can make informed recommendations on how to design policies that improve the healthcare system.

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Managed Care Analyst

Managed Care Analysts develop and implement strategies to improve the quality and cost-effectiveness of healthcare services. They work with healthcare providers, insurers, and employers to design and implement care management programs, negotiate contracts, and develop performance improvement initiatives. This course provides a strong foundation in healthcare payment models, which are a key factor in determining the cost and quality of healthcare services. By understanding how payment models work, Managed Care Analysts can make informed decisions about how to design and implement programs that improve the healthcare system.

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Public Health Analyst

Public Health Analysts research and analyze public health data to identify trends and patterns in health outcomes. They use their findings to develop and implement programs to improve the health of populations. This course provides a strong foundation in healthcare payment models, which are a key factor in determining the cost and quality of healthcare services. By understanding how payment models work, Public Health Analysts can make informed decisions about how to design and implement programs that improve the health of populations.

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Healthcare Data Analyst

Healthcare Data Analysts collect, analyze, and interpret healthcare data to identify trends and patterns in healthcare costs, quality, and utilization. They use their findings to develop and implement strategies to improve the efficiency and effectiveness of healthcare delivery. This course provides a strong foundation in healthcare payment models, which are a key factor in determining the cost and quality of healthcare services. By understanding how payment models work, Healthcare Data Analysts can make informed decisions about how to collect, analyze, and interpret data to improve the healthcare system.

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Healthcare Finance Manager

Healthcare Finance Managers oversee the financial operations of healthcare organizations, including budgeting, forecasting, and financial reporting. They work with senior management to develop and implement financial strategies to improve the financial performance of their organizations. This course provides a strong foundation in healthcare payment models, which are a key factor in determining the cost and quality of healthcare services. By understanding how payment models work, Healthcare Finance Managers can make informed decisions about how to manage the financial resources of their organizations.

See salaries and explore the career path for Healthcare Finance Manager

Health Insurance Agent

Health Insurance Agents sell and service health insurance policies to individuals and groups. They work with clients to assess their needs and find the best coverage options. This course provides a strong foundation in healthcare payment models, which are a key factor in determining the cost and quality of healthcare services. By understanding how payment models work, Health Insurance Agents can make informed recommendations to their clients on how to find the best coverage options for their needs.

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Healthcare Information Manager

Healthcare Information Managers oversee the collection, storage, and use of healthcare data. They work with healthcare providers, insurers, and other stakeholders to develop and implement systems to improve the quality and efficiency of healthcare delivery. This course provides a strong foundation in healthcare payment models, which are a key factor in determining the cost and quality of healthcare services. By understanding how payment models work, Healthcare Information Managers can make informed decisions about how to collect, store, and use data to improve the healthcare system.

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Health Policy Researcher

Health Policy Researchers study the impact of health policies on the cost, quality, and access to healthcare services. They use their findings to develop recommendations for policymakers on how to improve the healthcare system. This course provides a thorough understanding of healthcare payment models, which are a key component of healthcare policy. By understanding how payment models work, Health Policy Researchers can make informed recommendations on how to design policies that improve the healthcare system.

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Healthcare Executive

Healthcare Executives oversee the operations of healthcare organizations, including hospitals, clinics, and nursing homes. They are responsible for developing and implementing strategies to improve the financial performance and quality of care of their organizations. This course provides a strong foundation in healthcare payment models, which are a key factor in determining the cost and quality of healthcare services. By understanding how payment models work, Healthcare Executives can make informed decisions about how to manage their organizations to improve the healthcare system.

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Healthcare Provider

Healthcare Providers provide medical care to patients, including physicians, nurses, and pharmacists. They work with patients to diagnose and treat illnesses and injuries, and to promote health and wellness. This course provides a strong foundation in healthcare payment models, which are a key factor in determining the cost and quality of healthcare services. By understanding how payment models work, Healthcare Providers can make informed decisions about how to provide care to their patients in a cost-effective and efficient manner.

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