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Lechauncy Woodard, Sara G. McNeil, and Susie Gronseth

COURSE 1 of 7. This course is designed to introduce you to the concept of value-based care (VBC). While the information you will explore is general, it will help you establish a solid foundation for continued learning and future thinking about the concept of VBC. Through a historical lens, you will explore the creation of Medicare and Medicaid and the evolution of commercial insurance, TRICARE, and the Veterans Health Administration. While history is an important filter for understanding healthcare in this country, you will learn how each of these mechanisms emerged, the populations served, and what changes occurred over time, with a focus on funding and expenditures. In addition, this course will help you establish a firm foundation for understanding the development and evolution of quality measures and outcomes in healthcare. By developing an understanding of what quality is and how it is measured, you can begin a knowledge-building exploration of the components of quality in healthcare. Why is this important? In value-based care models, providers must meet quality measures and improve the health outcomes of their patients. In the summative assignment, you will use a national system of quality measures to develop a plan that would positively impact value within your healthcare organization.

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What's inside

Syllabus

Introduction to Value-Based Care
This module is designed to introduce you to the concept of value-based care. While the information you will explore is general, it will help you establish a solid foundation for continued learning and future thinking about the concept of VBC as you progress through this certificate program. Even if you have an understanding of or experience with VBC, this module might serve as a useful review. Remember, as you read or hear terms or concepts that are new to you, have your digital (Word doc) or analog (paper) notepad handy to write them down. At any time, you can use your favorite search engine to learn more. Be a self-directed learner!
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The U.S. Healthcare System (Medicare, Medicaid, Commercial Insurance, TRICARE, and the Veterans Health Administration: Creation, Evolution and Change
TThis module is designed as an overview of the U.S. healthcare system. Through a historical lens, you will explore the creation of Medicare and Medicaid and the evolution of commercial insurance, TRICARE, and the Veterans Health Administration (VHA). While history is an important filter for understanding healthcare in this country, the majority of this module will examine how each of these mechanisms emerged, the populations served, and changes over time, with a focus on funding and expenditures. You will also explore relationships and critical differences across these mechanisms. While the information you will explore is general, it is designed to help you establish a solid foundation for continued learning and future thinking about the concept of VBC as you progress through this certificate program. Even if you have an understanding of the general healthcare landscape, this module might serve as a good review. Remember, as you read or hear terms or concepts that are new to you, have your digital (Word document) or analog (paper) notepad handy to write them down. At any time, you can use your favorite search engine to learn more. Be a self-directed learner!
Development and Evolution in Healthcare Quality Measures and Outcomes
This module is designed to help you establish a firm foundation for understanding the development and evolution of quality measures and outcomes in healthcare. By developing an understanding of what quality is and how it is measured, you can begin a knowledge-building exploration of the components of quality in healthcare. From there, you’ll synthesize the importance of outcomes in healthcare management and how they have evolved, and reflect on opportunities for the future. Why is this important? As you have already explored in this course, in value-based care models, providers must meet quality measures and improve the health outcomes of their patients. While the information you will explore is general, it is designed to help you establish a solid foundation for continued learning and future thinking about the concept of value-based care as you progress through this certificate program. Even if you have an understanding of quality measures and outcomes, this module might serve as a good review. Remember, as you read or hear terms or concepts that are new to you, have your digital (Word doc) or analog (paper) notepad handy to write them down. At any time, you can use your favorite search engine to learn more. Be a self-directed learner!
Course Project: Making This My Own
A key theme of Course 1 is evolution. You explored the evolution of value-based care (Module 1), the evolution of the U.S. healthcare landscape (Module 2), and the evolution of quality measures and outcomes in healthcare (Module 3). And as expected with any evolution, complexities naturally emerge. This is quite evident in your brief examination of the diverse U.S. healthcare landscape with all of the various types of insurance supported by various types of revenue models and serving various individuals. Equally complex is the array of national quality measures and outcomes across healthcare, where some people focus on the patient or the provider and others on the care setting or a particular healthcare condition. And, as this certificate program is an introduction to value-based healthcare, the complexities of this system might emerge when striving to answer, “What is value?” However, being complex is not an obstacle for achieving success; in fact, it is often a catalyst for positive change. Whether you are currently working in healthcare or are pursuing a healthcare career, throughout this certificate program you should be asking: “How does the information connect to and strengthen my understanding of value-based care?” And regardless of whether your organization is considering a transition to VBC, is in the midst of doing so, or has successfully made the transition to VBC, a secondary question must always be: “How do I lead from where I am to support successfully and or advance VBC?” Let’s begin this summative assignment by applying what you have explored in this course to your current (or future) practice to address the following: What would be your role in helping to drive better outcomes for patients/members? Using a national system of quality measures explored in Module 3, develop a plan that would positively impact value within your healthcare organization (office, practice, site or system). Follow the steps below to complete this assignment.

Good to know

Know what's good
, what to watch for
, and possible dealbreakers
Develops a solid understanding of the concept of value-based care (VBC)
Examines the creation and evolution of the U.S. healthcare system, including Medicare, Medicaid, commercial insurance, TRICARE, and the Veterans Health Administration
Explores the development and evolution of quality measures and outcomes in healthcare
Taught by experts in the field of healthcare
Requires students to develop a plan to improve value within their healthcare organization
Suitable for healthcare professionals and students

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Reviews summary

Intro to value-based care

Learners say this is a well-received introductory course to Value-Based Care. Students say the course is engaging and informative. The course is often praised for its clear format and detailed content. Reviews indicate that the course provides a solid foundation for understanding the history, principles, and current state of Value-Based Care in the U.S. healthcare system.
Engaging peer reviews
"Really enjoyed the peer reviews!!!! "
Provides high-quality content
"Great information."
Introductory or refresher course
"Excellent introduction to VBC!"
Course is well-organized and thorough
"Very detailed introduction."
Some confusion about peer assignments
"The peer assignment was a little confusing."

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 Value-Based Care: Introduction to Value-Based Care and the U.S. Healthcare System with these activities:
Compile Resources on Value-Based Care Models
Creating a consolidated repository of resources will provide easy access to relevant materials throughout the course.
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  • Identify reputable sources providing information on VBC models.
  • Collect and organize articles, reports, or websites on the topic.
Review Key Healthcare Terminology
Review key healthcare terminology to ensure a solid foundation for understanding the course content.
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  • Consult a medical dictionary or glossary.
  • Practice using the terms in context by reading healthcare articles or case studies.
  • Create flashcards or a notebook to record and memorize the terms.
Write a Blog Post Summarizing Key Concepts of VBC
Creating a blog post requires distilling and presenting the key concepts of VBC, reinforcing understanding.
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  • Identify the main concepts of value-based care.
  • Write a draft of the blog post, explaining the concepts clearly.
  • Review and revise the blog post for accuracy and clarity.
Ten other activities
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Review Value-Based Care Concepts
Reviewing the fundamentals of value-based care will reinforce your understanding of the course materials and prepare you for the upcoming modules.
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  • Read the course syllabus and module 1 materials
  • Take notes on the key concepts and definitions
  • Create a mind map or concept diagram to visualize the relationships between the concepts
Review Basics of Healthcare in the U.S.
A foundational understanding of the U.S. healthcare landscape can improve comprehension of VBC models.
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  • Review key concepts of healthcare delivery and financing in the U.S.
  • Summarize the history of healthcare reform and policy changes in the U.S.
Discuss VBC Implementation Challenges with Peers
Engage in discussions with peers to share experiences and challenges in VBC implementation.
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  • Connect with other healthcare professionals in your network or online forums.
  • Initiate or participate in discussions about VBC implementation challenges.
  • Share your own experiences and learn from the insights of others.
  • Identify common challenges and explore potential solutions.
Explore Healthcare Financing Systems
Following tutorials on the different healthcare financing systems will help you understand their evolution, funding, and impact on value-based care.
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  • Find online tutorials on Medicare, Medicaid, Commercial Insurance, TRICARE, and the Veterans Health Administration
  • Follow the tutorials and take notes on the key features, benefits, and challenges of each system
  • Compare and contrast the different systems and identify their implications for value-based care
Analyze Quality Measures on a Healthcare Website
Practice analyzing quality measures on a healthcare website to gain insights into the quality of care provided.
Show steps
  • Identify a reputable healthcare website that provides quality measure data.
  • Select a specific healthcare topic or condition.
  • Analyze the quality measures associated with the topic, including rates and trends.
  • Draw conclusions about the quality of care based on the data.
  • Share your findings with a peer or healthcare professional for feedback.
Design a Value-Based Care Presentation
Developing a presentation on VBC will necessitate a thorough understanding of the concept and its implications.
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  • Outline key concepts and benefits of VBC.
  • Develop slides or visuals to illustrate the main points.
  • Rehearse and prepare to deliver the presentation.
Collaborate with Peers on a VBC Case Study
Working with peers on a case study allows for exchange of diverse perspectives and deepens understanding of VBC principles.
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  • Form a study group with other students in the course.
  • Select a case study related to VBC implementation.
  • Analyze the case study and discuss findings with the group.
Explore Value-Based Healthcare Best Practices
Explore value-based healthcare best practices through guided tutorials to understand how to implement them in practice.
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  • Identify healthcare organizations or agencies that have successfully implemented VBC.
  • Review online tutorials or case studies on VBC best practices.
  • Consider the applicability of these practices to your own healthcare setting.
  • Develop a plan to pilot or implement a VBC initiative.
Volunteer as a Mentor for Students Interested in VBC
Mentoring others requires a deep understanding of VBC, solidifying knowledge and fostering personal growth.
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  • Identify platforms or organizations where you can offer mentoring services.
  • Prepare materials and resources to support mentees.
  • Connect with mentees and provide guidance on VBC concepts and career paths.
Attend a Value-Based Healthcare Workshop
Attend a value-based healthcare workshop to gain practical insights and networking opportunities.
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Show steps
  • Identify and register for a reputable VBC workshop.
  • Engage actively in the workshop sessions and discussions.
  • Network with other healthcare professionals and experts in the field.
  • Apply the knowledge and skills gained to your own healthcare practice.

Career center

Learners who complete Value-Based Care: Introduction to Value-Based Care and the U.S. Healthcare System will develop knowledge and skills that may be useful to these careers:
Physician Executive
Combining clinical expertise with business acumen, this role leads and manages healthcare organizations or departments. The course provides essential knowledge of the U.S. healthcare system, value-based care, and quality measures. These insights empower Physician Executives to drive improvements in patient care and organizational performance.
Healthcare Data Analyst
Healthcare data analysts use data to improve the quality, efficiency, and cost-effectiveness of healthcare delivery. The course can provide a solid foundation for this role by providing an overview of the U.S. healthcare system, the evolution of value-based care, and the development of quality measures and outcomes in healthcare. Additionally, the course provides insights into data analysis techniques and tools specific to healthcare.
Quality Improvement Manager
Quality improvement managers are responsible for planning, implementing, and evaluating quality improvement initiatives in healthcare organizations. The course can help build a foundation for success in this role by providing an overview of the evolution of quality measures and outcomes in healthcare, as well as insights into the development and implementation of value-based care models. Additionally, the course provides practical tools and techniques for quality improvement.
Healthcare Administrator
Healthcare administrators oversee the day-to-day operations of healthcare organizations. They are responsible for managing budgets, ensuring operational efficiency, and improving quality of care. The course can provide a solid foundation for understanding the complexities of the U.S. healthcare system and the importance of value-based care. Additionally, the course provides insights into quality measures and outcomes in healthcare, which are essential for effective healthcare administration.
Healthcare Market Researcher
Healthcare Market Researchers gather and analyze data to study market trends, consumer behavior, and industry dynamics in the healthcare sector. The course lays a strong foundation by providing an overview of the U.S. healthcare system, value-based care evolution, and quality measures. This knowledge helps researchers understand the landscape they operate in and make informed decisions.
Health Economist
Health economists apply economic principles to healthcare issues. The course can provide a solid foundation for this role by providing an overview of the U.S. healthcare system, the evolution of value-based care, and the development of quality measures and outcomes in healthcare. Additionally, the course provides insights into economic modeling and analysis techniques specific to healthcare.
Health Information Manager
Individuals in this role lead the healthcare delivery process from a data-driven perspective. They use data analytics to monitor patient progress, track quality, and identify areas for improvement. The course can help build a foundation by providing an overview of quality measures and outcomes in healthcare. Additionally, the course provides insights into the evolution of the U.S. healthcare system, which is essential for understanding the current landscape of healthcare delivery.
Healthcare Lobbyist
Healthcare Lobbyists represent the interests of healthcare organizations, advocating for policies that support their clients. The course offers valuable insights into the U.S. healthcare system, value-based care, and quality measures. By understanding the healthcare landscape, lobbyists can effectively communicate their clients' perspectives and influence policy decisions.
Risk Manager
Risk managers identify, assess, and mitigate risks in healthcare organizations. The course can provide a solid foundation for this role by providing an overview of the U.S. healthcare system, the evolution of value-based care, and the development of quality measures and outcomes in healthcare. Additionally, the course provides insights into the risk management process and tools for risk assessment and mitigation.
Regulatory Affairs Specialist
Regulatory affairs specialists ensure that their organizations comply with applicable laws and regulations. In healthcare, regulatory affairs specialists may focus on issues such as product safety, data privacy, and quality control. The course can provide a solid foundation for this role by providing an overview of the U.S. healthcare system, the evolution of value-based care, and the development of quality measures and outcomes in healthcare. Additionally, the course provides insights into the regulatory landscape of the healthcare industry.
Policy Analyst
Policy analysts research and analyze public policy issues to inform decision-making. In healthcare, policy analysts may focus on issues such as healthcare access, quality of care, and cost containment. The course can provide a solid foundation for this role by providing an overview of the U.S. healthcare system, the evolution of value-based care, and the development of quality measures and outcomes in healthcare. Additionally, the course provides insights into the political and economic factors that shape healthcare policy.
Health Policy Analyst
Health policy analysts research and analyze health policy issues to inform decision-making. The course can provide a solid foundation for this role by providing an overview of the U.S. healthcare system, the evolution of value-based care, and the development of quality measures and outcomes in healthcare. Additionally, the course provides insights into the political and economic factors that shape health policy.
Healthcare Consultant
These professionals provide advice and support to healthcare organizations on a variety of issues, including strategic planning, operational improvement, and financial management. The course can help build a foundation for success in this role by providing an overview of the U.S. healthcare system, the evolution of value-based care, and the development of quality measures and outcomes in healthcare. This knowledge can enable healthcare consultants to make informed recommendations and develop effective solutions for their clients.
Healthcare Financial Manager
Healthcare financial managers are responsible for the financial planning, budgeting, and reporting of healthcare organizations. The course can provide a solid foundation for this role by providing an overview of the U.S. healthcare system, the evolution of value-based care, and the development of quality measures and outcomes in healthcare. Additionally, the course provides insights into healthcare financial management practices and tools.
Medical Writer
Medical writers create educational and promotional materials for healthcare organizations, including patient education materials, marketing materials, and scientific articles. The course can provide a solid foundation for this role by providing an overview of the U.S. healthcare system, the evolution of value-based care, and the development of quality measures and outcomes in healthcare. This knowledge can enable medical writers to create accurate and informative materials that are tailored to the needs of their audience.

Reading list

We've selected nine 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 Value-Based Care: Introduction to Value-Based Care and the U.S. Healthcare System.
Provides a comprehensive overview of the concept of value-based healthcare, including its history, evolution, and key components. It valuable resource for anyone looking to gain a deeper understanding of this important topic.
Explores the concept of disruptive innovation and how it can lead to the failure of large, established companies. It valuable read for anyone interested in understanding the challenges of implementing value-based healthcare.
This landmark report from the Institute of Medicine provides a comprehensive overview of the quality of healthcare in the United States and offers recommendations for improvement.
This textbook provides a comprehensive overview of the history and evolution of the U.S. healthcare system.
This handbook is an essential reference for anyone working in the Medicare or Medicaid programs.
Provides a comprehensive overview of quality measures for behavioral health. It covers the key concepts, challenges, and opportunities involved in measuring and improving the quality of behavioral health care.
Provides a comprehensive overview of the Affordable Care Act. It covers the key provisions of the law, as well as its impact on health care providers.

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