Health Care Payment and Policy
This course covers the types of health care payors and the relationships between them, including HMOs, PPOs, CMPs, Medicare and Medicaid, and other managed care arrangements. Topics will include utilization review, ERISA, agency doctrine and payor operational and contracting issues. Students will become familiar with managed care and analyze healthcare plans and policies. (LLM only or with permission)
Outcomes: Describe the structure and organization of the US health care system; Identify basic concepts related to health insurance coverage; Explain how both private health insurance and public health insurance function and how they are financed; Compare and contrast health care delivery models; Identify the various determinants of access to care for low-income and vulnerable populations; Evaluate how specific policy considerations (including quality of care, aging population, technology, etc.) will likely affect access to care and health care spending; Explain the major drivers of cost growth and the factors that threaten the sustainability and solvency of the US health care system.
Outcomes: Describe the structure and organization of the US health care system; Identify basic concepts related to health insurance coverage; Explain how both private health insurance and public health insurance function and how they are financed; Compare and contrast health care delivery models; Identify the various determinants of access to care for low-income and vulnerable populations; Evaluate how specific policy considerations (including quality of care, aging population, technology, etc.) will likely affect access to care and health care spending; Explain the major drivers of cost growth and the factors that threaten the sustainability and solvency of the US health care system.