Future Healthcare Payment Models

Overview

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.