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Aug 21, 2024
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PH 325 - Health Care Payment Systems Units: 3 Fundamentals of health financing. Discussion of public and private funding mechanisms. Discussion of various payment structures, including value-based payments, fee-for-service, capitation, etc. Overview of funding streams for research, prevention activities, and education.
Prerequisites: PH 110. Possible Instructional Methods: On-ground or Hybrid. Grading: A-F grading only. Course Typically Offered: Fall & Spring
Student Learning Outcomes - Upon successful completion of this course students will be able to:
- Explain the impact of payment systems on various stakeholders: patients, providers, large purchasers and insurance companies
- Summarize the basic financial structure of insurance and the different types of insurance, including different types of health insurance
- Identify commonly used approaches to assess and manage financial risk and accountability in health care
- Understand various reimbursement methodologies including public programs such as Medicare and Medicaid/Medi-Cal
- Recognize the interrelationship between regulatory and market mechanisms in shaping payment systems
- Explain various triggers of health care costs and proposals to contain those costs
- Understand the financial impact of health-seeking behavior and the rationale for incentivizing primary prevention
- Understand the impact of the Affordable Care Act on health payment system structures in the US.
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