This course is part of the Healthcare Trends for Business Professionals Specialization

4.5
stars
35 ratings

Rina Vertes

3,867 already enrolled

Offered By

Healthcare Trends for Business Professionals SpecializationNortheastern University

About this Course

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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.

Flexible deadlines

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Shareable Certificate

Earn a Certificate upon completion

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Course 2 of 4 in the

Healthcare Trends for Business Professionals Specialization

Beginner Level

Approx. 16 hours to complete

English

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What you will learn

Identify the drivers and trends of healthcare spending from the perspective of various stakeholders.
Critically assess the impact of strategic and financial approaches that have been put in place by the ACA and the various modifications.
Evaluate how healthcare payment models currently work and the new direction that value-based payment is taking.
Identify how financial and non-financial metrics can be appropriately combined to improve a healthcare stakeholders’ value proposition.

Flexible deadlines

Reset deadlines in accordance to your schedule.

Shareable Certificate

Earn a Certificate upon completion

100% online

Start instantly and learn at your own schedule.

Course 2 of 4 in the

Healthcare Trends for Business Professionals Specialization

Beginner Level

Approx. 16 hours to complete

English

Could your company benefit from training employees on in-demand skills?

Try Coursera for Business

Instructor

Instructor rating

4.4/5 (6 Ratings)

Rina Vertes

Executive Professor, President at Marjos Business Consulting LLC

D'Amore-McKim School of Business

3,867 Learners

1 Course

Offered by

Northeastern University

Founded in 1898, Northeastern is a global research university with a distinctive, experience-driven approach to education and discovery. The university is a leader in experiential learning, powered by the world’s most far-reaching cooperative education program. The spirit of collaboration guides a use-inspired research enterprise focused on solving global challenges in health, security, and sustainability.

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Syllabus - What you will learn from this course

Week1

Week 1

4 hours to complete

Current Healthcare Spend and Trend

4 hours to complete

13 videos (Total 48 min), 1 reading, 3 quizzes

13 videos

Course Introduction3mIntroduction to Module 11mWhat's the Fuss? Part 15mWhat's the Fuss? Part 25mStakeholders5mHealthcare Differs from Other Transactions3mSources of Funds2mUses of Funds2mHealthcare Spend4mHealthcare Trend4mArticle Intro: "Cost Conundrum"2mConsumer Perspective: Person-on-the-Street Interview: Cathy3mConsumer Perspective: Person-on-the-Street Interview: Keith2m

1 reading

The Cost Conundrum30m

3 practice exercises

Check Your Knowledge10mCheck Your Knowledge30mWeek 1 Quiz (Graded)35m

Week2

Week 2

4 hours to complete

I Thought we were done with this: Insurance Markets

This week we will describe the various elements which underline health insurance within the United States. For example, third party payment structures and risk pooling, to name a few. This week we will focus some time on the Affordable Care Act (ACA) which is a very complex piece of legislation. Special attention will be made on provisions of the ACA that impact insurance markets, financing, healthcare costs, and payment models.

4 hours to complete

12 videos (Total 56 min), 1 reading, 3 quizzes

12 videos

Week 2 Introduction2mHow Does Insurance Work?3mRisk Pooling3mSelection Impact on Risk Pools and Premium Costs3mBackground on U.S. Health Insurance2mAffordable Care Act5mAccess to Insurance3mInterview with Mark Guanya: Part 117mMedicare Changes3mInsurance Sources3mBenefits3mArticle Introduction: "The Bitter Pill"2m

1 reading

The Bitter Pill30m

3 practice exercises

Check Your Knowledge30mCheck Your Knowledge30mWeek 2 Quiz (Graded)35m

Week3

Week 3

5 hours to complete

Value-Based Payment Models

This week will continue to "follow the money". We will focus much of our attention on the shortcomings of a Fee-for-Service payment model. Our attention will shift to alternative payment models that have been implemented, allowing for certain comparisons to be made. Lastly, we will review some results that have been achieved because of the new payment models. This week I will leave you by asking, If we know that the Fee-for-Service payment model is dysfunctional, why is it continuously used?

5 hours to complete

12 videos (Total 71 min), 2 readings, 3 quizzes

12 videos

Week 3 Introduction3mContractual Reforms to Address Cost and Trend3mManaged Care4mArticle Introduction: Dealing with Medical Practice Variations2mFee-for-Service Payment Models5mBundled Payments4mHealthcare Differences6mMedical Homes3mCapitation or Salary3mReference Pricing and the Consumer3mWhat Drives Results?5mInterview with Mark Guanya: Part 224m

2 readings

Dealing with Medical Practice Variations: A Proposal for Action30mCMS Vignettes45m

3 practice exercises

Check Your Knowledge30mCheck Your Knowledge30mWeek 3 Quiz (Graded)35m

Week4

Week 4

4 hours to complete

Evolving Integrated Models: Putting It All Together

This week we shift our focus from reviewing current payment models and strategies to applying some of the models and concepts to "real-world" scenarios. We will use fictitious examples, as well as published articles to bring together all of the concepts. As with most things, there is not one single answer to solving the healthcare cost, quality, and value problems. I encourage you to think "outside of the box" and as always, "follow the money!"

4 hours to complete

8 videos (Total 29 min), 2 readings, 3 quizzes

8 videos

Week 4 Introduction2mCongestive Heart Failure (CHF)4mArticle Introduction2mSpine Care3mBundles4mArticle Introduction2mIora Health3mCourse Summary4m

2 readings

Overkill: An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?25mThe Last Company You Would Expect is Reinventing Health Benefits30m

2 practice exercises

Check Your Knowledge30mCheck Your Knowledge30m

Reviews

4.5

15 reviews

5 stars
62.85%
4 stars
28.57%
3 stars
5.71%
1 star
2.85%

TOP REVIEWS FROM FUTURE HEALTHCARE PAYMENT MODELS

by SWDec 1, 2021

Good explanations & conversations. The first few sections were a bit simplistic but the later chapters were excellent. Glad I spent the time.

by MNApr 12, 2022

Excellent instructor

Gave the course 5 stars, however one thing I would point out is that some articles are not available without paid subscriptions to the source newspapers.

by ACNov 3, 2020

It is a good course. you will get the idea of healthcare payment model.

by OOMay 5, 2020

The energy the Professor brings into the course is amazing.

View all reviews

About the Healthcare Trends for Business Professionals Specialization

Frequently Asked Questions

When will I have access to the lectures and assignments?
Access to lectures and assignments depends on your type of enrollment. If you take a course in audit mode, you will be able to see most course materials for free. To access graded assignments and to earn a Certificate, you will need to purchase the Certificate experience, during or after your audit. If you don't see the audit option:
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The course may offer 'Full Course, No Certificate' instead. This option lets you see all course materials, submit required assessments, and get a final grade. This also means that you will not be able to purchase a Certificate experience.
What will I get if I subscribe to this Specialization?
When you enroll in the course, you get access to all of the courses in the Specialization, and you earn a certificate when you complete the work. Your electronic Certificate will be added to your Accomplishments page - from there, you can print your Certificate or add it to your LinkedIn profile. If you only want to read and view the course content, you can audit the course for free.
Is financial aid available?
Yes. In select learning programs, you can apply for financial aid or a scholarship if you can’t afford the enrollment fee. If fin aid or scholarship is available for your learning program selection, you’ll find a link to apply on the description page.

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About this Course

What you will learn