This course provides an overview of emerging models of healthcare delivery and payment, as well as their impacts on providers and patients, including cost, quality, and outcomes. You will learn how to evaluate and best apply various types of models in different circumstances to help ensure a successful transition to a value-based healthcare system, while also considering such factors as clinical integration, new technologies, and risk management. Students also explore strategies for successful performance in various care and payment models, including targeted quality improvement and care management strategies for high-cost, high-risk patient populations.
Other topics of exploration and discussion include:
- Financial reporting requirements specific to healthcare
- Healthcare claims processing/reimbursement and government payer types
- Prospective payment systems and diagnostic related groups (DRGs)
- Coding and revenue cycle management
Some examples of assignments and projects in this class include:
- A financial strategy assignment focused on ensuring a hospital is profitable
- A researched plan for a new hospital based on standards from the Centers for Medicare & Medicaid Services
- A value-based care plan scope
Course Outcomes
Upon completing this course, you should be able to:
- Identify healthcare financial reporting requirements.
- Analyze prospective payment systems.
- Define fraud and abuse within the healthcare context.
- Understand the importance of electronic health record (EHR) adoption and the concept of meaningful use.
- Develop a plan for healthcare providers to deliver value-based care.
- Evaluate sustainable strategies for the successful implementation of new care and payment models.
- Appreciate the changes providers and health plans are undergoing to meet the needs of the industry’s financial transformation, the factors associated with success or failure, and the likelihood of sustainable transitions to new business models.
Click here for the official course description from the American University Catalog.
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