312.651.01
Principles and Applications of Advanced Payment Models in Population Health Management
Location
East Baltimore
Term
2nd Term
Department
Health Policy and Management
Credit(s)
3
Academic Year
2024 - 2025
Instruction Method
In-person
Tu, Th, 8:30 - 9:50am
Auditors Allowed
No
Available to Undergraduate
No
Grading Restriction
Letter Grade or Pass/Fail
Course Instructor(s)
Contact Name
Frequency Schedule
Every Year
Resources
Prerequisite
The health care services delivery landscape is rapidly transforming. New competencies are required for clinicians, especially physicians, and mid-level managers or administrators in order to effectively navigate and succeed under value-based reimbursement models and population-oriented health delivery initiatives being demanded by federal and state governments.
Presents an overview of major issues related to the design, function, management, regulation, and evaluation of health insurance and managed care plans and implications for population health management. Provides a firm foundation in basic concepts pertaining to private and public sector health insurance/benefit plans. Includes key topics such as, population care delivery and payment innovations and management techniques, provider payment models, risk-sharing and other incentives for organizational integration, quality and accountability, cost-containment. Reviews innovative payment models and initiatives supporting health care providers and health care organizations in testing alternative care delivery in the context of three core strategies for improving the US health system: improving the way health care providers are paid, improving the way care is delivered, and increasing the availability of information to guide decision-making.
Learning Objectives
Upon successfully completing this course, students will be able to:
- Understand the role of payers within the healthcare ecosystem
- Express what determinants of health are and how Alternative Payment Models (APMs) and Population Health Management (PHM) can influence them as well as health outcomes
- Identify issues related to the design, function, management, regulation and evaluation of health insurance programs on managing care organizations, including Accountable Care Organizations (ACOs)
- Understand relationship of provider-based PHM strategies to upstream APMs
- Evaluate the impact of payment models on population health programs and stakeholders and the impact of the various models on health care expenditures and utilization, beneficiary and health care provider experiences with care, and, where feasible, health outcomes
- Apply course concepts in development APM and a PHM response
Methods of Assessment
This course is evaluated as follows:
- 15% Quizzes
- 15% Reflection
- 70% Group Work
Enrollment Restriction
Restricted to MHA students in HPM only