HC - 505 Healthcare Payment Systems and Value Based Reimbursement

Credits: 3

Managed healthcare is a rapidly expanding component of our healthcare system, and healthcare managers will need to have a strong understanding of this trend. This course provides a comprehensive background in the key concepts of managed care.It also explains the strengths and weaknesses of various managed care models such as Health Maintenance Organizations (HMO), Point of Service Plans (POS), and Preferred Provider Organizations (PPO), as well as the different forms of vertically integrated systems. The course also examines operational issues to include case management, contracting, compensation, and utilization management. The unique requirements for Medicaid and Medicare managed care plans are also analyzed.