Description: This course explores the history, structure and likely future trends of health insurance in the U.S. The course includes policy analyses of health insurance related issues focusing on potential solution alternatives to political and practical problems. It provides in depth overview of basic features of private and public health insurance.
Course Goals: The major objective of the course is to provide the student with a comprehensive understanding of how the United States public/private health insurance system functions. It will provide future health services leaders with a working knowledge of the interrelationships between public programs and private insurance and approaches to cost control using risk management, provider reimbursement, benefit design and other approaches.
Competencies: 1. Improvement in writing, presentation and analytic skills, focused on framing issues and developing logical approaches to the resolution of issues.
2. Practical understanding of how the private insurance market functions, including how the market is segmented and the competencies required for each segment.
3. Understanding of the impact of risk on private insurance and techniques that are utilized to manage and mitigate the influence of risk selection.
4. Identification of the different international models for health care financing and coverage and the unique aspects of the American system.
5. Appreciation of the distinction between lowering costs to improve competitive advantage and lowering overall health care costs and the tactics and strategies that could be developed for each approach.
6. Understanding of the challenges that confront the future viability of public health insurance programs, including assessment of the options that will be considered, and the strengths and weaknesses of centralized versus decentralized administrative models.
7. Improved skills in working with groups to evaluate and craft potential solutions to policy issues.
8. Recognize the challenges inherent in balancing affordability, access and quality in public and private health insurance programs and the tradeoffs that are required to achieve a mix that meets purchaser and political requirements.