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Principles and Applications of Advanced Payment Models in Population Health Management

1st term
Online Programs for Applied Learning
3 credits
Academic Year:
2021 - 2022
Instruction Method:
Auditors Allowed:
Grading Restriction:
Letter Grade or Pass/Fail
Course Instructors:
Alvia Siddiqi Yousaf

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. Key topics include 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. Innovative payment models and initiatives supporting health care providers and health care organizations in testing alternative care delivery and payment models are reviewed 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:

  1. Identify issues related to the design, function, management, regulation and evaluation of health insurance programs on managing care organizations, including ACOs
  2. Distinguish between both private and public sector programs and the impact on delivery system transformation of CMMI payment initiatives
  3. 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
Methods of Assessment:

This course is evaluated as follows:

  • 25% Quizzes
  • 30% Discussion Board
  • 45% Group Work

Enrollment Restriction:

Restricted to OPAL MAS in Population Health Management students and Certificate in Population Health Management students

Instructor Consent:

No consent required