Future Healthcare Payment Models

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  • Current Healthcare Spend and Trend
    • This week's focus will be on understanding the various stakeholders in healthcare. We will review the "math" surrounding healthcare costs and how it can fluctuate. Healthcare drivers will be reviewed to identify trends. As you move through the weekly material, I encourage you to think about the impact that the drivers have on the delivery of the healthcare services.
  • I Thought we were done with this: Insurance Markets
    • This week we will describe the various elements which underline health insurance within the United States. For example, third party payment structures and risk pooling, to name a few. This week we will focus some time on the Affordable Care Act (ACA) which is a very complex piece of legislation. Special attention will be made on provisions of the ACA that impact insurance markets, financing, healthcare costs, and payment models.
  • Value-Based Payment Models
    • This week will continue to "follow the money". We will focus much of our attention on the shortcomings of a Fee-for-Service payment model. Our attention will shift to alternative payment models that have been implemented, allowing for certain comparisons to be made. Lastly, we will review some results that have been achieved because of the new payment models. This week I will leave you by asking, If we know that the Fee-for-Service payment model is dysfunctional, why is it continuously used?
  • Evolving Integrated Models: Putting It All Together
    • This week we shift our focus from reviewing current payment models and strategies to applying some of the models and concepts to "real-world" scenarios. We will use fictitious examples, as well as published articles to bring together all of the concepts. As with most things, there is not one single answer to solving the healthcare cost, quality, and value problems. I encourage you to think "outside of the box" and as always, "follow the money!"