Managing Health Care Services in a Value Based Setting
PASS / NO CREDIT
Healthcare services have long existed in a fee-for-service world where providers could maximize profits through the provision of a great quantity of services. Existing institutions blunted incentives to provide high quality care or care that resulted in a downstream reduction in the use of healthcare services. This world is changing - with many providers and payers moving towards a value-based regime where firms can earn profits when patients receive higher quality care thereby reducing downstream utilization, often of acute, specialty, and post-acute care. In response to this new reality there is a growing number of new entrants attempting to manage the care of enrollees in both public and private health insurance plans in a variety of value-based payment models. Additionally, many incumbent firms are modifying their strategies for this new paradigm. Success in a value-based world requires firms to develop and/or acquire new assets and implement new operating models. This course is a study of the systems necessary to succeed in this new world with a focus on the finance, strategy, marketing, and economics of care delivery in a value-based model. Our objective is to understand how the healthcare system is organized (or not) and managed (or not) so that we can create and capture value through the delivery of care. A large focus of the course will be about how smaller players and new entrants engage with the large and powerful incumbents that are central to the existing system.
Healthcare Pathway - Provider