Managed Care: Impact on Healthcare Decision Making
This course focuses on questions of mission and vision ("How does managed care support the triple aim of US healthcare: improving the patient experience, improving population health, and reducing per capita cost?”) and on questions of strategy and operations ("How can public health professionals successfully adopt and leverage managed care business models to improve affordable, sustainable access to high quality care?”). We will focus mainly on strategy formulation (“How can we better manage the business of healthcare?”) and on the content of strategies (such as healthcare reform and value-based healthcare), examining their strengths and weaknesses from a variety of managed healthcare stakeholder perspectives. We also will focus on public health strategy implementation (“How can new technologies and infrastructure, such as virtual healthcare, be leveraged to improve affordable, sustainable, high quality care across the socioeconomic spectrum?”).
All public health stakeholders face substantial challenges that demand strategic responses, often in uncertain economic, political, and healthcare demand contexts. To deal effectively with these challenges, public policy professionals, healthcare providers, and healthcare management executives need knowledge and skills in strategic thinking and managed care management: setting and aligning goals with their organization’s mission; handling complex trade-offs between demand for services and resource constraints; leading organizational change; defining measures of cost-effective health outcomes success; improving work processes; motivating staff and other stakeholders; cultivating relationships with the leading organizations in relevant managed care segments; and dealing with market place crises and environments in transition. In short, the course emphasizes the multiple, related requirements of the professional’s job: analysis of current situation and anticipated key trends, identification of key issues, development of creative strategies and tactics, and execution with realistic, attainable metrics.
HPAM-GP 1830 and HPAM-GP 1833