PAM 5570

Health Care Organizations

Course Description

Course information provided by the Courses of Study 2021-2022.

This course familiarizes students with the organizational structure of the U.S. health care system. First, we will talk about the history of U.S. health care and develop an understanding of the financial streams and different institutions. Second, we will study the purpose of and issues related to health insurance and the different coexisting U.S. insurance systems. We will also analyze why people are un- and underinsured and how health care reforms tried to address this issue. Third, we will learn about health care providers, outpatient and inpatient care as well as reimbursement methods, including "value-based" reimbursement. Then, we study access and quality of medical care. Finally, we will discuss rising health care costs in an international comparison and briefly talk about other health care systems.

When Offered Fall.

Permission Note Enrollment limited to: Sloan students or permission of instructor.

• Understanding the basic organizational setup of the US health care system, also from a historical perspective, its various components, how they relate and interact.
• Gaining a good knowledge of the financial flows within and between the system components, how health care in the US is financed, and how providers are reimbursed.
• Understanding the main objectives und functions of (health) insurances from a theoretical point of view and why theory and reality may differ.
• Acquiring tools to understand and analyze the economic incentives at work between insurers and providers as well as between providers and insurees.
• Identifying key problem areas within the US health care system; evaluating reform proposals with the tools and knowledge acquired throughout the course, and making own reform suggestions.
• Understanding the legislative and political process of health policy reforms, how it relates to the general organization of the health care system, and developing awareness of issues entailed.
• Assimilating different basic principles of how health care systems can be organized; understanding organizational differences between the American and other international health care systems.
• Acquiring the ability to understand and analyze complex issues and processes.
• Learning to isolate objective arguments from value judgments and ideology and why this is of particular importance when health care is involved
• Practicing how to provide constructive critique and how to deal with constructive critique; improving the ability to work effectively in teams and learning how to express arguments and ideas in a constructive, clear and concise manner.

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