“This would be a great world to dance in if we didn’t have to pay the fiddler.”
What is this course about?
The healthcare market, like all markets, comprises different players that can be categorized as buyers and sellers. This second of four courses in the series, “Understanding the US Healthcare Market,” focuses on health plans (aka insurers) as a major commercial seller by describing their roles, examining their business strategies, and quantifying their financial experience.
How services are bought and sold determines the relationship between quality and price. This is true of all markets, although the healthcare market can be particularly complex because of the many players with often misaligned incentives. Sometimes these players work together in a single structure and other times each player works relatively independently. In either case, purchasers and consumers do not always see how these players relate in the overall marketplace nor is it easy to determine either price or quality.
Health plans typically function as intermediaries between healthcare purchasers (e.g. employers) and healthcare’s major providers – hospitals and physicians. This course examines key health plan purchasing, financing, benefits and contracting trends. The other courses in the series examine financial trends and behaviors of healthcare’s major players:
- Employers and other Purchasers
- Hospitals and Physicians
- Drug Companies and Pharmacy Benefits Mangers
Who is it for?
Benefits administrators on the front lines of employer sponsored health insurance
HR professionals interested in improving benefit purchasing
Purchasing managers interested in improving benefit purchasing
Chief Human Resources Officers responsible for purchasing healthcare benefits
Chief Financial Officers responsible for managing the bottom line
Chief Executive Officers concerned about healthcare costs eroding the bottom line
What will I learn to do?
- Define and delineate the roles of healthcare’s health plans/insurers.
- Examine market and financial trends in the health insurance industry.
- Define and identify trends in various payment models.
- Describe how health plans measure quality.