CE Credits: Valid for 1.0 PDCs for the SHRM-CP or SHRM-SCPKnowledge Benefits is an approved SHRM recertification provider. Learn More
Release Date: April 12, 2017
Expires: April 11, 2019

Hospitals and Physicians


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What is this course about?

The health­care mar­ket, like all mar­kets, com­pris­es dif­fer­ent play­ers that can be cat­e­go­rized as buy­ers and sell­ers. This third of four cours­es in the series, “Under­stand­ing the US Health­care Mar­ket,” focus­es on hos­pi­tals and physi­cians as a major com­mer­cial sell­ers by describ­ing their roles, exam­in­ing their incen­tives, 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.

Over the past decade or so, hos­pi­tals and physi­cians have large­ly – although not entire­ly – con­sol­i­dat­ed into large health sys­tems. 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
  • Health Plans
  • 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?

  1. Define and delin­eate the roles of healthcare’s health plans/insurers.
  2. Exam­ine mar­ket and finan­cial trends in the health insur­ance indus­try
  3. Define and iden­ti­fy trends in var­i­ous pay­ment mod­els
  4. Describe how health plans mea­sure qual­i­ty


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