Health Care Insurance: Managing and Designing Policies, Plans and Products

Healthcare Industry Courses, On Campus Courses

Introduction:

Health care insurance is an agreement in which an insurance company agrees to pay for some or all of your medical expenses in exchange for a monthly premium payment. Health care insurance can cover you from diagnosis to treatment, and can also offer you access to private health care services that may not be available or affordable through the public health system. Health care insurance is relevant for health care professionals, managers, policymakers, and researchers who want to understand the challenges and opportunities in the health care sector, and how to manage and design health care insurance policies, plans and products that meet the needs and preferences of consumers and providers.

This course will provide you with a comprehensive overview of the key concepts and methods of health care insurance, and how they can be applied to real-world problems and cases. You will learn about the types and characteristics of health care insurance plans and schemes, the role and rationale of health insurance markets and regulations, the tools and techniques for health insurance pricing and underwriting, the methods and measures for health insurance quality and performance, and the best practices and standards for health insurance innovation and sustainability.

Objective

The objective of this course is to equip you with the knowledge and skills to:

Understand the basic concepts and theories of health care insurance and how they relate to health care systems and policies
Analyse the types and sources of health care insurance plans and schemes and the factors that influence them
Evaluate the benefits and challenges of health care insurance and the factors that enable or hinder its implementation
Apply health care insurance concepts and methods to manage and design health care insurance policies, plans and products that suit various health care settings and contexts
Communicate effectively and persuasively about health care insurance to various audiences and stakeholders

Target Audience

This course is designed for professionals who work in or are interested in the health care sector, such as:

Health care providers (e.g., physicians, nurses, pharmacists, therapists, etc.)
Health care managers and administrators (e.g., hospital directors, clinic managers, health plan executives, etc.)
Health care policymakers and regulators (e.g., government officials, public health agencies, health care organizations, etc.)
Health care researchers and consultants (e.g., academics, analysts, evaluators, etc.)

Benefits Of Taking This Course

By taking this course, you will:

Enhance your analytical and critical thinking skills in the health care domain
Gain a deeper understanding of the current issues and trends in the health care sector and their implications for health care insurance and quality improvement
Learn how to use health care insurance frameworks and tools to inform and improve your health care decisions and actions
Develop your ability to communicate and collaborate with other health care professionals, managers, policymakers, and researchers

Content

The course will consist of five days of lectures, discussions, exercises, and case studies, covering the following topics:

Day 1: Introduction to Health Care Insurance
- What is health care insurance and why is it important in health care?
- What are the main concepts and theories of health care insurance and how do they relate to health care systems and policies?
- What are the main sources and methods of data collection and analysis in health care insurance?
Day 2: Types and Sources of Health Care Insurance Plans and Schemes
- What are the types and characteristics of health care insurance plans and schemes and how are they defined and classified?
- What are the sources and drivers of health care insurance plans and schemes and how do they vary across different health care settings and contexts?
- How do health care consumers, providers, insurers, and regulators perceive and respond to health care insurance plans and schemes?
Day 3: Health Insurance Markets and Regulations
- What are the role and rationale of health insurance markets and regulations in health care and how are they designed and implemented?
- What are the components and functions of health insurance markets and regulations in health care and how do they interact and integrate with each other?
- What are the best practices and standards for health insurance markets and regulations in health care and how are they evaluated and improved?
Day 4: Health Insurance Pricing and Underwriting
- What are the tools and techniques for health insurance pricing and underwriting in health care and how are they applied and used?
- What are the criteria and methods for health insurance risk assessment and management in health care and how are they applied and used?
- What are the strategies and actions for health insurance cost containment and efficiency in health care and how are they applied and used?
Day 5: Health Insurance Quality and Performance
- What are the methods and measures for health insurance quality and performance in health care and how are they applied and used?
- What are the challenges and opportunities for health insurance quality and performance in health care and how are they addressed and exploited?
- What are the benefits and outcomes of health insurance quality and performance in health care and how are they measured and communicated?