Este curso forma parte de Programa especializado: Value-Based Care

4.5
estrellas
37 calificaciones

Susie Gronseth +1 instructores más

3082 ya inscrito

Ofrecido Por

Programa especializado: Value-Based CareUniversity of Houston

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COURSE 4 of 7. This course is designed to help you build high-level knowledge of the current medical coding and payment mechanisms of most U.S. healthcare services, referred to as fee-for-service. You will explore why the fee-for-service model has contributed to higher costs in the U.S. healthcare system without clearly improving health outcomes. You will examine the importance of coding to reflect chronic conditions and other diagnoses accurately and how value-based care and payments utilize these measures and data. As you learn about a model to replace fee-for-service, you’ll encounter a range of payment options considered to be value-based that utilize a framework from the Health Care Payment Learning and Action Network (HCP-LAN). To build on those options, you will learn how risk-adjustment, quality scores, and patient satisfaction measures are critical parts of value-based care and payment contracts. In the summative assignment, you will demonstrate your knowledge by comparing fee-for-service and value-based contracts, using specific examples to explain and justify the importance of documentation and coding, and identifying ways that risk-adjustment and patient satisfaction are incorporated into value-based care contracts.
CME Accreditation
The American Academy of Family Physicians (AAFP) has approved this course for Continuing Medical Education Prescribed Credits. Visit the FAQs for important information regarding 1) Term of approval and 2) Accreditation and Credit Designation statements.

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Curso 4 de 7 en

Programa especializado: Value-Based Care

Nivel principiante

Beginning course

Aprox. 5 horas para completar

Inglés (English)

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Prueba Coursera para negocios

Qué aprenderás

Explain fee-for-service medical coding and payment mechanisms and why fee-for-service leads to higher costs without clearly improving outcomes.
Describe the range of value-based payment options from the HCP-LAN Alternative Payment Model framework.
Describe the importance of risk adjustment, quality scores, and patient satisfaction measures in value-based care contracts.

Habilidades que obtendrás

Health Education
value-based care
Patient Care
Public Health
Health Care

Fechas límite flexibles

Restablece las fechas límite en función de tus horarios.

Certificado para compartir

Obtén un certificado al finalizar

100 % en línea

Comienza de inmediato y aprende a tu propio ritmo.

Curso 4 de 7 en

Programa especializado: Value-Based Care

Nivel principiante

Beginning course

Aprox. 5 horas para completar

Inglés (English)

¿Podría tu empresa beneficiarse de la capacitación de los empleados en las habilidades más demandadas?

Prueba Coursera para negocios

Instructores

Calificación del instructor

4,66/5 (14 calificaciones)

Susie Gronseth

Clinical Associate Professor

Curriculum and Instruction

9542 alumnos

7 cursos

Sara G. McNeil

Associate Professor

Curriculum and Instruction

70.849 alumnos

8 cursos

Ofrecido por

University of Houston

Established in 1927, the University of Houston empowers students in their pursuit of learning, discovery, leadership and engagement. Located in a sprawling metropolis, our premier Tier One campus provides students with cutting edge programs including undergraduate, graduate, doctoral, distance and continuing education. Ranked among the best colleges in America, UH is home to award-winning faculty, innovative research centers, has one of the most diverse student populations in the nation, and alumni who have become international leaders.

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Programa - Qué aprenderás en este curso

Semana1

Semana 1

2 horas para completar

From Fee-For-Service to Value-Based Payments

In this course, you will build high-level knowledge of the current medical coding and payment mechanisms of most U.S. healthcare services, referred to as fee-for-service. Then you will explore why the fee-for-service model has contributed to higher costs in the U.S. healthcare system without clearly improving health outcomes. As you examine a model to replace fee-for-service, you’ll encounter a range of payment options considered to be value-based. To build on those options, you will explore how risk-adjustment, quality scores, and patient satisfaction measures are critical parts of value-based care and payment contracts. This module is an introduction to and exploration of value-based payment models utilizing a framework from the Health Care Payment Learning and Action Network (HCP-LAN). As a preparatory step to that introduction and review, the module starts with a high-level review of current fee-for-service payments, coding for those payments, and the problems resulting in increased healthcare costs and lower-than-expected quality in the U.S. Remember, as you read or hear terms or concepts that are new to you, have your digital (Word doc) or analog (paper) notepad handy to write them down. At any time, you can use your favorite search engine to learn more. Be a self-directed learner!

2 horas para completar

10 videos (Total 48 minutos), 2 lecturas, 1 cuestionario

10 videos

If this is your first VBC course, please watch our Welcome.37sHow This Course Works3mLevel Set2mCurrent and Historical Reimbursement Models4mCPT (Current Procedural Terminology) Codes4mICD (International Classification of Disease) Codes2mFee-For-Service: Volume Not Value2mPopulation Costs and Value: Think Like an Insurance Company10mMoving to Value8mExamples of Current Value-Based Arrangements in Traditional Medicare7m

2 lecturas

Explore the Optional Resources for Module 110mReferences for Module 110m

1 ejercicio de práctica

Module 1 Quiz30m

Semana2

Semana 2

2 horas para completar

Quality and Risk Adjustment in Value-Based Payments

In the previous module, you examined the importance of coding to reflect chronic conditions and other diagnoses accurately. You also explored how value-based care and payments utilize these measures and data. As you explore the four categories of the HCP-LAN alternative payment models (APMs)—also known as value-based payment arrangements or value-based contracts – the acronym of the latter is also VBC. As with other acronyms, you will learn to read VBC in context to determine if we are talking about care or payments/contracts. The focus of this module is on two key aspects of value-based payment models: 1) The need for, and methods of, risk-adjustment in value-based contracts, and 2) Quality scores and patient satisfaction measures, which are critical parts of value-based care and contracts. At the end of this module, you will examine how those elements are utilized in value-based contracts. Remember, as you read or hear terms or concepts that are new to you, have your digital (Word doc) or analog (paper) notepad handy to write them down. At any time, you can use your favorite search engine to learn more. Be a self-directed learner!

2 horas para completar

11 videos (Total 58 minutos), 1 lectura, 1 cuestionario

11 videos

The History and Purpose of Risk Adjustment3mThe Role of Risk Adjustment in Value-Based Care and Payment Models7mMedicare Risk Adjustment (MRA) Payment Model7mRisk Adjustment Is a Collaborative Effort3mMeasuring and Paying for Quality3mMedicare Star Rating Program Framework4mConsumer Assessment of Healthcare Providers and Systems3mHEDIS5mPatient Safety Measures2mComprehensive Population-Based Payment Models from HCP-LAN9mA Value-Based Payment Spectrum5m

1 lectura

Explore the Optional Resources for Module 210m

1 ejercicio de práctica

Module 2 Quiz30m

Semana3

Semana 3

1 hora para completar

Course Project: Making This My Own

In this course, you have examined how the fee-for-service model emerged from current medical coding and payment mechanisms and why this model has contributed to higher costs in the U.S. healthcare system. In the videos and discussion postings relating the quest to replace the fee-for-service model, you explored a range of value-based payment options and how risk-adjustment, quality scores, and patient satisfaction measures are critical parts of value-based care and payment contracts. Whether you are currently working in a healthcare provider or payer organization or aspiring to work in either, it is paramount that you be able to synthesize, reframe, and put into practice knowledge gained from this course. Even more important is to recognize that the responsibility for applying this knowledge is shared by providers and payers, as ultimately it is the provider-payer partnership that leads to successful value-based care.

1 hora para completar

Reseñas

4.5

8 reseña

5 stars
62,16 %
4 stars
32,43 %
3 stars
2,70 %
1 star
2,70 %

Principales reseñas sobre VALUE-BASED CARE: REIMBURSEMENT MODELS

por MK15 de jun. de 2022

Its an excellent course with a lot of insights on how to develop models of reimbursement. Its very specific to the US however, and examples from other countries would be useful.

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Acerca de Programa especializado: Value-Based Care

Learners may study at their own pace to take any of the six courses and the Capstone Project course independently (receiving a certificate for each) or collectively for the specialization designation. This specialization is intended for healthcare professionals, faculty, and students pursuing healthcare-related studies to develop an awareness of Value-Based Care reimbursement and operating models. Through six courses and a Capstone project, you will develop an understanding of your individual responsibility to lead a culture of collaboration in the workplace focused on value-based care. Our industry partner, Humana, brings their expertise and years of experience in providing quality care.

Preguntas Frecuentes

¿Cuándo podré acceder a las lecciones y tareas?
El acceso a las clases y las asignaciones depende del tipo de inscripción que tengas. Si tomas un curso en modo de oyente, verás la mayoría de los materiales del curso en forma gratuita. Para acceder a asignaciones calificadas y obtener un certificado, deberás comprar la experiencia de Certificado, ya sea durante o después de participar como oyente. Si no ves la opción de oyente:
es posible que el curso no ofrezca la opción de participar como oyente. En cambio, puedes intentar con una Prueba gratis o postularte para recibir ayuda económica.
Es posible que el curso ofrezca la opción 'Curso completo, sin certificado'. Esta opción te permite ver todos los materiales del curso, enviar las evaluaciones requeridas y obtener una calificación final. También significa que no podrás comprar una experiencia de Certificado.
¿Qué recibiré si me suscribo a este Programa especializado?
Cuando te inscribes en un curso, obtienes acceso a todos los cursos que forman parte del Programa especializado y te darán un Certificado cuando completes el trabajo. Se añadirá tu Certificado electrónico a la página Logros. Desde allí, puedes imprimir tu Certificado o añadirlo a tu perfil de LinkedIn. Si solo quieres leer y visualizar el contenido del curso, puedes auditar el curso sin costo.
¿Hay ayuda económica disponible?
Sí. En ciertos programas de aprendizaje, puedes postularte para recibir ayuda económica o una beca en caso de no poder costear los gastos de la tarifa de inscripción. Si hay ayuda económica o becas disponibles para tu selección de programa de aprendizaje, verás un enlace para postularte en la página de descripción.
Is this activity accredited for Continuing Medical Education (CME)?
The American Academy of Family Physicians (AAFP) has reviewed Value-Based Care: Reimbursement Models and deemed it acceptable for AAFP credit. Term of approval is from 01/01/2021 to 12/31/2021. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Following this CME activity, participants will have the opportunity to earn an additional two Prescribed credits for participation in the Translation to Practice® exercise. Information on Translation to Practice® will be shared within the activity. Credit approval includes the following sessions:
3.00 Enduring Materials, Self-Study AAFP Prescribed Credit(s) - Value-Based Care: Reimbursement Models
2.00 Enduring Materials, Self-Study AAFP Prescribed Credit(s) - Value-Based Care: Reimbursement Models- Translation To Practice

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Value-Based Care: Reimbursement Models

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Qué aprenderás

Habilidades que obtendrás