Introduction to Healthcare Systems

Review:

Review the fact sheet. Arrive to class familiar with content.

Fact Sheet on Healthcare Financing and Reform

Watch:

Search the Khan Academy website (khanacademy.org) and create a log-in. Locate the “Health Care System” modules.  To do this, first select the “Science” category, then “Health and Medicine”, then “Health Care System”.  All students should arrive to class capable of quickly accessing the Khan Academy website.

View Khan Academy Modules as necessary. Three Khan academy modules are listed below.  The content of these modules is summarized.  Students with background knowledge in the listed content and fact sheet content are NOT required to view the modules.  The modules are a supplementary assignment and should be completed as necessary based on student background and understanding of the US healthcare system and payment systems.  Note: students may need to access Khan Academy modules for small group work during the breakout session.

Module 1: Health care system overview (8 minutes)

Explains how patients/populations, providers, and payors interact.  Introduces government insurance, direct payment of patient to doctor, HMOs and PPOs.  Explains the rationale for insurance to mitigate risk and discusses the need to manage “moral hazard” as well as over-utilization of services when not directly responsible for payment.

Module 2: Paying doctors (12 minutes)

Defines FFS, capitation and salary.  Describes the lack of cost accountability to patients and providers in the third party payor system.  Describes issues with capitation with particular attention on “cherry picking” or patient shifting.

Module 3: Medicare overview  (16 minutes)

Introduces Medicare and Medicaid.  Defines populations covered for Medicare (Elderly/ALS/ESRD) and Medicaid (low income) as well as funding source (Federal Government for Medicare and combined Federal and State for Medicaid).  Defines Secretary of HHS and CMS (Centers of Medicare and Medicaid Services).  Describes Medicare parts A-D.