Value-Based Care: Introduction to Value-Based Care and the U.S. Healthcare System

COURSE 1 of 7. This course is designed to introduce you to the concept of value-based care (VBC). While the information you will explore is general, it will help you establish a solid foundation for continued learning and future thinking about the concept of VBC. Through a historical lens, you will explore the creation of Medicare and Medicaid and the evolution of commercial insurance, TRICARE, and the Veterans Health Administration. While history is an important filter for understanding healthcare in this country, you will learn how each of these mechanisms emerged, the populations served, and what changes occurred over time, with a focus on funding and expenditures. In addition, this course will help you establish a firm foundation for understanding the development and evolution of quality measures and outcomes in healthcare. By developing an understanding of what quality is and how it is measured, you can begin a knowledge-building exploration of the components of quality in healthcare. Why is this important? In value-based care models, providers must meet quality measures and improve the health outcomes of their patients. In the summative assignment, you will use a national system of quality measures to develop a plan that would positively impact value within your healthcare organization.

• Introduction to Value-Based Care
• This module is designed to introduce you to the concept of value-based care. While the information you will explore is general, it will help you establish a solid foundation for continued learning and future thinking about the concept of VBC as you progress through this certificate program. Even if you have an understanding of or experience with VBC, this module might serve as a useful review. 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!
• The U.S. Healthcare System (Medicare, Medicaid, Commercial Insurance, TRICARE, and the Veterans Health Administration: Creation, Evolution and Change
• TThis module is designed as an overview of the U.S. healthcare system. Through a historical lens, you will explore the creation of Medicare and Medicaid and the evolution of commercial insurance, TRICARE, and the Veterans Health Administration (VHA). While history is an important filter for understanding healthcare in this country, the majority of this module will examine how each of these mechanisms emerged, the populations served, and changes over time, with a focus on funding and expenditures. You will also explore relationships and critical differences across these mechanisms. While the information you will explore is general, it is designed to help you establish a solid foundation for continued learning and future thinking about the concept of VBC as you progress through this certificate program. Even if you have an understanding of the general healthcare landscape, this module might serve as a good review. Remember, as you read or hear terms or concepts that are new to you, have your digital (Word document) 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!
• Development and Evolution in Healthcare Quality Measures and Outcomes
• This module is designed to help you establish a firm foundation for understanding the development and evolution of quality measures and outcomes in healthcare. By developing an understanding of what quality is and how it is measured, you can begin a knowledge-building exploration of the components of quality in healthcare. From there, you’ll synthesize the importance of outcomes in healthcare management and how they have evolved, and reflect on opportunities for the future. Why is this important? As you have already explored in this course, in value-based care models, providers must meet quality measures and improve the health outcomes of their patients. While the information you will explore is general, it is designed to help you establish a solid foundation for continued learning and future thinking about the concept of value-based care as you progress through this certificate program. Even if you have an understanding of quality measures and outcomes, this module might serve as a good review. 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!
• Course Project: Making This My Own
• A key theme of Course 1 is evolution. You explored the evolution of value-based care (Module 1), the evolution of the U.S. healthcare landscape (Module 2), and the evolution of quality measures and outcomes in healthcare (Module 3). And as expected with any evolution, complexities naturally emerge. This is quite evident in your brief examination of the diverse U.S. healthcare landscape with all of the various types of insurance supported by various types of revenue models and serving various individuals. Equally complex is the array of national quality measures and outcomes across healthcare, where some people focus on the patient or the provider and others on the care setting or a particular healthcare condition. And, as this certificate program is an introduction to value-based healthcare, the complexities of this system might emerge when striving to answer, “What is value?” However, being complex is not an obstacle for achieving success; in fact, it is often a catalyst for positive change. Whether you are currently working in healthcare or are pursuing a healthcare career, throughout this certificate program you should be asking: “How does the information connect to and strengthen my understanding of value-based care?” And regardless of whether your organization is considering a transition to VBC, is in the midst of doing so, or has successfully made the transition to VBC, a secondary question must always be: “How do I lead from where I am to support successfully and or advance VBC?” Let’s begin this summative assignment by applying what you have explored in this course to your current (or future) practice to address the following: What would be your role in helping to drive better outcomes for patients/members? Using a national system of quality measures explored in Module 3, develop a plan that would positively impact value within your healthcare organization (office, practice, site or system). Follow the steps below to complete this assignment.