Health care delivery models are continually evolving as a result of industry trends, economic pressures and legislative mandates. As a result, it is difficult for consumers to stay informed of current options to make the best decisions for their health care. This course reviews the evolution of health plan types, demonstrating how the different plans utilize various models for delivering care to consumers.
Lesson 1: Basic Plan Types and Funding
Details the evolution of managed care and the different plan types that are common today, as well as how these plan types are funded and the different tools used for managing plan costs.
Lesson 2: Plan Features That Deliver Care to Consumers
Identifies two major plan features, tiered networks and telemedicine, which may be used to deliver specialty care to consumers and discusses the advantages and challenges associated with each feature.
Lesson 3: Models of Care Delivered by Providers and Utilized by Plans
Describes three models of care—patient-centered medical homes (PCMH), centers of excellence and accountable care organizations (ACO)— that plans may approve for consumers to use. Also reviews how the Patient Protection and Affordable Care Act (ACA) has affected the delivery of health care since its establishment.
Lesson 4: Advising Consumers
Explains how to advise consumers on choosing between different plan types and how plan features and delivery models can affect plan choices.