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US Payers Industry Primer

By FifthElement
Instructor-Paced
Free
The US spends more on healthcare than any other country, with these healthcare services financed by a complex mixture of public and private payers. There is no single nationwide model of health insurance and insurance programs all differ with respect to benefits covered, sources of financing and payments to healthcare providers. As well as being the most expensive, the US healthcare system is the most complex. This primer will introduce you to the different types of insurance programs in the US, how they are financed, underwritten and administered. You will learn about the key characteristics of an insurance plan and how insurance companies work with health providers, the government, employers and other key players like Pharmacy Benefits Managers to deliver insurance coverage.
Table of Content
  • Introduction
  • Characteristics of an Insurance Plan
  • US Payers
  • Insurance Plan Contracts
  • The Reimbursement Process
  • Wrap-up
Skills
Health Care Industry Payments Industry Health Care System Prospective Payment Systems Publicly Funded Health Care Health Systems Health Care Benefits Medicare Healthcare Services Healthcare Delivery Models
Modules