Description
This course deals with the financing and reimbursement functions associated with medical care in the United states. Primary attention is directed towards the economic purpose, structure, operation, and performance of the private health insurance industry. Emphasis is placed on the business of providing health insurance products such as underwriting, medical claims cost control, pricing, and marketing. In that context, managed care techniques, benefit package designs including consumer directed health plans, and cost sharing mechanisms are discussed. Attention is also paid to the Medicare and Medicaid programs, the impact of government regulations on the operation and performance of the private health insurance industry, and health care reform. (3 units; As offered)