Course Title: Health Care, Mechanics of Insurance and Reimbursement

Course Code: UU-HCM-1030-UG

Programme: Bachelor of Arts in Healthcare Management

Credits: 4.00

Course Description:

Course/Module Description:

This course combines the insights of health economics with a strategic perspective on the business of health. The first section will consider the costs and benefits of medical interventions, while the second considers insurance theory and places special emphasis on the challenges facing firms in the face of the rising costs of health benefits as well as opportunities for private insurers operating in publically financed markets.

Course/Module Objectives:

The main objectives of the course are:

1. To provide exposure to the design and operation of healthcare financial and reimbursement systems
2. To examine the current system of financing health care and the factors affecting it
3. To discuss the employer-based health insurance and relationships to reimbursement systems.

Course/Module Learning Outcomes:

After completion of the course students are expected to be able:

1. To compare and contrast Medicare and Medicaid with regard to population served
2. To describe the nature and current trends in employer-based health insurance and relationships to reimbursement systems
3. To define the primary types of costs and revenues
4. To identify the main sources of money to pay for health care
5. To describe its intended purpose, relation to moral hazard, and potential unintended consequences for patients
6. To differentiate between co-pay and co-insurance
7. To explain Medicare with respect to covered services.

Prerequisites: UU-BA-IND100-UG