Health Insurance and Risk Management (HLTH620)
This course addresses the financing and reimbursement functions associated with medical care in the United States. Primary attention will be directed toward the economic purpose, structure, operation, and performance of the private health-insurance industry. Emphasis will be placed on the business of providing health-insurance products such as underwriting, and on 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 will be discussed. Attention also will be 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 in the United States.