COURSE 4 of 7. This course is designed to help you build high-level knowledge of the current medical coding and payment mechanisms of most U.S. healthcare services, referred to as fee-for-service. You will explore why the fee-for-service model has contributed to higher costs in the U.S. healthcare system without clearly improving health outcomes. You will examine the importance of coding to reflect chronic conditions and other diagnoses accurately and how value-based care and payments utilize these measures and data. As you learn about a model to replace fee-for-service, you’ll encounter a range of payment options considered to be value-based that utilize a framework from the Health Care Payment Learning and Action Network (HCP-LAN). To build on those options, you will learn how risk-adjustment, quality scores, and patient satisfaction measures are critical parts of value-based care and payment contracts. In the summative assignment, you will demonstrate your knowledge by comparing fee-for-service and value-based contracts, using specific examples to explain and justify the importance of documentation and coding, and identifying ways that risk-adjustment and patient satisfaction are incorporated into value-based care contracts.
University of Houston
Established in 1927, the University of Houston empowers students in their pursuit of learning, discovery, leadership and engagement. Located in a sprawling metropolis, our premier Tier One campus provides students with cutting edge programs including undergraduate, graduate, doctoral, distance and continuing education. Ranked among the best colleges in America, UH is home to award-winning faculty, innovative research centers, has one of the most diverse student populations in the nation, and alumni who have become international leaders.
Learners may study at their own pace to take any of the six courses and the Capstone Project course independently (receiving a certificate for each) or collectively for the specialization designation. This specialization is intended for healthcare professionals, faculty, and students pursuing healthcare-related studies to develop an awareness of Value-Based Care reimbursement and operating models. Through six courses and a Capstone project, you will develop an understanding of your individual responsibility to lead a culture of collaboration in the workplace focused on value-based care. Our industry partner, Humana, brings their expertise and years of experience in providing quality care.
Is this activity accredited for Continuing Medical Education (CME)?