PPOL-640 HEALTH CARE QUALITY: RECENT POLICY ISSUES
Fall for 2017-2018
This course provides an introduction to how public policy can be used to improve healthcare quality and the public reporting of quality. Topics include: (1) The Quality Gap; Disparities; The National Quality Strategy under the Affordable Care Act (ACA); international comparisons; quality post-ACA: health savings accounts and the Quality Payment Program under MACRA and MIPS; (2) Quality measures and the science of ranking and comparing providers; (3) Designing incentives for rewarding quality: pay-for-performance models versus behavioral economic models (Nudge theory, default theory, peer group effects, shame); shared-savings models; accountable care organizations (ACOs) and other Alternative Payment Models; (4) Protecting the patient: patient safety and medical errors; the Checklist Manifesto; alternative tort reforms, the Apology Initiative; payment policies for hospital-acquired conditions and readmissions; (5) Coordinating care: electronic health records; the medical home model; bundled payment design; end of life care; POLST reforms; (6) Measuring preventive care quality: debates over screening guidelines; the science of measuring the cost offsets and outcomes of preventive care and pharmaceuticals; (7) Reporting quality: report cards; consumer use of public reports; physician use of internal reports; (8) Measuring overuse, underuse, waste, and the costs-savings from quality; comparative effectiveness methods; geographical cost and quality variation; (9) Current policy issues in personalized medicine and genomics; and (10) The impact of insurer/provider competition and consolidation on quality. By the end of the course, students should be able to think critically about the key health policy issues related to improving healthcare quality.
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