Learning Objectives
Upon completion of this course, the student will be able to describe the factors that have influenced the growth of managed healthcare, the main cost-containment strategies developed by managed care organizations (MCOs), quality control mechanisms of managed healthcare organizations; models, elements, and cost-containment mechanisms of integrated healthcare delivery systems (IDSs); disease management, information systems, and the role of providers and pharmacy in managed care; trends in managed care; and opportunities for the healthcare representative.
Who Should Take This Course
Sales representatives, managers, and others who interact with healthcare providers and administrators in managed care organizations (MCOs).
Career Applications/Benefits
The proliferation of managed care, provider integration, and other methods of healthcare delivery, such as disease management, continues to have broad implications for the pharmaceutical industry. These models are redefining the way that pharmaceutical products are prescribed, utilized, and delivered. Many major pharmaceutical companies have adapted to the managed care marketplace by providing specialized training to healthcare representatives to better meet the needs of this new customer class. These and other developments are at the center of a radical shift in the role that pharmaceutical manufacturers are playing in American healthcare today—one that is now based less on the provision of product and more on the delivery of total healthcare. This course will be of particular benefit to those who interact with MCOs, which are focused on ways to provide quality healthcare as efficiently as possible. It also has value to those in pharmaceutical companies who have partnered with MCOs to initiate disease management services, which focus on specific diseases that complement their product line. Pharmaceutical therapies are often key components of disease management programs for conditions such as asthma, diabetes, and cardiovascular disease.
Chapter Content
Chapter One: Introduction to Managed Healthcare
- The Emergence of Managed Healthcare
- Cost-Containment Strategies in Managed Healthcare
- Managed Care and Major Healthcare Payers
Chapter Two: Issues and Trends in Managed Care
- Evaluating the Quality of Managed Care
- Integrated Delivery Systems
- Disease Management
- Information Technology in Managed Healthcare
Chapter Three: Roles of Providers and the Pharmacy in Managed Care
- Healthcare Professionals and Managed Care
- Hospitals in the Managed Care Environment
- Ancillary Providers and Managed Care
- The Managed Care Pharmacy
Chapter Four: Managed Care Trends and the Pharmaceutical Industry
- Trends and Forces in Managed Care
- Opportunities for the Healthcare Representative in Managed Healthcare