Course Overview

BUS-301.1: The Managed Healthcare Market (3 Credits)
Program(s): CMR and CPM

COURSE CONSULTANTS

THIRD EDITION:

J. Lyle Bootman, PhD ScD
Dean, College of Pharmacy

Professor of Pharmacy, Medicine, and Public Health

Executive Director of the Center for Health Outcomes and PharmacoEconomic (HOPE) Research

Arizona Health Sciences Center
University of Arizona
Tucson, Arizona

Mark Callahan, MD
Chief, Division of Outcomes and Effectiveness Research
Department of Public Health
Weill Medical College of Cornell University
New York, New York

Graduate Supplement
BUS-5301
To earn graduate-level credit, this supplement and course BUS-301.1 must be successfully completed.

Click here for more information about graduate-level credit.

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.

Course Description:
This course provides an overview of the managed healthcare market in the United States. It discusses developments in U.S. healthcare that led to the implementation and growth of managed care, describes the components of various types of managed care delivery systems, and discusses key concepts for cost containment and quality improvement within MCOs. The course also discusses the changing roles of healthcare providers working in the managed care market and opportunities for healthcare representatives.

Related Courses:
• The 21st Century Physician
• Disease Management
• The Evolving Healthcare Community
• Outcomes: Measurement, Management, and Marketing
• The Pharmaceutical Industry
• The Value of Pharmaceuticals

Chapter Content:

Chapter 1: Introduction to managed healthcare
	The Emergence of Managed Healthcare Cost-Containment Strategies Managed Care and Major Healthcare Payers
Chapter 2: Issues and Trends in Managed Care
	Evaluating the Quality of Managed Care Integrated Delivery Systems Disease Management Information Technology
Chapter 3: 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 4: Managed care trends and the pharmaceutical industry
	Trends and Forces in Managed Care Opportunities for the Healthcare Representative

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.