Main description:

This is a text based on the primary author's course notes presented over the past five years at Carnegie-Mellon U. This text is an overview of the US healthcare system, with specific emphasis on flow charting the entire system as to how it's integrated. Coverage of the reimbursement system, along with extensive coverage on health care IT, is also included. Issues such as operational efficiency, quality improvement and big data opportunites are covered in detail. There will be numerous examples and end-of-chapter pedagogy to enhance learning.

Contents:

Overview of government structures. How policy turns into law & regulation. Health policy and reform policies. The intersection of public, population health and health care reform. The health care delivery value chain. The payers. Accountability care organizations and PACE. Managed service organizations. Wellness and disease management. Retailers. Alternative Site Providers. Hospitals. Distributors and intermediaries. Manufacturers. The health service professionals. Role of World Health Organization. International classification of diseases. How Medicare and Medicaid distribution benefits.The insurance model. Insurer funding sources. Revenue cycle management. Biotechnology. Bio-pharmaceutical. Diagnostics. Medical devices. Financial managment systems. Clinical management systems. Healthcare analytics. Health IT. Finacial management systems. Clinical management systems. Healthcare analytics. Population health management. The future of health care.