HIM 141 - Healthcare Delivery Systems

1. Foundations, values and evolution of health care delivery systems
2. Health services organization and delivery in the U.S.
3. Health care organization structure and operation
4. Commercial managed care and federal insurance
5. Payment methodologies and systems
6. Regulatory quality monitoring requirements
7. External standards, regulations and initiatives
8. Health care leadership
9. Health care professionals and their roles
10. Health care delivery in the future

1. Describe the evolution of the U.S. healthcare system. (1, 10)
2. Connect health services organization delivery, structure and operations in the U.S. (2,3,9) Domain 111.A.1-2
3. Differentiate between commercial, managed care and government sponsored insurance plans. (4) Domain. I.D.1-2
4. Apply policies and procedures to comply with the changing regulations among various payment systems for health care services like Medicare, Medicaid and managed care plans. (5) Domain I.D. 2
5. Evaluate established regulatory guidelines to comply with reimbursement and reporting requirements. (6) Domain I.D.4
6. Differentiate between regulating bodies within health care and identify standards organizations that impact healthcare delivery. (7) Domain III.A.1
7. Categorize the role and responsibilities of the governing body and administrative leadership in healthcare organizations. (8) Domain III.A.2
8. Differentiate the roles of various providers and disciplines throughout the health care continuum. (9) Domain III.A.2
9. Connect how changes emerging in health care models, workforce challenges, public health initiatives, clinical technologies and evidence-based medicine will influence the future of health care in the U.S. (10)