Regulated Competition in Healthcare Systems: Theory & Practice

Erasmus University Rotterdam via Coursera

Go to Course: https://www.coursera.org/learn/regulated-competition-healthcare-systems

Introduction

# Course Review: Regulated Competition in Healthcare Systems: Theory & Practice ## Overview In today's rapidly evolving landscape of healthcare, effective governance and regulation are essential for ensuring that individuals have access to affordable and high-quality medical services. The course "Regulated Competition in Healthcare Systems: Theory & Practice" on Coursera addresses this vital subject through a detailed examination of the concept of regulated or managed competition in healthcare systems. It provides a comprehensive platform for learners interested in exploring how different countries navigate the intricacies of healthcare regulation and competition. ## Course Structure and Content The course is structured around several key modules, each tackling different aspects of regulated competition: 1. **Introduction and Overview**: This introductory module sets a welcoming tone, introducing the instructors and giving learners insight into the course structure. It’s a great starting point for networking with peers. 2. **Why Government Intervention is Necessary & Waves of Healthcare Reform**: Here, students delve into the history of government interventions in healthcare, particularly noting several critical reforms made throughout the 20th century. This context is vital for understanding how and why the current systems are structured as they are. 3. **Market & Government Failure in Healthcare**: This module presents a balanced examination of how both markets and governments can fail in healthcare. It raises essential questions about the balance required to avoid pitfalls inherent in market-based reforms. 4. **Theory of Regulated Competition in Healthcare Systems**: Students explore the theoretical framework of regulated competition and its potential to boost both affordability and efficiency in healthcare delivery, making it a cornerstone of the course. 5. **Preconditions for Achieving Efficiency & Affordability in Competitive Healthcare Markets**: The ten specific preconditions outlined in this module are crucial for evaluating the success of regulated competition models and provide practical insights applicable to real-world situations. 6. **Ongoing Reforms: Premium Regulation, Risk Equalization & Risk Sharing in Health Insurance Markets**: This segment focuses on how to promote affordability in health insurance and addresses the challenges posed by risk selection, equipping learners with tools to mitigate these issues. 7. **Ongoing Reforms: Competition Regulation in Healthcare**: In this module, learners confront the complexities of competition regulation, including nuances like hospital mergers and insurer power, which significantly affect healthcare dynamics. 8. **Ongoing Reforms: Provider Payment in Healthcare Systems**: This module examines various provider payment structures and their implications for maintaining a high-quality healthcare system. It provides a thorough exploration of payment incentives that drive provider behavior. 9. **Key Takeaways & Farewell**: The concluding module wraps up the course by summarizing important learnings, helping learners reinforce their knowledge and ensuring they leave equipped with a clearer understanding of the subject matter. ## Learning Experience The course is delivered through engaging video lectures and interactive materials, allowing for a flexible learning pace. The instructors are knowledgeable and present the information clearly, encouraging critical thinking and active engagement with the content. Moreover, the structure allows for hands-on learning, enabling students to reflect on their own and others' health care systems, hence fostering a collaborative environment. Peer interactions through discussion forums enhance the learning experience and build community among participants from diverse backgrounds and regions. ## Recommendation I highly recommend "Regulated Competition in Healthcare Systems: Theory & Practice" to anyone interested in healthcare policy, public health, or health economics. Whether you are a student, a professional in the industry, or just an interested individual wanting to grow your knowledge base, this course provides invaluable insights into regulated competition's theory and real-world applications. The information and skills acquired throughout the course are not only relevant in an academic context but also practically applicable in current discussions around healthcare reform in various parts of the world. Completing this course will not only enhance your understanding of regulated competition but also empower you to engage with pressing healthcare issues more effectively. Overall, this course is a significant investment in your professional development in the health sector, and its structured approach makes complex topics more approachable and engaging. Don’t miss out on this opportunity to deepen your understanding of healthcare systems!

Syllabus

Introduction and overview

In this module you will be introduced to the teachers involved in this MOOC and you will get an overview of the topics covered by this MOOC. Moreover, you will be asked to briefly introduce yourself. Have fun!

Why government intervention is necessary & waves of health care reform

In this module you will learn why government intervention in health care is necessary and how governments have intervened in the past century. You will learn that in high income countries three waves of government intervention in health care can be distinguished. Enjoy!

Market & government failure in healthcare

In this module you will learn that, particularly in health care, markets and governments are both far from perfect. The key challenge for market-based health system reform is therefore: how to navigate between market failure and government failure? As a start, you will learn some important lessons that should be taken into account when considering the introduction or strengthening of competition for healthcare provision. Enjoy!

Theory of regulated competition in healthcare systems

In this module you will learn about the model of regulated competition in healthcare systems. More specifically, you will learn what this model looks like and how it can help to simultaneously achieve affordability and efficiency. Have fun!

Preconditions for achieving efficiency & affordability in competitive health care markets

This module will introduce you to ten specific preconditions for achieving efficiency and affordability in competitive healthcare markets. For each precondition, you will learn what the consequences could be if this precondition is not fulfilled. In addition, you will learn to use the preconditions to evaluate the progress of the implementation of regulated competition. Good luck and have fun!

Ongoing reforms: premium regulation, risk equalization & risk sharing in health insurance markets

Social health insurance markets typically include premium regulation to promote affordability of health insurance for people with expensive medical conditions. A side-effect of premium regulation is that it confronts consumers and insurers with incentives for risk selection. In this module you will learn about typical forms of risk selection and their welfare effects. Moreover, you will learn about tools for the regulator to mitigate selection problems. Have fun!

Ongoing reforms: competition regulation in health care

In this module the focus is on effective competition regulation as an important precondition for achieving efficiency in competitive healthcare markets. You will first learn about the basic principles of this type of regulation, after which you will learn about three key issues regarding competition regulation in healthcare. These issues are: (1) hospital merger control; (2) insurer monopsony power; and (3) the potential trade-off between integration, coordination and the use minimum volume standards on the one hand and competition on the other. Good luck and have fun!

Ongoing reforms: provider payment in healthcare systems

In other videos about the preconditions for regulated competition, you’ve learned that in addition to consumers and insurers, providers of care should also be stimulated to spend resources wisely. Clearly, the extent to which this is the case depends on the way in which providers are paid for their services. This module therefore focuses on provider payment systems, and specifically on the design thereof. The core of the module consists of 7 videos divided over 3 lessons: (1) What drives provider payment reform? (2) Provider payment incentives & reform: what does the theory say? And (3) Value-based payment methods: types, design and effects. In contrast to the first lesson, lessons 2 and 3 start with a short introduction which you should read before you begin. Have fun!

Key takeaways & farewell

Congratulations, you are about to complete this MOOC! By now, you should be able to explain the model of regulated competition in healthcare including its background, principles and preconditions for success. In this final module we summarize the primary takeaways from this MOOC and say goodbye.