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Course Overview

Health insurance and managed care play a critical role in balancing access, cost, and quality in healthcare systems. Leaders must understand financing mechanisms, risk management, and innovative approaches that drive value-based care.

This Health Insurance and Managed Care Strategies Training Course provides insights into insurance models, managed care structures, and emerging strategies to align incentives across payers, providers, and patients.

Through case studies and interactive exercises, participants will analyze global insurance systems, managed care contracts, and approaches to ensure sustainable, equitable healthcare financing.

Course Benefits

• Gain a clear understanding of health insurance principles.

• Explore managed care models and strategies.

• Strengthen risk management and cost-control skills.

• Improve alignment between payers and providers.

• Support value-based and patient-centered care systems.

Course Objectives

• Explain core concepts of health insurance and managed care.

• Compare public and private insurance systems globally.

• Evaluate managed care structures and contracts.

• Apply strategies for controlling costs and improving outcomes.

• Assess risk management approaches in health insurance.

• Analyze the role of policy in shaping insurance markets.

• Design strategies to enhance equity and sustainability.

Training Methodology

The course uses a mix of lectures, case studies, group discussions, and simulations. Participants will explore real-world insurance models and practice decision-making for managed care strategies.

Target Audience

• Insurance professionals and healthcare payers.

• Healthcare executives and administrators.

• Policy makers and regulators in health financing.

• Providers engaged in managed care arrangements.

Target Competencies

• Health insurance design and management.

• Managed care contracting and evaluation.

• Risk management in healthcare financing.

• Value-based and cost-effective care strategies.

Course Outline

Unit 1: Fundamentals of Health Insurance

• Principles of health insurance.

• Key terminology and concepts.

• The role of insurance in healthcare access and equity.

• Economic rationale for health insurance systems.

Unit 2: Managed Care Models and Structures

• Evolution of managed care.

• HMOs, PPOs, and other managed care models.

• Contracting between payers and providers.

• Benefits and limitations of managed care.

Unit 3: Financing and Risk Management

• Risk pooling and risk adjustment.

• Cost-containment strategies.

• Premium setting and reimbursement methods.

• Addressing adverse selection and moral hazard.

Unit 4: Policy and Regulation of Insurance Markets

• The role of government in insurance regulation.

• Policy reforms and their impact on insurance models.

• Ensuring consumer protection and fairness.

• International perspectives on insurance regulation.

Unit 5: Innovations and Future Directions

• Value-based insurance design.

• Digital health and insurance innovation.

• Public-private partnerships in managed care.

• Global lessons for sustainable financing.

Ready to strengthen your expertise in healthcare financing?
Join the Health Insurance and Managed Care Strategies Training Course with EuroQuest International Training and lead the future of sustainable healthcare delivery.