PHRM 519 Healthcare Delivery Systems Syllabus 2012 (3)

Short lecture followed by interactive class policy

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Short lecture followed by interactive class policy analysis (Obj #s 1, 4) Pizzi 2 (9/6) Financing and Reimbursement for Healthcare Services and Managed Care The flow of funds for medical care and pharmaceuticals in the U.S. and how reimbursement differs between traditional and managed care insurance models (Obj #s 2, 5) Pizzi 3 (9/13) Pharmaceuticals: From Development to Delivery Overview of the phases of drug development; definition, role of the P&T Committee, Benefit Design (formularies, co-payments, prior authorization, tiering), pharmacy distribution channels and REMs (Obj #5) Health Policy Team Debate 1: Employers Dropping or Reducing Contribution towards Healthcare Coverage (Teams 1 & 2) Pizzi 4 (9/20) Medicare and Medicaid Structure, Scope, and Financing (Obj #3) Health Policy Team Debate 2: Limiting Opioid Dispensing to REMS-Certified Pharmacies (Teams 3 & 4) Pizzi 5 (9/27) Prescription Drug Coverage through Medicare (with focus on Medicare Part D): History on the development of the Medicare drug benefit through the Medicare Modernization Act of 2003; Medicare drug benefit design and administration; Medication Therapy Management (MTM) (Obj #3) Health Policy Team Debate 3: Expanding Medicaid Eligibility Requirements as Legislated through Health Reform (Teams 5 & 6) Pizzi 6 (10/4) US Health Reform of 2010: The Patient Protection and Affordable Care Act (PPACA) Overview of components of H.R.3590 – Patient Protection and Affordable Care Act – with discussion of pharmacy-related inclusions (Obj #s 2, 3) Health Policy Team Debate 4: PBMs Reducing Access to Brand Name Drugs (Teams 7 & 8) Pizzi 7 (10/11) Midterm Examination (HERBUT AUDITORIUM) 8 (10/18) Quality Improvement in US Healthcare Definition of healthcare quality, overview of quality measurement standards and pay for performance (Obj #4) Health Policy Team Debate 5: Supreme Court Upholding the Individual Mandate (Teams 9 & 10) Jacoby*, Pizzi 9 (10/25) Long Term Care Overview of long term care and medication delivery in long term care settings (Obj #2) Health Policy Team Debate 6: Medicare Refusing to Pay for Hospital Readmissions within 30 days for Pneumonia Patients (Teams 11 & 12) Knowlton*, Pizzi 10 (11/1) Other Models of Healthcare Delivery Discussion of health and healthcare in the context of sociopolitical values; comparison of the US model of healthcare to other countries’ models of healthcare (Obj #s 3,4) Health Policy Team Debate 7: Bundled Medicare Payments for End Stage Renal Disease Patients Receiving Dialysis (Teams 13 & 14) Maio*, Pizzi 11 (11/8) Pharmacy Quality Overview of medication-related healthcare quality measures, and national efforts to engage pharmacists in quality through the Pharmacy Quality Alliance (Obj #4) Quiz Pizzi 12 (11/15) NO CLASS (11/22) NO CLASS – THANKSGIVING HOLIDAY 13 (11/29) Policy Analysis Presentations, Session 1** CLASS IS EXTENDED UNTIL 4:50 PM Pizzi 14 (12/6) Policy Analysis Presentations, Session 2** CLASS IS EXTENDED UNTIL 4:50 PM (HERBUT AUDITORIUM) Pizzi * Guest lecturers are listed in Appendix A.
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