BE 608: Agenda and formalities

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Welcome!

Course Overview

• In this course we will use basic economic concepts to understand key features of the US health care system.
• Data driven approach to understanding the US health care system.
• We will examine the role of government and how health policy affects insurance coverage, access to care and health spending.
• Throughout the lecture we will talk about ways in which we're learning that COVID has affected our health care system and our vision of health care access for the future.

BE 608 Course Topics

Challenges Facing the US Healthcare System (Spending)

• Why does the US spend so much more than any other country?
• What are some implications of spending growth?
• How has the COVID-19 crisis affected health spending?

The goal of this lecture is to give you the "lay of the land."

Economic Issues in Healthcare

• How is healthcare different from other goods?
• What are the policy implications?
• How can we evaluate the efficiency of the US health care system

Competition in Health Care

What are the causes and consequences of provider consolidation?

What is the policy response to market power?

BE 608 Course Topics

The Role of Government and Recent Health Policy

• What role does government policy play in health markets?
• What have been the most recent policy changes, and what are the implications?
• What proposals are on the horizon?

Social Determinants of Health

• What are important social determinants of health? 
• How can providers and payers effectively improve population health?

Alternative Payment Models

• How are new payment/delivery models designed?
• What is the evidence on their effects?

Course Readings

All readings are available as pdfs from the Canvas site.

Readings vary in length and style. All are (pretty) non-technical.

Starting next week, you are expected to do the reading before class.

Over the course of the semester I may add some (not many).

Upcoming Readings

Garber and Skinner, “Is American Health Care Uniquely Inefficient?” Journal of Economic Perspectives, 2008

• Frames international comparisons of health spending in terms of the economic concepts of productive and allocative efficiency.

Gawande, "Overkill," The New Yorker

• Popular press article providing context for the academic work

BE 608 Assignments and Grading

Grades based on a mix of individual and group assignments.

Individual

• Homework assignment (due 11/8): 10%
• Class participation: 20%
• Final Exam December 13 (online), 6:30pm: 35%

Group

• In class presentation on payment/delivery reform: 35%

BE 608 Assignments and Grading

Elective course curve

• Excellent: 35% Max
• Good: 40% Max
• Pass: Max 35%
• Low Pass or Fail: 5% 

Typically 75% of students get Exc or Good, 25% get pass, and 1 or 2 get LP or F.

If you are not a Ross student: you should ask your home college's registrar how these grades will translate

Course Format

• I want us to learn together and from each other in person
• That said, please don't come to class if you're not feeling well
  • Email me and I will send you a link to a video recording
  • I will excuse you from the participation grade for that class

Class Participation

Supreme Court Justice Brandeis famously wrote: "the state may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country."

States are often at the vanguard, trying to make markets and policy work better. Sometimes these attempts fail and sometimes they succeed. 

If you haven't already, I'd like you to all choose a state (sign up through Canvas using the google spreadsheet link). At each lecture I'll give you a question to research over the week, and we can discuss what you find in class the following week.

Analysis of Payment/Delivery Reforms

• The Federal government and the private sector have invested in a number of reforms that change the way providers are paid with the goal of achieving the “triple aim” (improving the patient experience, improving population health, reducing the per capita cost of health care.)
• These new models are similar in the sense that they are alternatives to traditional fee-for-service models. A common objective is to “shift from  a system that pays for volume to one that pays for value.”
• The different models vary in how exactly they seek to achieve these goals.

Analysis of Payment/Delivery Reforms

I will post details about five reform initiatives that are representative of leading strategies and that are sufficiently advanced that there is published research on their effects.

Working in groups, you are to prepare a short (8-10 minute) presentation on one of these payment reforms.

More details coming soon!

Contact/Office Hours

• Office hours are Tuesday afternoon--sign up with Calendly link
• If you can't make that time, email me and we will set up a separate time
• I am available in person or over Zoom
• Email mille@umich.edu

Calendar

• We have 6 weeks of class, no class the week of Thanksgiving
• In class presentations are December 6th
• Final exam is online on Wednesday, December 13th

Mental Health Services

• On the syllabus you can find some information on mental health services on campus.
• Many of these services are free and all of them will be confidential.

Questions?