MPV_HFAR Healthcare Finance and Reimbursement

Ekonomicko-správní fakulta
jaro 2025

Předmět se v období jaro 2025 nevypisuje.

0/2/0. 5 kr. Ukončení: z.
doc. JUDr. Ivan Malý, CSc. (cvičící)
doc. JUDr. Ivan Malý, CSc.
Katedra veřejné ekonomie – Ekonomicko-správní fakulta
Kontaktní osoba: Jana Biskupová
Dodavatelské pracoviště: Katedra veřejné ekonomie – Ekonomicko-správní fakulta
Omezení zápisu do předmětu
Předmět je určen pouze studentům mateřských oborů.
Mateřské obory/plány
Cíle předmětu
The course builds on the mainly theoretical knowledge of the functioning of quasi-markets in healthcare acquired in the course Introduction to Healthcare Economics. It focuses on the institutional design of financial flows in health systems. The aim of the course is:
(a) to present current insurance systems as a mix of public and private institutions working together to ensure access to a universal health care;
(b) using a logical-historical method to introduce students to a wide range of payment mechanisms and explain the logic of their operation in relation to the resolution of the main dilemmas of contemporary health systems; and
(c) to lead students to understand how different payment mechanisms influence provider behaviour and what role key features of payment mechanisms play in this, such as how the performance base is defined, whether and how the price of performance or total reimbursement is predetermined and/or regulated, etc.
Výstupy z učení
Upon completing the course, the student will be able to:
- identify and describe the ways in which the quantity, structure and price of health services are determined in current public health insurance systems;
- explain how different reimbursement mechanisms and regulations influence the behaviour of health service providers;
- identify and describe trends in health care financing;
  • 1. Financial flows in the healthcare system. Funding.
  • 2. Health insurance funds - main dilemmas (solidarity, stability, fiscal context).
  • 3. Co-payments. Forms, amounts, impacts.
  • 4. Redistribution of funds. Instruments for minimising adverse selection and cream skimming.
  • 5. Health insurance companies as administrators of funds, contractors, and guarantors of access to care. Health insurance plans. Creating a network of contractors.
  • 6. Payer competition vs. single payer. Resource allocation mechanisms between care segments and regions.
  • 7. Reimbursement mechanisms. Typologies. Performance payments. Alternatives to defining performance.
  • 8-9. Specifics of the most commonly used reimbursement in each service segment (capitation, fee-for-service, DRG).
  • 10. Price setting, reimbursement amounts. Market, contractual, administrative prices. Price regulation.
  • 11. Prepaid care. Regulation of total reimbursement.
  • 12. Case study - reflection of changes in the reimbursement mechanism in health care provider decision-making.
    doporučená literatura
  • Raulinajtys-Grzybek, M. (2015). Pricing health services: Transaction cost approach. Anchor Academic Publishing (aap_verlag).
  • Casto, A. B., & Forrestal, E. (2013). Principles of healthcare reimbursement (p. 371). American Health Information Management Association.
  • Mossialos, E., & Le Grand, J. (Eds.). (2019). Health care and cost containment in the European Union. Routledge.
  • Good practice in health financinglessons from reforms in low and middle-income countries. Edited by Pablo E. Gottret - George Schieber - Hugh Waters. Washington, DC: World Bank, 2008, xxiv, 504. ISBN 9780821375121. info
  • Shi, L., & Singh, D. A. (2022). Essentials of the US health care system. Jones & Bartlett Learning. chapt.6th
Výukové metody
lectures, class discussion, group projects, presentations by professionals in the sectors, homework, readings.
Metody hodnocení
final essay & group project
Vyučovací jazyk
Další komentáře
Předmět je vyučován každoročně.
Výuka probíhá každý týden.

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