In collaboration with Healthfirst and SUNY Downstate Office for Institutional Equity, the goal of the series, How Healthcare is Paid for in the US and the Role of Managed Care, is to introduce medical students, residents, and faculty to the current state of healthcare payment models in the United States, including:
Additional topics that affect practitioners directly will be covered, such as:
SUNY Downstate medical students, faculty, and residents who see Healthfirst members.
| Date | Topic | Presenter / Video Replay |
|---|---|---|
| Jan. 24, 2025 | Course Introduction: Health insurance in the US: past and present state of healthcare payment | Maja Castillo, MD, MHA Medical Director |
| Jan. 31, 2025 | State Programs: How states fund healthcare-Medicaid, EP, QHP | Errol Pierre, MPA, DBA, SVP State Programs |
| Feb. 7, 2025 | Medicare: CMS and the health plan’s role in Medicare products | Jen Cohen-Smith, SVP Medicare Programs |
| Feb. 21, 2025 | Value-based payment and the Healthfirst model | Lisa Jenkins, RN, VP Delivery System Engagement |
| Feb. 28, 2025 | How Healthfirst works toward health equity. (Case examples include gene therapy and maternity program, 1115 Waiver) | Paul Amajor, MD, MS-HSM, Maja Castillo, MD, MHA, Medical Director |
| Mar. 7, 2025 | Pharmacy: How medications are paid for in the health system | Bhavesh Modi, VP Pharmacy |
| Mar. 14, 2025 | Quality: How is it measured and why is it important in a health plan | Michele Lebarr, Director Clinical Quality |
| Mar. 28, 2025 | Analytics: Using analytics to promote health and equity in an MCO | Sule Baptiste, AVP Data Science |
| Apr. 4, 2025 | What is utilization management and why do health plans do it? | Daniel Halevy, MD, VP Senior Medical Director |
| Apr. 25, 2025 | Policy: How health policy affects MCOs and how Healthfirst works with policymakers | Kirsten Beach, VP Gov Affairs |
| May 2, 2025 | What is medical coding and why is it important? | Sandra Monsalve, AVP Clinical Documentation & Coding Excellence |
| May 9, 2025 | Putting it all together: Case studies of real life at Healthfirst and seminar closing Q&A session | Maja Castillo, MD, MHA Medical Director |
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