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When teaching about the health care system, sponsors and faculty can select specific topics from a range of relevant issues. Below is an outline of the content of the Tufts Health Care Institute (THCI) program when offered as a four-day model. (Earlier versions of the course included sessions on a fifth day.)

The four-day Mini-Rotation addressed the following themes:

  • Health care organization and financing
  • Public and private insurance
  • Pay-for-performance incentives
  • Drivers of health care costs
  • Quality assessment
  • Chronic care management
  • New models of care
  • Health care reform initiatives

A typical agenda for THCI’s four-day course was structured as follows:

Day 1: The Organization and Financing of the U.S. Health Care System

  1. Introduction to Rotation; Overview of Day 1
  2. The Evolution of the U.S. Health Care and Financing System
  3. Medicare and Medicare Advantage Health Plans
  4. Contemporary Health Insurance
  5. Medicaid: Payment and Provision of Care
  6. Breakout group exercise: “Choosing Health Plans All Together” (CHAT)

Day 2: Quality Matters

  1. Introduction to Quality; Overview of Day 2
  2. Public Reporting of Physician Performance
  3. Health Plans and Quality
  4. Providers and Quality & Patient Safety
  5. Community Health and Health Disparities
  6. Breakout group exercise: “Using Performance Data for Quality Improvement”

Day 3: Cost, Access, Care Management and New Models of Care

  1. Introduction to Costs and Delivery System Reform; Overview of Day 3
  2. The Continuing Challenges of Controlling Health Care Spending
  3. Utilization Management
  4. Breakout group exercise: “Utilization Management”
  5. Patient-Centered Medical Homes and Chronic Care Management for the Elderly
  6. Accountable Care Organizations

Day 4: Health Reform and Shaping the Future

  1. Introduction to Health Reform; Overview of Day 4
  2. Panel Discussion – The Affordable Care Act: Evaluating the Rollout and Discussing Next Steps
  3. Practicing Medicine in the Era of Health Reform
  4. Bringing it Back Home: Implications for Your Practice
  5. Reflections, Summary of the Course; Evaluation and Post-Course Assessment

Overall Learning Objectives
The overall learning objectives for the Tufts Health Care Institute (THCI) Mini-Rotation are itemized below. After completing this mini-rotation, the resident should be able to:

  • Describe the major components and recent history of the U.S. health care system, including:
    • Models of health care financing and care delivery systems
    • Tenets of insurance reimbursement
    • Principles of population-based resource allocation, and
    • Goals of health reform legislation
  • Explain systems approaches that are used to improve quality and influence physician performance, such as public reporting and pay-for-performance.
  • Compare and contrast strategies and techniques used by different stakeholders—including patients, providers, payers, employers and government—to address issues of health care access, payment and quality.
  • Identify activities and design features of health plans, delivery systems and physician practices—such as care management, decision-support tools, technology assessment, practice-level performance reports, and quality improvement methods—intended to optimize the health outcomes, patient experience, and cost-effectiveness of care.

Note: Objectives for each session are available with the Instructional Materials.