Healthcare Cost and Insurance Premium Analysis

 

Syllabus for course at advanced level

 

Course Name

Healthcare cost and insurance premium analysis

 

Course code : KUKM2112301 (Elective)

Department: : Department of Health Policy and Management

Main field : Health Financing

Term : Semester 4

Time commitment : 120 hours

 

Prerequisites and special admittance requirements

Admitted to the master’s program in health policy and management.

 

Course content

This course is motivated by the need for students to understand the process of costing analysis and calculation of health insurance premiums. The costing process provides insight into the economic burden of a disease and understanding the resources expended by the health system, other payers, and patients.

The different risks of each person receiving health insurance benefits make premium setting calculations necessary. Trend analysis of data related to morbidity, mortality and financial loss due to an event is used to develop modeling assumptions that are then developed in the form of insurance product design and costing, so that it will benefit equity, financial stability and protection from loss, especially for insurance participants.

 

Learning objectives

After completing the course the student should be able to:

  1. Identify topics to be taught in the Cost and Premium Analysis Course, Lecture Sessions and Teaching Methods
  2. Explain about Cost Management
  3. Explain the Concept of Unit Cost Analysis
  4. Explain the basic theory of probability
  5. Discuss the calculation of health service premium
  6. Explain Modeling in Social Security System
  7. Discuss model construction in social security system
  8. Calculating Unit Cost Analysis with Top-Down Method
  9. Calculate unit cost analysis with the buttom-up method
  10. Apply unit cost analysis for health facility management decision making
  11. Analyze the concept of health service tariff
  12. Calculate health service tariff
  13. Apply multiple stage model and its estimation
  14. Calculate health service premium
  15. Apply social security system modeling to policy making

 

Topics

  1. Introduction to Cost and Premium Analysis
  2. Cost Management
  3. Concept of Unit Cost Analysis
  4. Unit Cost Analysis Exercise with Top-Down Method
  5. Unit Cost Analysis Exercise with Bottom-Up Method
  6. Unit Cost Analysis for Health Facility Management Decision Making
  7. Health Service Tariff Concept
  8. Health Service Tariff Calculation Exercise
  9. Basic Theory of Probability
  10. Multiple Stage Model and Its Estimation
  11. Premium Calculation
  12. Premium Calculation Exercise
  13. Modelling the Social Security System: Introduction
  14. Social Security System Modelling: Model Construction
  15. Social Security System Modelling: Application to Policy Making

 

Education

The teaching consists of:

  • Lectures
  • Self-study through eLearning
  • Quizzes/assignments/discussion forum in eLearning: Case-based learning
  • Online synchronous discussion

The teaching is delivered through a combination of 60% in-person classes and 40% online classes.

 

Forms of examination

The course is examined through:

  • Assignments, 10%
  • Quiz, 20%
  • Final exam, 70%

 

Required reading

  • Özaltın, A. and Cashin, C., 2014. Costing of health services for provider payment: a practical manual based on country costing challenges, trade-offs, and solutions. Washington, DC: Joint Learning Network for Universal Health Coverage.
  • Horngren, C.T., Datar, S.M. and Rajan, M.V., 2012. Cost accounting: A managerial emphasis-14th Edition. New Jersey: Pearson Education, Inc.
  • Blocher, E.J., Stout, D.E. and Cokins. G., 2010. Cost management: A strategic emphasis (5ed.). New York, NY: McGraw Hill International.
  • Dickson, D.C., Hardy, M., Hardy, M.R. and Waters, H.R., 2013. Actuarial mathematics for life contingent risks. Cambridge University Press.
  • Pitacco, E., 2014. Health insurance. Basic Actuarial Models, Cham, Switzerland: Springer Verlag.
  • Cichon, M., Newbrander, W., Yamabana, H., Normand, C., Weber, A., Dror, D. and Preker, A., 1999. Modelling in health care finance: A compendium of quantitative techniques for health care financing. International Labour Organization