The Pennsylvania State UniversityCollege of Health and Human Development

Department of Health Policy & Administration 

HPA 420-01: Principles of Managed CareSPRING Semester 2009

Classroom: 005 Life Sciences BuildingClass Hours: TR 2:30 pm – 3:45 pm

1

 Instructor: Diane M. Spokus, Ph.D., C.H.E.S.Office: 501 B Ford BuildingOffice Hours: W 2:00 p.m. - 4:00 p.m. and by appointmentTelephone: (717) 994-1798Email: dms201@psu.edu

Teaching Asst: Nengliang Yao, Teaching Assistant504A Ford BuildingEmail: nzy105@psu.edu

2

Office Hours: Mondays 10 AM – 12:00 PM and by appointment

 Course Description: HPA 420 is a survey of managed health care, including history, typology, financing, operations and management, and outcomes for patients, providers, and special populations.  Prerequisites: HPA 101 and HPA 301.

3

 Course Objectives: The goal of HPA 420 is to help students prepare for careers in the field of health policy and health administration. These days, virtually any health care job requires a fundamental understanding of the history, operation, and important current issues associated with various types of managed care organizations and techniques for managing the health of populations. After taking HPA 420 students will be able to,

Explain how managed care has and continues to influence health care delivery in the US

4

Understand the meaning of managed care in terms of insurance programs, organizational entities, and population health management approaches.

  Be able to distinguish between different types of managed care organizations

and health care providers and their attendant organizational structures. 

Understand the relationships between managed care organizations and providers, including physicians, physician groups, and hospitals.

5

Be able to identify the key stakeholders involved in managed care health insurance and policy proposals affecting managed care.

  Understand how the market for managed care health insurance operates and is

influenced by various types of market and non-market incentives and regulations. 

6

Intelligently discuss the problems and promises of managed care insurance programs for vulnerable populations such as the elderly, the poor, the disabled, injured workers, and children.

  Describe methods for evaluating the quality of care delivered by managed care

organizations. 

7

Understand how important operating decisions, such as hiring, provider contracting, determination of premiums and fees, and expansions and acquisitions, are made.

Understand the reasons for the ‘backlash’ against managed care, including increased legislation and media attention.

Web Resources:

8

A course web page will be established through the ANGEL system to provide students with electronic access to important class information. In addition to the syllabus, class schedule, and course policies and procedures, the instructor will also make class notes and weekly discussion questions available on the course web page. Students can print these notes before class. Class announcements will also be communicated via this page. The URL for the web page is: http://cms.psu.edu .

Attendance and Class Participation – Since class attendance and participation are important to individual success in HPA 420, attendance will be taken daily. Absences in excess of two will negatively affect a student’s grade. Because two unexcused

9

absences are allowed, additional absences will not be excused except for emergency situations with appropriate documentation. Students participating in class and receiving full credit for class attendance will be given a bump up in the final letter grade for the course (i.e. B to B+).  

Throughout the semester there will be taped Highmark and Geisinger guest speaker presentations that relate to the chapters we discuss. These guest speaker presentations enable you to translate what is learned in the classroom into reality. You are to take notes during the presentations as you would for a class lecture.

10

 

Required Readings: 1.      Text:  

11

Kongstvedt, P.R. 2007 Essentials of Managed Health Care (5th edition), Jones and Bartlett Publishers. The text is available at the Penn State bookstore.  

2. Electronic Readings:  

12

Accessible readings to supplement the Kongstvedt text are required and can be found as downloadable electronic files in the Electronic Reading folder under the Lessons tab on the ANGEL course web page.  The bibliographic references for the readings are as follows: 

1. Peterson, M.A. 1999. “Introduction: Politics, Misperception, or Apropos?” Journal of Health Politics, Policy and Law, Vol. 24, No. 5: 873-886.

13

2. Reinhardt, U.E. 1999. “The Predictable Managed Care Kvetch on the Rocky Road from Adolescence to Adulthood.” Journal of Health Politics, Policy and Law, Vol. 24, No. 5: 897-910.

3. Luft, H.S. 1999. “Why Are Physicians So Upset about Managed Care?” Journal of Health Politics, Policy and Law, Vol. 24, No. 5: 957-966.

4. Wilensky, G.R. 1999. “What’s Behind the Public’s Backlash?” Journal of Health Politics, Policy and Law, Vol. 24, No. 5: 1015-1019.

14

5. Zelman, W.A. 1999. “The View from the Health Plan Trenches.” Journal of Health Politics, Policy and Law, Vol. 24, No. 5: 1095-1098.

6. Scanlon, D.P. et al. 1998. "Health Plan Report Cards: Exploring Differences in Plan Ratings". Joint Commission Journal on Quality Improvement, 24(1), 5-20.

15

7. Felt-Lisk, Suzanne, Mays, Glen P. 2002. “Back to the Drawing Board: New directions in Health Plans’ care Management Strategies”, Health Affairs, 21(5), 210-217

8. Mays, Glen P., Claxton, Gary, White, Justin. 2004. “Managed Care Rebound? Recent Changes in Health Plans’ Cost Containment Strategies”, Health Affairs, W4, 427-436

16

9. Draper, Debra A., Claxton, Gary. 2004. “Managed Care Redux: Health Plans Shift Responsibilities to Consumers”, HSC Issue Brief No. 79, 1 – 4

10.Robinson, James C., Yegian, Jill M. 2004. “Medical Management After Managed Care”, Health Affiars, W4, 269-280

11.Robinson, James C., Casolino, Lawrence. 1996. “Vertical Integration and Organizational Networks in Health Care”, Health Affairs, Spring, 7-22

17

12.Fireman, Bruce, Bartlett, Joan, Selby, Joseph. 2004. “Can Disease Management Reduce Health Care Costs by Improving Quality?”, Health Affairs, November/December, 63-75

13.Miller, Robert, Luft, Harold. 2002. “HMO Plan Performance Update: An Analysis of the Literature, 1997-2001”, Health Affairs, July/August, 63-86

14.McGlynn, Elizabeth A., Asch, Steven M., Adam, John, Keesey, Joan, Hicks, Jennifer, DeCristofaro, Alison, Kerr, Eve A. (2003) The Quality of Health Care

18

Delivered to Adults in the United States. New England Journal of Medicine. 348(26): 2635-2645.

15.Kleinke, J. D. 2005. “Dot-Gov: Market Failure and the creation of a national health information technology system”, Health Affairs, Sept/Oct 1246-1262

16.Hillestad, Richard, Bigelow, James, Bower, Anthony, Girosi, Federico, Robin Meili, Scoville, Richard, Taylor, Roger 2005. “Can Electronic Medical Record

19

Systems Transform Health Care? Potential Health Benefits, Savings, and Costs”, Health Affairs 24(5): 1103-1117.

17.GAO (Government Accountability Office) Report. August 1996. “Health Insurance Regulation: Varying State Requirements Affect Cost of Insurance”. GAO/HEHS-96-161

20

18.Rogal, Deborah L., Stenger, Robert J. 2001. “The Challenge of Managed Care Regulation: Making Markets Work?” Health Care Financing and Organization (HCFO) Report.

19.Jensen, Gail A., Morrisey, Michael A. 1999. “Employer Sponsored Health Insurance and Mandated Benefit Laws”. Milbank Quarterly 77(4): 425-459.

20.CBO (Congressional Budget Office). October 13, 2004. “An Analysis of the Literature on Disease Management Programs”.

21

21.Enthoven, Alain C., Schauffler, Helen H., McMenamin, Sara. 2001. “Consumer Choice and the Managed Care Backlash”. American Journal of Law and Medicine 27: 1-15.

22.Mechanic, David. 2004. “The Rise and Fall of Managed Care”. Journal of Health and Social Behavior 45(special): 76-86.

22

3. Additional Required Electronic Readings - Depending on the topic and schedule, other additional readings may be added during the course of the semester. These readings will be posted on the course web page and students will be notified of the day in which the readings will be discussed in class.

4. Discussion Questions – Additional written assignments that are used for group discussions can be found in the Discussion Question folder located in ANGEL for each chapter of the required text.

23

Course EvaluationThe final grade for this course is based on each student’s performance on four criteria. Each criterion is listed in the table below and followed by brief summary in the subsequent sections.

EVALUATION CRITERION RELATIVE WEIGHT

24

1. Backlash Questions

a) Read 10 Backlash Questions and submit the answers to the questions in the ANGEL drop boxes. Also, please hand in a hard copy in class.

10%

Total 100 points

25

2. Written Assignments: a) Discussion Questions for selected Chapters

15 chapters (10 points each) Question/Answers

(Located in Discussion Topic Folder in Angel) b) Economics and Statistical Analysis Assignments

20%

150 points

100 pointsTotal 250

points26

3. Examinations (15% each)

Exam #1 (150 points) Exam #2 Exam #3 Final Exam (last day of class)

60%

(150 x 4)Total 600

points

27

4. Class Participation In-class participation Attendance MANDATORY FOR GUESTSPEAKERS. If a guest speaker presents, students not attending the class presentation will have 10 points deducted from their total semester point score for each missed presentation. Attendance will be taken in class. In – class group and individual assignments (Example: One Taking Sides Issue, internet search)

50

50 points

28

TOTAL 100% 1000 points

NOTE: We may have several guest speakers throughout the semester. When

guest speakers are scheduled, attendance is mandatory. Students not attending

class will receive a 10-point deduction from their final grade for each guest

29

speaker that they miss. Attendance will be taken. Speakers may travel several

hours to present before a class of 25 students. Speakers are a means to translate

content into reality and they could be a good resource for a future internship or

position. You are required to take notes and ask questions of the guest speaker.

30

Grades

Please keep in mind that the grade of “B” indicates “extensive achievement” or an above average/acceptable level of proficiency. This grade is expected of all students. In other words, it means clean, well-written work. It is assumed that the grade given will be a “B.” Therefore, the grade of “A” represents better than extensive achievement. “B’s” are not given because you have done something wrong or from instructor bias against grade inflation. “A’s” are given because you have done something

31

outstanding and better than anticipated of the average student. Of course, worse grades can be given to reflect poorer performance.

Letter grades will be determined for each assignment based on the following scale:

Grading Scale

Grade Percentage Total Points Accumulated

32

A 94 - 100% 940 - 1000 pts.A- 90 - 93.9% 900 - 939 pts.B+ 87 - 89.9% 870 - 899 pts.B 84 - 86.9% 840 - 869 pts.B- 80 - 83.9% 800 - 839 pts.C+ 77 - 79.9% 770 - 799 pts.C 70 - 76.9% 700 - 769 pts.D 67 - 69.9% 670 - 699 pts.F 66.9% or Below 669 pts. or Less

33

Examinations (60%) 600 points

There will be three examinations throughout the course and a final exam. These examinations will require a thorough understanding and integration of the material to do well. Each exam will consist of a combination of multiple choice questions. Exams will

34

require each student to display proficiency in critical thinking, applying intellectual standards to integrate theoretical and applied elements on substantive issues in the management of human resources. The exams will cover the material in the texts, the syllabus, lectures, backlash questions and relevant guest speaker discussion concepts.

Backlash Question Written Assignment:Backlash Questions (10%) 100 points

Read 10 Backlash Questions and submit the answers to the questions in the ANGEL

35

drop boxes. You will receive credit only if it is in the drop box. Also, please hand in a hard copy in class. The questions are spread over several weeks. The readings are long and it is an assignment that should be completed when the readings are due. This will eliminate feeling overwhelmed when you must meet the submission deadline. When you have completed all backlash questions for the semester, you should have a minimum total of 10-12 pages of answers for all backlash questions. This submission is required for all assignments.

36

Other Written Assignments: (15%) 150 points

1) Discussion chapter questions (15%) are located in the Discussion folder under the Lessons Tab in ANGEL. You are to answer 15 chapter questions and bring a hard copy to class my records. It is to your advantage to keep up with the questions and answers because they will be your study guide for the exams. If you submit your questions and answers several days prior to exams for that period, you will receive feedback. I’ve listed due dates in the schedule which are to be used as a guide for when the questions and answers need to be submitted. You are also required to submit the assignment in

37

the drop box in ANGEL. This submission is required for all assignments.

2) Economic and Statistical Analysis (10%) 100 points

Assignments will be assigned. There will be a lecture on this topic that you should plan to attend. I will also provide you with a detailed handout. Please complete the assignment and submit through the ANGEL drop box. Assignment #1 due February 17.

38

Class Participation (5%) 50 points

Most are confined to in-class activities, the internet search. In-class group assignments are given throughout the course and are collected and recorded. Refer to the email notices and course schedule for assigned readings and deliverables.

NEWSPAPER READINGS

39

Throughout the semester students are required to read newspapers. You can choose the Centre Daily Times, USA TODAY or New York Times and clip out articles related to healthcare. Students are required to bring the articles to class to discuss during a period which will be assigned each week. Students submitting and sharing emerging news stories will be given class participation credit.

Course Requirements and Grading:

40

The requirements for HPA 420 have been chosen to help students achieve the objectives established for the course. Specifically, the course requirements will allow students to demonstrate that they:

        Have acquired important historical and contextual knowledge        Can think critically and analytically        Can write effectively

Class Participation (5%) 50 points

41

Class participation consists of in-class participation (including in-class discussion questions, assigned Taking Sides handouts, newspapers articles on healthcare related issues, discussant participation). Flip charts may be used for some group work and drop boxes provided occasionally for notes on specific exercises, etc. Therefore, participation embodies the following:

1. Regular class attendance. Each student is expected to come to all scheduled class sessions.

2. Comprehensive understanding. Each student will gain a better

42

understanding of managing human resources when he or she reads all the assigned readings and cases prior to class and is prepared for a critical review of the material in class discussions and team sessions.

3. Deliverables. Each student must complete and submit all written assignments on the dates due. No late assignments will be accepted without a legitimate prior excuse.

4. Intellectual integrity. Each student must adhere to the highest ethical standards for academic conduct. This topic is addressed in greater detail under the course syllabus section entitled Academic Conduct.

43

General Assignment Guidelines1. All written assignments must include a cover page with your name, title of the

course, title of the case, instructor name, and date.

2. All written assignments must be typed or word-processed, double-spaced, proofread and professional in appearance. Margins are to be no smaller than

44

one inch on all sides. Please number the pages of each assignment, beginning with the first page of your paper. Do NOT number the cover page. The style and format of each report, including references, should adhere to the Publication Manual of the American Psychological Association Manual (5th Edition). While there is no suggested page length, I recommend that reports should be long enough to sufficiently develop and address the salient issues in the assignment. Label appendices and refer to them appropriately in the text of your paper. Papers that do not follow these guidelines will automatically have 5% deducted. Exceptions include the use of mathematical calculations,

45

graphs, and figures.

3. Grades for assignments not completed by the specified deadline will be reduced as follows: (a) papers which are late will have 10% subtracted from the grade for the first day they are late, and (b) then 5% per day for each day thereafter. THERE WILL BE NO EXCEPTIONS. PLEASE PLAN AHEAD. Requests for extensions will not be considered without a prior legitimate excuse from the instructor. Such intentions must also be communicated in writing to the instructor at least one week prior to the

46

specified due date. Please be sure to adhere to both procedures. Early assignments are welcomed!

Academic Conduct

The academic rules and regulations of Pennsylvania State University are published in the Undergraduate Degree Programs Bulletin and on-line at http://www.psu.edu/ufs/policies/. The following summaries are intended as a guide for students.

47

Absences. Students are required to attend all scheduled class sessions. Absences in excess of 15 percent may be sufficient cause for a Failing or Unsatisfactory grade. A student who does not complete assigned academic work because of absence from class is responsible for making up that work in accordance with instructions provided by the faculty member consistent with any policy established by the faculty of the respective department, school or college. A school or college faculty, a department faculty, a course director or an individual instructor may establish attendance standards

48

and will determine whether a student will be permitted to make up work missed as a result of absence(s). Legitimate reasons for missing class must adhere to Penn State University Academic Policy on Class Attendance.Academic Integrity and Professional Conduct *Note: (For more detailed and up-to-date information on plagiarism and academic dishonesty, students are strongly encouraged to visit http://tlt.its.psu.edu/suggestions/cyberplag/cyberplagstudent.html .

Resources on Plagiarism and Appropriate Citation:

49

Students who are unfamiliar with the University's academic honesty policy and policies regarding plagiarism and proper citation should consult the student handbook and other university documents outlining these policies. The University Writing Center is also a valuable resource for questions regarding appropriate citation. In addition, the following web pages may be of interest.  1. The Penn State Writing Center: http://www.psu.edu/dept/cew/writingcenter/writingc.htm2. Descriptions of plagiarism:

50

http://academicintegrity.cas.psu.edu/Plagiarism.htmlhttp://www.ma.psu.edu/~sjg9/eng202/202plagi.htm 

Department of Health Policy & Administration’s StanceHealth care is a field that will challenge an individual’s personal and professional ethics and morals on a daily basis. From patient confidentiality to the balance between cost control and quality care, health professionals, health policy-makers, and health administrators face ethical dilemmas that must be handled in a responsible manner.

51

This is an industry in which ethical compromises and shortcuts can simply have the worst consequences imaginable.

HPA takes its responsibility to develop high ethical principles in its students seriously. We try to emphasize questions and issues in class that help students see all the ethical, legal, and moral implications of their decisions.

We think that student ethical behavior in class and at the University reflects the way they will behave when confronted with ethical dilemmas in the workplace. As a

52

consequence, we feel there is no room in this field for students who believe that it is acceptable to plagiarize, cheat, or otherwise violate standards of academic integrity at Penn State.

Penn State policy on Academic Integrity is clear. Academic dishonesty includes, but is not limited to, cheating, plagiarizing, fabricating of information or citations, facilitating acts of academic dishonesty by others, having unauthorized possession of examinations, submitting work of another person or work previously used without informing the instructor, or tampering with the academic work of other students. The

53

HPA faculty expects students to comply with the spirit as well as the letter of all university, college and department ethical standards. Accordingly, it is the responsibility of each student to understand all ethical standards that apply to their work. Lack of knowledge of ethical standards will not excuse an ethical violation. We expect students to understand and respect these standards. Each faculty member can be asked to clarify how these standards apply to assignments in their classes.

Penalties for violations of academic freedom are left to the individual faculty member's discretion. However, under most circumstances, Department policy recommends

54

penalizing academic dishonesty by assigning an "F" for the course and referring the student to the Office of Judicial Affairs for a disciplinary conference.

Emergency Preparedness Information

Emergencies that would cause substantial disruption of academic and other campus activities, such as an epidemic of some sort, might lead to classes being cancelled. Currently, the most relevant information that would be useful in communicating to

55

students an emergency is that they sign up for the PSU text messaging service, PSUTXT, at:http://newswires.psu.edu/?cmd=psutxt-register. A campus-wide emergency will be announced via PSUTXT as well as by other mechanisms, but this may be the fastest. (Of course this requires that you have a cell phone that can accept text messages.) Another very general, but helpful source of information is the government’s website concerning individual and family preparedness, at:www.ready.gov

56

Academic Access for Disabled Students

“Penn State encourages academically qualified students with disabilities to achieve full participation and integration in its educational programs. It is Penn State’s policy not to discriminate against qualified persons with disabilities in its admission policies and procedures or its educational programs, services, and activities(The Pennsylvania State University 2004-06 Undergraduate Degree Programs Bulletin, p.53).”

57

Eligibility for Services: Students seeking these services are to request assistance from the Office for Disability Services (ODS) at 116 Boucke Building; 814-863-1807 (V/TTY) or by downloading forms from the Student Information section of the ODS website. Visit the following link for more details: http://www.equity.psu.edu/ods/student/student_info.asp.

HPA Club and Professional Activities:

58

The HPA department offers several professional networking and educational opportunities including the HPA club, a local chapter of the American College of Health Care Executives (ACHE), and various seminars and professional development workshops. Students are encouraged to actively participate in these activities. More information about these groups can be found at: http://www.clubs.psu.edu/up/hpa_ache/.

59

HPA 420: Principles of Managed Care

TENTATIVE Class ScheduleSPRING Semester 2009

Class Date TopicPeter Kongstvedt Textbook

Reading Assignment

Part 1 – Introduction to Managed Health Care

60

Note: Newspaper readings will be incorporated into class discussions

January 13Tuesday

   Syllabus Overview and Introduction to the Course

Kongstevedt (K) Text - Chapter 1

January 15Thursday “Healthcare Crisis: Who’s at

Risk” -- film

Kongstevedt (K) Text - Chapter 1 continued

61

Read Managed Care (MC) articles in ANGEL folder: 1) Peterson (1999)

Complete Backlash Questions and submit in drop box. Hard copy keep for class discussion.

62

January 20Tuesday

History of Managed Care

Chapter 1 Discussion Q & Adue. See ANGEL for Q & Aand drop box. These Q & Ashould be kept in a binderbecause they will be used asyour study guides for examsso it is important that you

*K: Chapter 1 (continued)

Read MC articles in ANGELfolder:1) Reinhardt (1999)2) Luft (1999)3) Wilensky (1999)

Then complete Backlash

63

complete them. You arerequired to submit a total of 15Chapter Questions andAnswers. Prior to the exam,you will receive feedback onthe Q & A’s submitted.

Questions to the abovearticles and submit in dropbox. Hard copy keep inbinder for classdiscussion.

64

January 22Thursday

Why the MC Backlash? - in class discussion

   History of Managed Care (continued)

Read MC articles in ANGELfolder:1) Zelman (1999)2) Mays, Claxton, White

65

Class Date TopicPeter Kongstvedt Textbook

Reading Assignment

Begin Chapter 2Discussion of Backlash Questions

Chapter 2 Q & A due

(2004); follow same directions above

Chapter 2 Discussion Questions

Taking Sides (Issue 1)Handout for Next class

January 27 Attendance is mandatory.

66

Tuesday GUEST SPEAKERTom Charles

Chapter 5Chapter 5 Q & A due

Read MC articles in ANGELFolder:1) Draper & Claxton (2004);2) Robinson and Yegian

(2004), andComplete Backlash Questions in ANGEL folder.

January 29 Chapter 3 Read MC articles in ANGEL

67

Thursday Elements of the Management Control and Governance StructureChapter 3 Q & A due

Taking Sides: Issue 1Will Managed Care Improve Health Care in the US?

Folder:1) Mechanic (2004)

Chapter 3 Discussion Questions

Taking Sides (Issue 2) Handout for next class

68

February 3Tuesday

Chapter 9Medical and Surgical UtilizationHighmarkDr. Patricia Reddy presentationChapter 9 Q & A due

Taking Sides: Issue 2Should Life Sustaining Medical

Read MC articles in ANGEL folder:Enthoven, Schauffler and McMenamin (2001)

Complete Backlash Questions.

Handout on Economic and

69

Care Be Rationed Based on Age?

Statistical Analysis.

February 5Thursday

HIGHMARK GUEST SPEAKER: Lisa Holden – Preventive Health Services

Exam #1 Study Guide – useyour chapter discussionquestions and answers and

70

Class Date TopicPeter Kongstvedt Textbook

Reading Assignment

the feedback you receivewhen it is submitted in theANGEL drop box.

February 10 Tuesday

   EXAM #1 (150 points) multiple

choice February 12Thursday Read Chapter 12

Prescription Drug Benefits in

Attendance is mandatory.Read MC articleRobinson and Caslino (1996).

71

Managed Health CareGuest Speaker: Terri Shively

Part 2 – The Healthcare Delivery System

February 17 Tuesday

Chapter 4 Myths and Assertions about Health PlansChapter 4 Q & A due

Chapter 4 Discussion Questions

72

Taking Sides: Issue 9 Should Embryonic Stem Cell Research be Permitted?

February 19Thursday

Behavioral HealthcareDr. Lonnie Marshall

presentation

73

Chapter 13Chapter 13 Q & A due

Taking Sides (Issue #4) Handout

February 24Tuesday

Chapter 8Chapter 8 Q & A duePerformance-Based Incentives in Managed Health Care

Taking Sides (Issue #6)

Chapter 8 Discussion QuestionsTaking Sides: Issue #4Is the Pharmaceutical Industry Responsible for the High Cost of Prescription Drugs?

74

handout

Class Date TopicPeter Kongstvedt Textbook

Reading Assignment

75

Part 3 – Medical Management

February 26Thursday

FILM Taking Sides: Issue #6 Should doctors ever help terminally ill patients commit suicide?

March 3Tuesday

MH and PGP in Case Management

Take notes for ExamRead MC article Felt-Lisk and Mays (2002)

76

Read Chapter 10Chapter 10 Q & A due

Fireman et al. (2004)

March 5Thursday

CKD, HTN, CVD in Disease Management

Read Chapter 11 Chapter 11 Q & A due

Take notes for Exam

Exam #2 Study Guide are your Q & A’s and the feedback you receive for submitting material in ANGEL drop box.

77

SPRING BREAK March 9 – March 13 March 17Tuesday

EXAM 2 (150 points) Taking Sides Handout

March 19Thursday

Chapter 12Ken Bretz, PharmacistHIGHMARK GUEST SPEAKER

Attendance is mandatory. Chapter 5 Discussion Questions

78

Chapter 12 Q & A due

March 24 Tuesday

HIGHMARK GUEST SPEAKER:Andrew Bloschichak, MD,Medical Director, MedicareChapter 26Medicare and Managed Care

Attendance is mandatory.

79

Chapter 26 Q & A due

Class Date TopicPeter Kongstvedt Textbook

Reading Assignment

80

Part 4 – Operational Management and Marketing

March 26Thursday

Read Chapter 14The Role of Health Plans in Preventing DiseaseChapter 14 Q & A due

81

March 31Tuesday

Read Chapter 15

Quality Management in HealthcareChapter 15 Q & A due

Read MC articlesMiller and Luft (2002)McGlynn et al. (2003)

April 2Thursday

Economic & Statistical Analysis – Brendon Colaco

Attendance is mandatory in order to complete

82

statistical assignment.

Read MC articleJensen and Morrisey (1999)

GAO (1996) & RogalApril 7Tuesday

Economic & Statistical Analysis – Brendon ColacoContinued

83

April 9Thursday

Chapter 6Chapter 6 Q & A Due

Basic Compensation of Physicians in Managed

Health Care

April 14Tuesday

Chapter 21GHP GUEST SPEAKER: Cindy Lamey, Sales & Marketing(Chapter 21 Q & A Due)

Economic & Statistical Analysis due

84

April 16Thursday

EXAM #3 (150 points)

April 21Tuesday

Chapter 20Chapter 20 Q & A due

Healthcare Consumerism

85

Class Date TopicPeter Kongstvedt Textbook

Reading Assignment

April 23Thursday

Chapter 7Chapter 7 Q & A due Hospitals, Facilities, and

Ancillary ServicesK16, K8

86

April 28Tuesday

TBA

April 30Thursday

FINAL EXAM

87

*Under reading assignments, K1 denotes chapter 1 of the Peter Kongstevdt text

*NOTE: Each student is responsible for the contents in this syllabus. The Instructor retains the right to make changes in the course syllabus requirements and schedule as best meets the course goals and learning objectives. There will also be guest speakers throughout the semester which will alter the course of the

88

schedule. Students will be covered only on what is covered up to the date of the exam. Students are also responsible for taking notes from guest speaker presentations.

89