EASTERN MENNONITE UNIVERSITYHARRISONBURG, VA

Department of NursingSpring 2012

COURSE: MBA 615 / NSG 515 - Health Care for Practice & Advocacy

INSTRUCTOR:

David E. Cockley Dr.PHAdjunct Professor

Phone / Voicemail: 540-568-2834e-mail Address: david.cockley@emu.edu

This course will be presented as a Hybrid course (with both on-line sessions and several sessions connected via GoTo Meeting for synchronous student discussions). Please note the designations of GoTo Meeting and on-line sessions and activities.

OFFICE HOURS: The following are the best times to reach me by phone. I teach full-time at James Madison University and these are my Office Hours (Eastern Standard Time)

Office HoursDAY TIME

Mon & Wed 10:00 – 12:002:00 – 3:00

Tues 9:00 – 10:30

OR BY APPOINTMENT

STATEMENT OF RATIONALE AND PURPOSE:

MBA 615 / NSG 515 provides a conceptual model of the American health care system and the governmental system of developing and implementing health policy. This includes a theoretical framework as well as a delineation of the functions and roles of the major sectors of the U.S. health care system.

COURSE OBJECTIVES:

By completion of this course, each student will be able to:

1. Understand the importance of health and health care to the U.S. Be able to articulate and analyze the defining characteristics of the health care delivery system, and identify the key stakeholders in the current system.

2. Describe the roles of federal, state, and local government in the U.S. health care system.

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3. Explore the key issues on the government’s health policy agenda including enactment of the Patient Protection and Affordable Care Act of 2010.

4. Understand the U.S. health care spending and the major sources of that spending. Differentiate between public and private spending on health care.

5. Describe state, federal, and local authorities for public health law, regulation, and services, including issues and concern in the current system.

6. Understand the detail of strategies for modifying personal health behaviors and identify the targets and characteristics of effective interventions.

7. Understand the nature of the access problem in the U.S., the economic and non-economic barriers to care, and how access barriers impact health status.

8. Describe the key components and sectors of the U.S. health care delivery system and the critical issues arising in each of the sectors.

9. Differentiate the sectors of the health care system by services offered, personnel utilized, methods of reimbursement, regulation requirements, and trends.

10. Identify and explain common attributes that are driving the components of the health care system to form integrated models to control costs and increase quality.

11. Discuss the differential definitions and components of Quality and how different health care organizations monitor organizational and provider performance for Quality of Care.

12. Understand the contributory factors to health care cost growth and the private and governmental mechanisms to contain health care costs.

13. Understand the purpose, function, and mechanisms of comparative effectiveness systems.

14. Identify and explain at least four ways that information technology positively augments the management and operations of health care organizations.

15. Differentiate the three main governance structures present in health care organizations and the relative advantages of each.

16. Understand the structure and role of the healthcare workforce, including primary care and specialty care, and the impact of recent reform efforts to increasing the supply of specific workforce sectors.

17. Analyze and be able to relate the key components of the 2010 Patient Protection and Affordable Care Act and its impact on the current health care system.

ON-LINE COURSE COMPONENTSMBA 615 / NSG 515 is presented in a modified (or hybrid) on-line format. This means that the class will connect together using GoToMeeting three times during the semester (see course outline below). The other weeks of class will have curricular materials available on-line, including posted PowerPoint presentations, supplemental readings, activities, and discussion questions.

Expectations for the on-line components of the course are detailed here:

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1. Because the nature of the online format is distinct from traditional class sessions, the expectations for class participation throughout the semester include an ongoing presence in the online sections of the course.

2. Students are to complete the textbook and other assigned readings plus assignment preparation before the designated on-line session(s).

3. Each weekly session and accompanying assignments and discussion forums will be posted by midnight each Saturday to allow a full week’s attention for (working) students.

4. Participation in the on-line components is expected for a minimum of at least two different days throughout the week. Participation is defined as making postings in the online discussion area – first, responding to the discussion questions posted for the week, and then responding to any follow-up questions as well as other comments by class colleagues.

5. On-line participation will include responses to designated on-line Forum (Discussion) questions, responses to instructor-generated and peer-generated questions, and location / analysis of on-line or other support materials for the session.

a. Students may be asked to respond from the readings or other material to a discussion question / topic

b. Students may be asked to respond to other students’ queries or perspectives on related topics

c. Responding “I agree” or other general affirmation statement does not constitute a sufficient response to discussion questions. No participation credit will be earned for such general responses

6. The allowable period for on-line discussion participation will generally be from 12:01 AM Sunday through 11:59 PM Saturday (Eastern Standard Time) of the designated week. Student participation outside of this window will not be acceptable for credit. Students should access the discussion / forum questions and make an initial response by Tuesday of the designated week. Follow-up or additional responses should be posted by Saturday morning.

Written assignments are to be transmitted (in MS Word – readable format) as an email attachment to the instructor.

PERFORMANCE STANDARDS AND EVALUATION:

Students will be evaluated based on their performance on several assignments:

1. research and preparation of a term paper on a specific U.S. health care system topic (see below),

2. a series of assignments related to the on-line components of this course (see below),

3. summary of the impact of PPACA reform policy section4. participation in weekly Forums (discussion questions),5. a comprehensive final examination covering the didactic content of the

course.

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TERM PAPER REQUIREMENTS:Students will select a specific sector or part of the current U.S. Health Care system for the term paper. The student may choose their own topic but it must be clearly focused on a health system or current health policy issue. The paper must deal with a topic affecting community, state, national or international populations. Please avoid personal health topics like exercise, sports, or personal health behaviors.

The Term Paper is expected to be of a depth to be reported in 5 – 8 pages. The term paper will conform to the American Psychological Association (APA) style (see the website www.apastyle.org ), including at least six reference sources from professional (peer-reviewed) journals. A topic outline including selection of the term paper topic and the general framework for addressing the topic is due to the instructor (on-line) by January 21st. The final term paper is due and to be posted on-line by March 17th.

ON-LINE ACTIVITIES AND ASSIGNMENTS:

During most weeks of the course, an on-line activity will be posted for students, to highlight material covered in the chapter topic(s) for that week. Students are encouraged to complete most of these activities as they will enhance the weekly teaching material. Five of these activities (selected by the student) will be submitted for credit (graded). All of these optional activities will be posted on Moodle as graded assignments. However each student needs only complete five of the assignments (written write-ups of findings worth up to 20 points each). If students complete more than five activities (with write-ups), the best five grades will be used for the student’s on-line activity grade.

AFFORDABLE CARE ACT TOPIC SUMMARY: Students will select one of the components of the 2010 Patient Protection and Affordable Care Act (PPACA) and summarize the specifics of how the selected section of the PPACA is / will be implemented. Emphasis should be made on its impact on health care organizations. A 5-8 page Section Summary is due and submitted by April 14th.ACA Section Summary Topics include:

Patient-Centered Medical Home Accountable Care Organizations Health Insurance Exchanges Impacts on Medicare providers and beneficiaries Impacts on Medicaid and CHIP providers and beneficiaries

“Starting Points” for the PPACA Topic Summary include:

The Henry J. Kaiser Family Foundation websiteo http://healthreform.kff.org/

DHHS PPACA linko http://www.healthcare.gov/law/features/index.html

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POINTS:

Performance Item PointsTerm Paper 100PPACA Topic Summary 100On-line (graded) Activities (5 x 20pts)

100

Comprehensive Final Exam 100Total Possible Points 400

GRADES:

360 – 400 A320 – 359 B280 – 319 C

< 280 U

ACADEMIC INTEGRITY:

By registering for this course, each student is advised that the EMU Honor Code is in effect for all class activities and assignments. Particular care should be taken to understand and comply with the EMU Honor Code in preparation of the term paper. Plagiarism is unacceptable and a direct violation of the Honor Code and academic integrity. Blatant plagiarism will result in failure of the course.

TEXTS:

Jonas, S. & Kovner, A.R. (2011). Health Care Delivery in the United States (10th Edition). New York, Springer Publishing Company. ISBN 978-0-8261-0687-2

Additional Readings and PowerPoint presentations can be found on the course (Moodle) website. Course website is available through http://moodle.emu.edu/

INSTRUCTIONAL ACTIVITIES AND RESOURCES:

A. Didactic instruction and participatory discussion of readings and additional materials via GoTo Meeting sessions and on-line discussion questions.

B. Learning through an independent term paper on a current public health issue, including library research, writing skills and a class presentation.

C. Weekly on-line activities to expand familiarity of students with course material.D. Reading texts and outside resources.

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MBA 615 / NSG 515 – Health Care for Practice & AdvocacyCourse Outline

WK Dates(weeks)

Topics On-line Activities Readings Due

1 Thursday January 5 7-9 PM ET

Session via GoTo MeetingCourse Introduction

Familiarize self w/ Moogle website & course layout

SyllabusJ&K Chp 1

2 Jan 8 – 14 U.S. Health Care System; Health Policy & Health Reform

Locate Kaiser Family Fdn Reform website; ForumQ

J&K Ch 2

3 Jan 15 – 21 Topic Outline Due

Health Care Finance Understand how your health organization is reimbursed by Medicare, Medicaid, and Private Insurance; ForumQ

J&K Chp 3

4 Jan 22 – 28 Public Health, Policy, Practice; Health Behaviors

Visit your local PH website, what services offered, other responsibilities? ; ForumQ

J&K Chp 6 & 7

5 Jan 29 – Feb 4 Access to Health Care What is the size of the uninsured popn in your home county? ;ForumQ

J&K Chp 8

6 Feb 5 – 11 Organization of Medical Care

What is changing role of the hospital / physician practice / NH? ForumQ

J&K Chp 9

7 Feb 12 – 18 Integrative Models & Performance

What new links are being built in Cx; ForumQ

J&K Chp 10

8 Feb 19 – 25 Quality Health Care ForumQ; What is P4P? How to define Quality? or Quality Services

J&K Chp 11

9 Feb 26 – Mar 3 Long-Term Care System; Elder Health Policy

ID 3 diff’t LTC services in your locality – Eligibility, Reimb, Ins Covrg; ForumQ

Kane & Kane, 2001Knickman et al., 2003

Thursday March 1, 7-9 PM ET

Course GoTo Meeting Session

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Mar 4 – 10 SPRING BREAK NO CLASS

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WK Dates(weeks)

Topics On-line Activities Readings Due

10 Mar 11 – 17 Term Paper Due

Health Care Costs & Value ForumQ; OECD data site on HC costs; Why is HC (in US) so expensive?

J&K Chp 12Heffler et al., 2005White, 2007Aaron, 2002

11 Mar 18 – 24 Information Technology; EHR; Governance & Management

Contact 2 local HC orgs, What IT services used, planned; Locate FP,NP,P HC agencies, Structd?

J&K Chp 14 & 16Masys, 2005Schlesinger & Gray, 2006

12 Mar 25 – 31 Comparative Effectiveness Forum Q J&K Chp 1313 Apr 1 – 7 Health Care Workforce Identify Supply of

given HC provider in your area, Shortage, Abundance; ForumQ

J&K Chp 15

14 Apr 8 – 14 ACA Topic Summ

Due

Health Reform in America (Patient Protection and Affordable Care Act)

Kaiser Family Foundation website

Thursday, April 12, 7-9 PM ET

Course GoTo Meeting Session

15 Apr 15 – 21 Future for U.S. Health Care Identify Strategic Plan for local HCO

J&K CHP 17

By April 28th Final Exam Due to Instructor

updated 5/5/23

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