COLLEGE OFHEALTH ANDHUMANSERVICES California Stateuniversity, Long Beach Department

COLLEGE OFHEALTH ANDHUMANSERVICES California StateUniversity, Long Beach Department ofHealthCareAdministration

REVISED:8/16/2017

HCA 502 – TheHealthCareSystem

Fall2017

Instructor: Grace Reynolds, DPA

E-mail:

Phone: 562-985-5885

Office: ET-215

OfficeHours: Tues. 2-3:30, Wed. 2-3:30

Pleasenoteimportant“Class NormsandExpectations”on pages9and10ofthissyllabus.

Section Number:01 Class Number:1845

Class Meets: August 28rd – Dec19thDay/ Time: Tuesdays, 4:00 – 6:45 p.m. Classroom: SPA 203

Additional Contact Information:

HCA ProgramAdministrativeCoordinator:

DebyMcGill, , HHS2-118

Tel. 562/985-5694; fax562/985-5886

CourseDescription: Overview, developmental summaryof theAmericanhealth caresystem and its drivingforces. Major elements of the health caresystem; today’s major health policy issues in a historical,economic and political context. Lettergradeonly(A-F). (Lecture)

CourseOutcomes, Competencies andAssessments:TheHealth CareAdministration Department hasadopteda competency-based curriculum, based on the American Collegeof Health CareExecutives (ACHE)Competencies Assessment Tool. As HCA502is one ofthe first courses that students majoringin Health Care Administration take, the emphasis is on acquiring competencies in HLA Domain 4, knowledgeof thehealthcareenvironment. Alignment of the expected outcomesand the ACHEcompetenciesprovides clear expectations and standards for students and instructors alike. Students will demonstrate alevel of proficiencyin each of the expected outcomes through the course assignments as indicated in the followingtable.

Learning Objective / Domain / Competency / Activity (A1),
Assignment (A2) orAssessment (A3)
Differentiate betweenthe
organization, administration and financingof theU.S. health caredelivery at the federal level and the statesystem and the principal California health care programs and administeringagencies / 4-Knowledge
of the healthcare system / Role ofnon-clinical professionals in the
healthcaresystem
Organization and deliveryof healthcare
Funding and payment mechanisms of thehealth caresystem
Theinterrelationships among access, quality, cost, resource allocation, accountabilityand community
Governmental, regulatory, professional and accreditation agencies
Educational fundingfor healthcarepersonnel
Nursing, physicians, and allied health professionals’ roles and practice
Managed caremodels, structures and environment
Socioeconomic environment in which the organization functions / A1-Class
discussions
A2- Term Paper A3-Midterm and final exams
Analyze the forces behind themajor
historical events that shaped the U.S. health caresystem / 4-Knowledge
of the healthcare system / Interaction and integration among
healthcaresectors
Workforceissues
Healthcaretechnological research and advancements / A1-Class
discussions
A3-Midterm and final exams
Analyzethe key
elements of health policyformation and the policymaking process / 4-Knowledge
ofthe healthcare system / Legislativeissuesand advocacy
Thepatient perspective
Workforceissues / A2- Term paper
Learning Objective / Domain / Competency / Activity (A1),
Assignment (A2) orAssessment (A3)
Interaction and integration among
healthcaresectors
Synthesize factors associated withmajor
contemporaryU.S. health carepolicy issues. / 4-Knowledge
of the healthcare system / Legislativeissuesand advocacy
Theinterrelationships among access, quality, cost, resource allocation, accountabilityand
community
Funding and payment mechanisms of thehealth caresystem. / A2-Term paper

Required Texts

Jonas &Kovner (2015).Health CareDeliveryin theUnited States(11thed.).New York: Springer PublishingCompany,LLC.

American Psychological Association. (2010).Publication manual of theAmerican Psychological

Association (6thed.). Washington, D.C.: Author.

Other requiredreading:

KaiserFamilyFoundation (2010). Summaryof new health reform law. Retrieved from:

Highly recommended reference/reading:

California HealthCare Foundation,California HealthLine.Freedailyelectronic newsletter.

Available at:

Garrard, J. (2007). Health Sciences LiteratureReview MadeEasy: The Matrix Method(2nded.).

Sudbury, MA: Jones & Bartlett.

Course lecturenotes willbeavailable on BeachBoard. Lectures will include extemporaneous informationinadditionto that innotes.

OtherRequirements:

1. Be prepared to discuss readings and topics actively in class—do not come with the expectation of sitting quietly throughout the course!

2. You must have an e-mail address andInternet access to usethe online BeachBoard coursesoftwaresystem.Ifyou haveproblems with BeachBoard,contact theCSULB TechnologyHelp Desk at 562-985-4959, via e-mailat r in-person at theHorneCenter.

3. All students must take the ACHE pre-test, that will be discussed during the first class.

Course Assignments:

Class Preparation,Participation andAttendance

The class format will be alimited lecture andinteractive discussion oftheassignedreadingsand otherrelevant materials.You are expected to haveread theassigned readings (text chaptersand web sites) beforetheclass session, and to beprepared to discuss them. Ifyou havetrouble understandingwhatyou read or hear, please askfor clarification in class oron the discussion boards on our coursewebsite…or make anappointment with meto discuss theproblem area(s). Disabled students requiringspecial accommodations, please advise meof same whenyoufirst attend our class. Our class attendancepolicyconforms to Universitypolicy:

To do well in this class,attendandparticipatein our scheduled class meetings. You will notbegivenamake-up assignment formissinga class meeting or in-class activity,even ifyou areexcused dueto illness or familyemergency. Rather, thepoints for these assignments will be calculated usingthe percentageof thetotal pointsyou earn foryour term paper, examand oral presentation combined. Forexample, ifyou earned 80 percenton each of thesethree assignments combined, oryour average scoreis 80percent for these, butyou missed class meeting#5 worth 10 points, you willbe assigned8 points forthat class meeting. Thesame calculationwillbe applied toeachand allclass meetingsyou miss.

The abovenotwithstanding,you maybe asked torepeat thecoursefor excessive absenteeism, defined asabsences frommorethan threeregularlyscheduled class meetingper our course syllabus meetingschedule. This applies to all absences, includingexcusedabsences.

Term Paper

Deliverable. Writearesearchpaper on the followingtopic:

Howshould healthcareintheU.S.beorganizedand financed? Inyour opinion, based on whatyou havelearned thus far, what is the mosteffectivewayof organizingandfinancing health care in theU.S.to improve access/coverageand constrain if not lower overallcost growth?Yourpaper should includethe folowingsections:

Summary

Brieflysummarizeyourpaper. (No sources/citations in this section.) Suggested length: No morethan onepage.

ProblemStatement

Identifythe problem(s)with thehealth caresystem in the U.S. and provide the evidence to supportyour opinions/assertions. Suggested length:Two-to-threepages.

History

Succinctlydescribetheorigins and backgroundofthe problem(s) in an historical framework. How did theproblem(s) evolve?Suggested length:Two-to-threepages.

Analysisof theProblem

Diveinto and summarizetheworks/writings of others doneto understand the problem(s). Suggested length:Three-to-fivepages.

AlternativeSolutions

Succinctlydescribethevarious solutions availableto address if not resolvethe problem(s).Suggested length:Two-to-fourpages.

Recommended Solution

What doyou recommendbedone? Why? Providesupportive arguments. Suggested length:One-to-three pages.

Conclusion/Reflections

Provideyour broadconclusions/thinkingthatyouhave about this subject, and describe anylessons learned fromthis assignment. (This is allyou; no sources/citations in this section.) Suggested length:One-half-to-onepage.

Grading Criteria. Developingwriting competenceis an intensive processthat includes developingideas and synthesizingsourcematerials to supportyour thinkingandreasoningon the subject ofyour studies. Therefore,you willneed to submitaresearch (term)paper.

Minimum/Maximumlength = 4,200-6,650 words. That isapproximatelytwelve (12)to nineteen (19)type-written, double-lined-spaced pages, notcountingcover/title pages, referencepages oranyattachments oraddendums. Also, aminimumoftwelve (12)referencesfrom current (2011 or later) qualified (i.e., peer-reviewed and scholarlysources), excluding anyfrom ourtext, dictionaries, myhandouts or mylecturesarerequired; websites are also NOT allowed to meet the minimum of 12 peer-reviewed references, though you may use and cite them appropriately—they will not count toward the minimum 12 references that must be peer-reviewed. (You mayquoteorparaphraseour text, dictionaries, myhandouts or lectures; however, these entries maynotcount toward theminimum numberof references required forthis assignment.)

UseAPA formatconsistently andcorrectly. Besureto include acorrectlyformatted title/cover page, butdo notincludededications, keywords, abstracts or executivesummaries. Points will be deducted for failing to conform to APA format including references cited in text, and the references list at the end of the paper.

NOTES:

1. This assignment requiresyou to do independent research; that is,you willnot be able to complete it usingour textbook and other coursematerials only. Theuniversityprovides both an online and onsite libraryserviceto helpyou withyour research.
2. The Health Care Administration/Health Sciences Librarian will come to class to answer specific questions you may have about accessing the Library’s electronic resources and to provide an overview of how the Library website and resources work.

3. Inaddition to uploading yourcompleted researchpaper online to the dropbox, pleasebringahard copy to class forme tograde. Useastaple, but no fancycovers orbinders needed.

TermPaperGradeRubric:

EXPERTPROFICIENTAPPRENTICENOVICE

INTEGRATION OF KNOWLEDGE

TOPIC FOCUS

Thepaperdemonstrates thattheauthorfully understandsandhas appliedconceptslearned inthecourse.Concepts areintegratedintothe writer’sowninsights. The writerprovides concludingremarksthat showanalysisand synthesisofideas.(+30 points)

Thetopicisfocused narrowlyenoughforthe scopeofthisassignment. Athesisstatement providesdirectionforthe paper,eitherby

statementofapositionor hypothesis.(+25points)

Thepaperdemonstrates thattheauthor,forthe

mostpart,understandsand hasappliedconcepts learnedinthecourse.Some oftheconclusions,

however,arenotsupported inthebodyofthepaper. (+20to+29points)

Thetopicisfocusedbut lacksdirection.Thepaperis abouta specifictopicbut

thewriterhasnot establishedaposition.(+20 to+24points)

Thepaper demonstratesthatthe author,toacertain extent,understands andhasapplied conceptslearnedin thecourse.(+15to

+19points)

Thetopicistoo broadforthescope ofthisassignment. (+15to+19points)

Thepaperdoesnot demonstratethatthe authorhasfully understoodand appliedconcepts learnedinthe course.(+0to+14 points)

Thetopicisnot clearlydefined.(+0 to+14points)

DEPTHOF DISCUSSION

CRITICAL THINKING, ANALYTIC REASONING AND EVALUATION

In-depthdiscussionelaborationinall sections ofthepaper.(+25

points)

STRONG:Consistently doesalloralmostallof thefollowing:

Accuratelyinterprets evidence,statements, graphics,questions,etc.

Identifiesthemost importantarguments (reasonsandclaims) proandcon.

Thoughtfullyanalyzes andevaluatesmajor alternativepointsof view.

Drawswarranted, judicious,non- fallaciousconclusions.

In-depthdiscussionelaborationinmostsections ofthepaper.(+20to+24 points)

ACCEPTABLE:Doesmost ormanyofthefollowing:

Accuratelyinterprets evidence,statements, graphics,questions,etc.

Identifiesrelevant arguments(reasonsand claims)proandcon.

Offersanalysesand evaluationsofobvious alternativepointsofview.

Drawswarranted,non- fallaciousconclusions. Justifiessomeresultsor procedures,explains reasons.

Fair-mindedlyfollows

Thewriterhas omittedpertinent contentorcontent runs-onexcessively. Quotationsfrom othersoutweighthe writer’sownideas excessively.(+15to

+19points)

UNACCEPTABLE: Doesmanyor some ofthefollowing:

Misinterprets evidence, statements, graphics,questions, etc.

Failstoidentify strong,relevant counter-arguments.

Ignoresor superficially evaluatesobvious alternativepointsof view.

Draws

Cursorydiscussion inallthesectionsof thepaperor brief discussioninonlya fewsections.(+0to

+14points)

WEAK:Consistently doesalloralmost

allofthefollowing:

Offersbiased interpretationsof evidence, statements, graphics,questions, information,orthe pointsofviewof others.

Failstoidentifyor hastilydismisses strong,relevant counter-arguments. Ignoresor superficially evaluatesobvious alternativepointsof

Justifieskeyresultsand procedures,explains assumptionsand reasons.

Fair-mindedlyfollows whereevidenceand reasonslead.

(+30points)

whereevidenceand reasonslead.

(+20to+29points)

unwarrantedor fallacious conclusions.

Justifiesfewresults orprocedures, seldomexplains reasons.

Regardlessofthe evidenceorreasons, maintainsor

defendsviewsbased on self-interestor preconceptions.

(+15to+19points)

view.

Arguesusing fallaciousor irrelevantreasons, andunwarranted claims.

Doesnotjustify resultsor procedures,nor explainreasons. Regardlessofthe evidenceor reasons,maintains ordefendsviews basedon self- interestor preconceptions.

Exhibitsclose- mindednessor hostilitytoreason.

(+0to+14points)

COHESIVENESSTiestogetherinformation fromall sources.Paper flowsfromoneissueor sectiontothenext. Author'swriting demonstratesan understandingofthe relationshipamong materialobtainedfrom

all sources.(+30points)

Forthemostpart,ties togetherinformationfrom all sources.Paperflows withonlysome disjointedness.Author's writingdemonstratesan understandingofthe relationshipamong materialobtainedfromall sources.(+20to+29 points)

Sometimesties togetherinformation fromall sources. Paperdoesnotflow- disjointednessis apparent.Author's writingdoesnot demonstratean understandingofthe relationshipamong materialobtained fromall sources. (+15to+19points)

Doesnottietogether information.Paper doesnotflowand appearsto becreated fromdisparate

issues.Headingsare necessarytolink concepts.Writing doesnotdemonstrate understandingany relationships.(+0 to+14points)

SPELLINGGRAMMAR (deductions)

SOURCES

(deductions)

No spelling,syntaxor grammarmistakes.

(-0points)

Atleast12 current sources,ofwhichatleast

10arepeer-review journalarticlesor scholarlybooks.Sources includebothgeneral backgroundsourcesand specializedsources. Special-interestsources andpopularliterature areacknowledgedas suchiftheyarecited.All

Minimalspelling,syntaxor grammarmistakes.

(-15points)

Morethan10current sources,ofwhichatleast8 arepeer-reviewjournal articlesor scholarlybooks. All websitesutilizedare authoritative.(-10points)

Noticeablespelling, syntaxorgrammar mistakes.

(-20points)

Fewerthan10 currentsources,or fewerthan8 are peer-reviewed journalarticlesor scholarlybooks.All

web sitesutilizedare credible.(-15 points)

Unacceptable numberofspelling, syntaxorgrammar mistakes.(-25 points)

Fewerthan9 current sources,orfewer than6 arepeer- reviewedjournal articlesor scholarly books.Notall web sitesutilizedare credible,and/or sourcesarenot current.(-20points)

-or-

CITATIONS

(deductions)

APA(Other)

web sitesutilizedare authoritative.(-0points)

Correctlycitesall materialanddata obtainedfromother sources.APAcitation styleisusedin bothtext andbibliography.

(-0points)

Correctlycitesmost materialanddataobtained fromothersources.APA citationstyleisusedin both textandbibliography.

(-15points)

ComplieswithmostAPA

Correctlycitessome materialanddata obtainedfromother sources.Citation styleiseither inconsistentor incorrect.(-20 points)

Complieswithsome

The Turnitin similarityindex is above 25%,in which case up to

56pointsmaybe deducted.

Doesnotcite sources.

(-25points)

(deductions)ComplieswithallAPA

requirements.(-0points)

requirements.

(-10points)

APArequirements.

(-15points)

Noncompliantor

complieswithfew APArequirements. (-20points)

Group Presentation

You maybe asked towork with other classmates todevelop and participatein agroup presentation, dependingon the sizeof our class. Each group will choose a contemporary issue in health care today. Your group may choose one topic from this list for presentation:

Pharmacy benefit administrators

Medical Savings Accounts

High Deductible Health Insurance Plans

Accountable Care Organizations

Mental Health Parity laws

Medicare Part D

Concierge medicine models

Employer-based health care trends

Oral PresentationFeedback/Rubric

Student(s) NameEarned Score:

/60

Content

-Presentationcontentprovidesaclearand concise overview of the topic.

-Contentpresentedis comprehensive, accurate, and believable

-Keypoints are noted

-Topic is researched adequately

(20 points)

Organization/Structure

-Presentationis well-organized, clear, and effectivelystructured

-There is anintroductionto gain theaudience’s

attentionand explainthepurposeof the presentation

(20 points)

Style/Presentation/Appearance

-Non-verbalcues/gestures are appropriateto presentation and flowofideas

-Contentknowledge/confidence areevident

-Time was used well/notrushed

(10 points)

UseofVisualAids

-Visualaids are used whereappropriate

-Visualaids are appropriatelyprofessionalgiven

the presentation’s context

-Theyare easytosee/read

-Media areusedcorrectly--i.e., overheads, videos, computergenerated slides,charts,etc.

-Visualaidscontributeto the overalleffectiveness

of the presentation

(5 points)

AudienceParticipation

-The presenter(s)involved the audienceand solicitedfeedback

-Questions fromthe audienceare effectively addressed andansweredcorrectly

(5 points)

Adherenceto Time Limit

-The presenter(s)stayed withintheallotted time limit (Failure todo somay resultin adeduction of points)

(-10to 0points)

Assignment Policies and Grading:

ALLassignments are due (TERM PAPER ISDUE) bythestart ofclassonthedates specified. Late assignments lose10%ofthetotal point valuefor eachcalendardaypast thedeadline that it is due. NOASSIGNMENTSWILL BEACCEPTED AFTEROURLASTDAYOF CLASS UNLESSPREARRANGED. Exceptions will bemadeif and onlyif eitheraverifiabledeath in your immediatefamilyoccurred oryou wereill and provide mewith verifiable (need phone number) notefrom aphysician on his or her officeletterhead ormedicationprescription pad. Otherwise, submit all assignments through BeachBoardwhen due. No missed exams can be made up without documentation of an absence that meets the University requirements for an excused absence. Personal travel does NOT count; work-related absences are NOT recognized by the University as excused.

Disabled students, who qualifyfor alternativetestingarrangements, pleaseadviseme at leasttwo weeks priorto theexams.

ClassNorms and Expectations:

I am a Professor and researcher with over 20 years ofexperienceworkingin health care policy, programmanagementand executivepositionsin health care. As such,Iendeavor to mergemyexperiencewith thecoursematerialto help preparestudents whoaspireto careers in health care. Moreover,Istructurethe assignmentsand coursedeliveryto maximizethe acquisition ofknowledgeaboutand comprehension of the coursematerialand topics. This is my orientation, sopleaseknow that while alleligiblestudents are welcometotakemyclass,those of you who takeit to meet an elective requirement mayfind the workandmyexpectations to be more arduous thanyouwant or need. Do not, however, let it be morethanyou expected. With that in mind,reviewthis syllabusthoroughly, askme questions about thecourse, and takethis coursewith meif and onlyifyou can embracethefollowing class norms and expectations:

1. Ourtextbook was chosen, in part, becauseitwaswritten for readers who possesslittle or no knowledgeof theU.S. healthcaredeliverysystem. Accordingly,Ido not teach from our text;that is, Ido not lectureon our assigned reading. Rather,Iwillaugment and supplement the knowledgeyouglean fromour assigned readingwith mylecturesandour class discussions. You will, though,betested andgraded on howwellyouknowand understand allreadingassignments and topics covered in class, so doask questions about the assigned reading either in classor onthe discussion board onour coursewebsite.

2. Students areexpected toattendallclass meetings. Attendancewillbetakenon aregular basis;however, thereis no penaltyformissing a class meeting.

3. This courseisabouta complexsubject withitsown language (i.e., industry-specific jargon), soIencourageinternational students andothers who havelittle orno knowledge about theU.S. healthcaredeliverysystem to findstudypartners who do andjoin astudy groupforthis course…orrun therisk ofgetting“lost in translation”and not grading well

on the courseassignments. Iwillendeavor to helpyou keep up as muchasI can, butyou mayneed this additional support.

4. Ourone examforthis courseis administered online and isopen-book, open-notes and comprised of multiple choicequestionsonly, soIwillnot be providingastudyguide.

5. This courserequiresyouto do independent research; that is,you willnot gradewellon your term paper assignmentbyusingour textbook and other course materials onlyto complete this assignment.Theuniversityprovides both an online and onsite library serviceto helpyou withthis. I have invited the Librarian to come to class to go over the many resources the library offers to CSULB students.

6. Resist thetemptation to ask meclarifyingquestions about assignments afterwe adjourn our class meetingor byemail between class meetings. Instead, for thebenefit of allour classmates, please speakup and ask anyand allquestions seeking clarification about our courseor our course assignments in class.

7. Ido notgiveextra creditor bonus point gradeopportunities. No exceptions.

8. I do not round grades up. If you receive a 89.9% your grade is a B. If you want an A, work for it and achieve 90% or higher.

Other Rulesand Policies:

1. CheatingandPlagiarism.Pleasebeaware ofandensurethatyourbehaviorconforms to

UniversityPolicy, ascontained inthe California StateUniversity, LongBeach PolicyStatement

80-01: No formofcheating willbetolerated. Anyonefoundto becheatingwill,atminimum,receive zero creditfor the assignmentortestinvolved. Stifferpenalties, includingcoursefailure, maybe imposed atmydiscretion. Also, Iwillreportanyincidentsofcheatingtouniversityofficials. Students willhave aright to file a grievanceiftheybelieve theywerecharged orpunished unjustly.

2. Although the universitycatalogdoesnotcover thisaspectofplagiarism, itis NOT acceptableto submit thesame paper fortwo courses. Ifyou want towrite apaperonthe same topicfortwo differentcourses, you mustsubmit two differentpapers.IfIdiscoverthatyou have submitted the samepaper for anothercourse, you willreceive an “F” for your paperin this course.

3. Withdrawalpolicy.PerUniversitypolicy: For withdrawalsafter2ndweekand before final3 weeks “permissibleforserious and compelling reasons;”theinstructorwillevaluate studentwithdrawalrequests on acase bycasebasis.

4. Please checkand make certainthatyouremailaddressis correctonBeachBoard,and knowthatI willrespondto allemailsIreceive within 24 hoursof yourhavingsentthem. Therefore, itwould be correctforyou to assume thatIdid notreceiveyourcommunication ifyou have notreceived a responsefrom me withinthattimeframe. So, please follow-up bycallingme directlyat (213)

324-3262;do notsend another email. Ifyou receivemy voicemail, slowlyinputyourname,

repeatyourphonenumber twice, andleave agood time forme to return yourcall.

Commitment to Inclusion: California State University,Long Beach is committed to maintainingan inclusivelearningcommunitythatvalues diversityand fosters mutual

respect. All students havethe right to participate fullyin universityprograms and activities free

from discrimination, harassment, sexual violence, and retaliation. Students who believethey havebeen subjected to discrimination, harassment, sexual violence, or retaliation on thebasisof aprotected status such asage, disability,gender,gender identity/expression, sexual orientation,

race,color, ethnicity, religion, national origin, veteran/veteran status oranyotherstatus protected bylaw, shouldcontact theOfficeof Equityand Diversityat (562)985-8256, UniversityStudent Union (USU)Suite301,