ANALYZE LEGISLATIVE PROCESSES AND PARTISAN POLITICS IN HEALTH POLICYMAKING.

ANALYZE LEGISLATIVE PROCESSES AND PARTISAN POLITICS IN HEALTH POLICYMAKING.

Saint Leo University

Graduate Business Studies

 

HCM590

Health Policy, Politics, and Reform

 

Course Description:

This course explores and analyzes health policy, legislative process, and health reform in the United States. Specifically, the course (a) examines key issues in the Patient Protection and Affordable Care Act and other major areas of health policy such as Medicare, Medicaid, dual eligibles, disparities, medical liability, and international comparisons, (b) assesses legislative processes and partisan politics, (c) evaluates emerging and evolving organizational structures and payment reform approaches, (d) critiques current policy and proposed reforms, and (e) prepares students to advocate for health reform and needed change.

 

Prerequisite: 

HCM520, HCM530, HCM540, HCM550

 

Textbook: 

Weissert, W. G. & Weissert, C. S. (2012). Governing health: The politics of health policy(4th ed.). Baltimore, MD: Johns Hopkins University Press. ISBN-13: 978-1-4214-0621-3

 

Learning Outcomes:

Upon completion of this course, students will be able to:

  1. Analyze legislative processes and partisan politics in health policymaking.
  2. Summarize and explain provisions and implications of the Patient Protection and Affordable Care Act and other key areas of the health policy landscape.
  3. Evaluate options in the design of new organizational structures and payment reform approaches.
  4. Critique current policy and proposed reforms.
  5. Advocate for health reform and needed change.
  6. Apply the Saint Leo University core values of community, responsible stewardship, and integrity.

 

Core Value:

Community: Saint Leo University develops hospitable Christian learning communities everywhere we serve. We foster a spirit of belonging, unity, and interdependence based on mutual trust and respect to create socially responsible environments that challenge all of us to listen, to learn, to change, and to serve.

 

Responsible Stewardship: Our Creator blesses us with an abundance of resources. We foster a spirit of service to employ our resources to university and community development. We must be resourceful. We must optimize and apply all of the resources of our community to fulfill Saint Leo University’s mission and goals.

 

Integrity: The commitment of Saint Leo University to excellence demands that its members live its mission and deliver on its promise. The faculty, staff, and students pledge to be honest, just, and consistent in word and deed.

 

Evaluation: 

  • Discussions: 8 @ 5 points each, 40 points total, 20% of course grade

 

  • 15-Point Module Assignments: 4 totaling 60 points, 30% of course grade o Essay on Political Strategy and Political Process (Module 1, 15 points) o            Policy Summary and Assessment Paper (Module 2, 15 points) o             Policy Memo (Module 3, 15 points)
    • Advocacy Letter to a State Legislator (Module 7, 15 points)

 

  • 20-Point Module Assignments: 2 totaling 40 points, 20% of course grade o Policy Critique (Module 5, 20 points)
    • Advocacy Paper (Module 6, 20 points)

 

  • Exams: 2 totaling 60 points, 30% of course grade o Midterm Exam: Medicare Reform Recommendations Presentation (Narrated PowerPoint)

(Module 4, 25 points) o Final Exam: Policy Paper (Module 8, 35 points)

 

  • Total Course Points: 200

 

Grading Scale:

 

         Grade     Score (%)

            A  95-100
            A-  90-94
            B+  86-89
            B  83-85
            B-  80-82
            C  75-79
            F  Below 75

 

Competency Areas and Levels: 

HCM 590 develops the following professional competency areas from the curriculum-wide competency model (next section):

 

Health Leadership Competency Model of the National Center for Healthcare Leadership

Professional Competency Development to Level 5 (create, formulate)

Critical and Analytical Thinking

Strategic Orientation

Systems Thinking

Professional Competency Development to Level 4 (evaluate, advocate)

Affective Domain

Professional Competency Development to Level 2 (apply, demonstrate)

Information Seeking

Written and Oral Communication

Change Leadership

Ethics in Management

Professionalism

Saint Leo University core values of community, responsible stewardship,

and integrity

 

Levels of Competency Mastery

Level 1: Comprehend (e.g., define, describe, explain, summarize)

Level 2: Apply (e.g., use, demonstrate, illustrate, calculate)

Level 3: Analyze (e.g., examine, distinguish, compare, contrast)

Level 4: Evaluate (e.g., weigh, recommend, conclude, justify, advocate)

Level 5: Create (e.g., propose, design, formulate, plan)

 

Glossary of Professional Competency Development Areas:

 

Health Care Management Professional Competency Development Areas

(based on the Health Leadership Competency Model of the

National Center for Healthcare Leadership, NCHL)

 

Transformation Domain

Visioning, energizing, and stimulating a change process that coalesces communities, patients, and professionals around new models of healthcare and wellness (NCHL). Competencies include:

 

  1. Critical and Analytical Thinking: The ability to quickly and accurately discern and understand information, a situation, or problem in order to suggest or take the best possible action (American Medical Association). This competency area aligns with the Saint Leo University Quality Enhancement Plan (QEP) for developing critical thinking skills and operationalizing Critical Thinking + Core Values = Decision Making

 

  1. Community Orientation: The ability to align one’s own and the organization’s priorities with the needs and values of the community, including its cultural and ethnocentric values and to move health forward in line with population-based wellness needs and national health agenda (NCHL).

 

  1. Financial Skills: The ability to understand and explain financial and accounting information, prepare and manage budgets, and make sound long-term investment decisions (NCHL).

 

  1. Information Seeking: An underlying curiosity and desire to know more about things, people, or issues, including the desire for knowledge and staying current with health, organizational, industry, and professional trends and developments (NCHL).

 

  1. Strategic Orientation: The ability to draw implications and conclusions in light of the business, economic, demographic, ethno-cultural, political, and regulatory trends and developments, and to use these insights to develop an evolving vision for the organization and the health industry that results in long-term success and viability (NCHL).

 

  1. Systems Thinking: The ability to approach, examine, and understand structures, processes, and outcomes from a perspective of complex networks of interactions and interdependencies (Programspecific).

 

Execution Domain

Translating vision and strategy into optimal organizational performance (NCHL). Competencies include:

 

  1. Change Leadership: The ability to energize stakeholders and sustain their commitment to changes in approaches, processes, and strategies (NCHL).

 

  1. Collaboration: The ability to work cooperatively with others as part of a team or group, including demonstrating positive attitudes about the team, its members, and its ability to get its mission accomplished (NCHL).

 

  1. Communication: The ability to speak and write in a clear, logical, and grammatical manner in formal and informal situations, to prepare cogent business presentations, and to facilitate a group (NCHL).

 

  1. Ethics in Management: The ability to exemplify, develop, and lead a values-based organizational culture that consistently practices high standards of integrity and ethics in day-to-day work and decisionmaking in response to ethical issues, conflicts, and challenges (Program-specific).

 

  1. Information Technology Management: The ability to see the potential in and understand the use of administrative and clinical information technology and decision-support tools in process and performance improvement. Actively sponsors their utilization and the continuous upgrading of information management capabilities (NCHL).

 

  1. Performance Measurement: The ability to understand and use statistical and financial methods and metrics to set goals and measure clinical as well as organizational performance; commitment to and employment of evidence-based techniques (NCHL).

 

  1. Process Management and Organizational Design: The ability to analyze and design or improve an organizational process, including incorporating the principles of quality management as well as customer satisfaction (NCHL).

 

  1. Project Management: The ability to plan, execute, and oversee a multi-year, large-scale project involving significant resources, scope, and impact (NCHL).

 

People Domain

Creating an organizational climate that values employees from all backgrounds and provides an energizing environment for them. Also includes the leader’s responsibility to understand his or her impact on others and to improve his or her capabilities, as well as the capabilities of others (NCHL). Competencies include:

 

  1. Human Resources Management: The ability to implement staff development and other management practices that represent contemporary best practices, comply with legal and regulatory requirements, and optimize the performance of the workforce, including performance assessments, alternative compensation and benefit methods, and the alignment of human resource practices and processes to meet the strategic goals of the organization (NCHL).

 

  1. Professionalism: The demonstration of ethics and professional practices, as well as stimulating social accountability and community stewardship. The desire to act in a way that is consistent with one’s values and what one says is important (NCHL).

 

  1. Relationship Building: The ability to establish, build, and sustain professional contacts for the purpose of building networks of people with similar goals and that support similar interests (NCHL).

 

  1. Team Leadership: The ability to see oneself as a leader of others, from forming a top team that possesses balanced capabilities to setting the mission, values, and norms, as well as holding the team members accountable individually and as a group for results (NCHL).

 

19. Affective Domain

In health care management education, teaching and learning in the affective domain emphasize selfreflection and development of student interests, attitudes, values, feelings, behaviors, motivation, respect, concern, responsibility, and commitment (Program-specific).

 

  1. Saint Leo University Core Values: Excellence, Community, Respect, Personal Development,

Responsible Stewardship, Integrity (Program-specific)

 

Attendance Policy:

Students are expected to view the course modules in the week they are offered and to log on to the course often enough to remain abreast of any communications from the instructor. It is the student’s responsibility to be aware of what is happening in the class online.

 

Late Policy:

All work must be submitted on time. Exceptions must be documented and acceptance is at the discretion of the faculty member.

 

Students with Disabilities:

Saint Leo University is committed to a policy which provides an equal opportunity for full participation of all qualified individuals with disabilities in accordance with the Americans with Disabilities Act. Appropriate academic accommodations and services are coordinated through the Office of Disability Services. Students with disabilities who require accommodation should contact the office as soon as possible via email: ADAOffice@saintleo.edu or telephone: (352) 588-8464. For additional information, students may access the Policy and Procedure Manual through the Saint Leo website.

 

Academic Honor Code:

The Academic Honor Code is published in its entirety in the Saint Leo University Catalog. The first paragraph is quoted below:

 

Saint Leo University holds all students to the highest standards of honesty and personal integrity in every phase of their academic life. All students have a responsibility to uphold the Academic Honor Code by refraining from any form of academic misconduct, presenting only work that is genuinely their own, and reporting any observed instance of academic dishonesty to a faculty member.

 

It is the responsibility of every member of the faculty and student body to cooperate in supporting the Honor Code. Academic misconduct includes but is not limited to the following categories:

 

Cheating

  • Providing or receiving academic work to or from another student without the permission of the instructor/professor.
  • Buying or selling academic work.
  • Violating test conditions.
  • Forging academic documents.
  • Copying computer programs.

 

Plagiarism

  • Stealing and passing off the ideas and words of another as one’s own or using the work of another without crediting the source whether that source is authored by a professional or a peer.
  • Submitting an article or quoted material from a periodical or the internet as one’s own.
  • Retyping or re-titling another student’s paper and handing it in as one’s own.  Intentionally or unintentionally failing to cite a source.

 

Complicity

  • Helping another student commit an act of academic dishonesty.

 

Misrepresentation

  • Resubmitting previous work, in whole or in part, for a current assignment without the written consent of the current instructor(s).
  • Having another student complete one’s own assignments, quizzes, or exams.  Lying to a professor.
  • Fabricating a source.

 

Please refer to the Saint Leo University Academic Catalog for more information on the Honor Code and procedures for adjudication.

 

Protection of the Academic Environment:

Disruption of academic process is the act or words of a student in a classroom or online environment which in the reasonable estimation of a faculty member (a) directs attention away from the academic matters at hand, such as distractions, persistent, disrespectful or abusive interruptions of academic discussions, or (b) presents a danger to the health, safety or well-being of the faculty member or students. Education is a cooperative endeavor, one that takes place within a context of basic interpersonal respect. We must therefore make the learning environment conducive to the purpose for which we are here. Disruption, intentional and unintentional, is an obstacle to that aim. We can all aid in creating the proper environment, in small ways and in more fundamental ways. So, when we speak in class, we can disagree without attacking each other and no one speaks in a manner or of off-topic content that disrupts the class. Any violation of this policy may result in disciplinary action. Please refer to the Student Handbook for further details.

 

Cannon Memorial Library Resources for Online Learning Courses:

 

Cannon Memorial Library

Librarians are available during reference hours to assist you. To contact the librarian on duty, please call 1.800.359.5945 or email reference.desk@saintleo.edu.

 

Reference Hours**

            Monday to Thursday  9 AM—10 PM
            Friday  9 AM—5 PM
            Saturday/Sunday 10 AM—6 PM

**Subject to change. Click the Ask a Librarian link on the Cannon Memorial Library homepage for current information.

 

Web Address (URL)

http://www.saintleo.edu/Academics/Library

 

Online Catalog (All Books, eBooks, and Media)

SLU students, faculty and staff may borrow books from Cannon Memorial Library through the online catalog. Use the Library Catalog link under Find Info on the library’s homepage to access the catalog. Books you can check-out have Location=Cannon Library, Second Floor and Status=Available. Use the Interlibrary Loanlink under Services on the library’s homepage to place your request.

 

Online Library Resources (Articles and eBooks)

Saint Leo provides an array of online article databases and eBook collections that support your classes. Use the Databases link under Find Info on the Cannon Memorial Library homepage to access the online resources.

 

CQ Researcher………………..…..….. (In-depth topical analysis by Congressional Quarterly)

Dissertations and Theses……..…..…. (A database of published Dissertations and Theses, including those from Saint Leo University)

EBSCO ………………………………… (Comprehensive all-subject database, includes Business Source

Premier, Academic Source Premier, ERIC, ATLA)

Literature Resource Center……..……. (Comprehensive source for literary topics, includes Twayne  Authors)

Newsbank: America’s Newspapers…. (625 U.S. newspapers)

ProQuest……………………………….. (Comprehensive all-subject database, includes ABI/Inform Global)

PsycINFO………………………………. (APA abstracts and indexing for psychology subjects)

Westlaw………………………………… (Comprehensive legal resource)

Wilson…………………………………… (Includes Education, Science, Humanities, & Business indexes)

 

Supplemental Library Resources

Saint Leo encourages students to obtain a public library borrowing card at their earliest convenience. Many state libraries grant public library cardholders free remote access to multiple online databases containing full-text articles. For further information, contact your local public library. To find updated links to all state libraries, as well as public libraries, law libraries, and college libraries in your area, go to http://www.publiclibraries.com/

 

Library Tutorial

The University strongly encourages all students to review the instructional tools. These tools can be accessed by clicking the links under Get Help. By learning to become more proficient researchers, students will also enhance their academic success. Please review the Library Tutorial by clicking the link under Get Help on the library’s homepage and complete the online test which will prepare you for utilizing the library’s resources and services. A score of 70 or higher is necessary to pass. Please allow yourself 15-20 minutes to take the test.

 

Additional Assistance: 

MBA program questions/concerns should be addressed to mbaslu@saintleo.edu. Technical questions concerning the course should be addressed to the eCollege Help Desk by clicking the Tech Support button in the upper right corner of the Course Home page.

 

 

Course Schedule: 

 

Module 1    Legislative and Political Processes
Objectives    At the conclusion of this module, students will be able to:

  • Examine and assess legislative processes, political strategies, and partisanism in the health policy realm.
Items to be Completed: Due No Later Than:
Post an introduction to the class Thursday 11:59 PM EST/EDT
Read:—Weissert & Weissert. Chapters 1 & 2 —Congressional Digest.

—Beaussier.

—Frakes.

View the Audio Visual Presentation (AVP)
Post an initial response to the discussion topic Thursday 11:59 PM EST/EDT
Post responses to at least two classmates Sunday 11:59 PM EST/EDT
Submit the Political Strategy Essay Sunday 11:59 PM EST/EDT

Assignments

 

 

 
Module 2    Patient Protection and Affordable Care Act
Objectives   At the conclusion of this module, students will be able to:

  • Summarize and explain provisions and implications of the Patient Protection and Affordable Care Act.

 

Items to be Completed: Due No Later Than:
Browse:—Full text of the Patient Protection and Affordable Care Act legislation

—U.S. Supreme Court ruling on the Patient Protection and Affordable Care Act

Read:—Kaiser Family Foundation. (2011). Focus on Health Reform: Summary of the New Health Reform Law

—Kaiser Family Foundation. (2012). Implementation Timeline

—Kaiser Family Foundation. (2012). A Guide to the Supreme Court’s Affordable Care Act Decision

Post an initial response to the discussion topic Thursday 11:59 PM EST/EDT
Post responses to at least two classmates Sunday 11:59 PM EST/EDT
Submit the Policy Paper Sunday 11:59 PM EST/EDT

Assignments

 

Module 3  New Organizational Structures and Payment Reform
Objectives  At the conclusion of this module, students will be able to:

  • Evaluate options in the design of new organizational structures and payment reform approaches.
  • Demonstrate the Saint Leo core value of community.
Items to be Completed: Due No Later Than:
Browse:— Innovation models at the Center for Medicare & Medicaid Innovation website
Read or View:Accountable Care Organizations  — Shortell, Casalino, and Fisher.

— Higgins, et al.

— Fisher, et al.

Primary Care Transformation  — Cleveland Clinic — Wagner, et al.

Bundled Payment for Care Improvement — American Hospital Association.

— Miller, et al.

— de Bakker, et al.

Post an initial response to the discussion topic Thursday 11:59 PM EST/EDT
Post responses to at least two classmates Sunday 11:59 PM EST/EDT
Submit the Policy Memo Sunday 11:59 PM EST/EDT

Assignments

 

 

  
Module 4    Medicare Reform
Objectives   At the conclusion of this module, students will be able to:

  • Analyze legislative processes and partisan politics in health policymaking.
  • Summarize and explain key provisions and implications of the Patient Protection and Affordable Care Act.
  • Evaluate options in the design of new organizational structures and payment reform approaches.
  • Demonstrate the Saint Leo University core value of responsible stewardship.

 

Items to be Completed: Due No Later Than:
View: —“Health Reform and Medicare: Overview of Key Provisions”—Audio Visual Presentation (AVP) on Medicare Part A Trust Fund Solvency Projections
Read:— Antos.

— Davis.

— Wilensky.

Post an initial response to the discussion topic Thursday 11:59 PM EST/EDT
Post responses to at least two classmates Sunday 11:59 PM EST/EDT
Submit the Midterm Presentation (Examination) Sunday 11:59 PM EST/EDT

Assignments

 

 

Module 5  Medicaid Policy and Dual Eligibles
Objectives  At the conclusion of this module, students will be able to:

  • Critique current policy and proposed reforms.
  • Demonstrate the Saint Leo University core value of community.
Items to be Completed: Due No Later Than:
Review: Kaiser Family Foundation. (2012). A Guide to the Supreme Court’s Affordable Care Act Decision.
Read:— Holahan, John, et al.

— Smith, Vernon K., et al.

— Snyder, Laura, et al.

Review Oregon’s Prioritized List of Health Services (2013)
View the Audio Visual Presentation (AVP) on Dual Eligibles
Post an initial response to the discussion topic Thursday 11:59 PM EST/EDT
Post responses to at least two classmates Sunday 11:59 PM EST/EDT
Submit the Policy Critique Paper Sunday 11:59 PM EST/EDT
Begin preparing for the Final Policy Paper (Final Examination) Module 8

Assignments

 

  
Module 6    Disparities in Health and Health Care
Objectives   At the conclusion of this module, students will be able to:

  • Advocate for health reform and needed change.
  • Demonstrate the Saint Leo University core value of integrity.

 

Items to be Completed: Due No Later Than:
Read:— Derose, K., Gresenz, C., and Ringel, J.

— Koh, H., Graham, G., and Glied, S.

— National Healthcare Disparities Report 2011.

— Peek, M., et al.

— Weinick, R. and Hasnain-Wynia, R.

Post an initial response to the discussion topic Thursday 11:59 PM EST/EDT
Post responses to at least two classmates Sunday 11:59 PM EST/EDT
Submit the Advocacy Paper Sunday 11:59 PM EST/EDT

Assignments

 

 

Module 7  Medical Malpractice Liability
Objectives  At the conclusion of this module, students will be able to:

  • Analyze legislative processes and partisan politics in health policymaking.
  • Critique current policy and proposed reforms.
  • Advocate for health reform and needed change.
  • Apply the Saint Leo University core value of responsible stewardship.
Items to be Completed: Due No Later Than:
Read:— American Medical Association.

— Jena, A. B., Seabury, S., Lakdawalla, D., and Chandra, A.

— Kachalia, A. and Mello, M. M.

— Mello, M. M., Chandra, A., Gawande, A. A., and Studdert, D. M.

Post an initial response to the discussion topic Thursday 11:59 PM EST/EDT
Post responses to at least two classmates Sunday 11:59 PM EST/EDT
Submit the Advocacy Letter Sunday 11:59 PM EST/EDT
 

 

Module 8    International Perspectives
Objectives   At the conclusion of this module, students will be able to:

  • Analyze legislative processes and partisan politics in health policymaking.
  • Summarize and explain provisions and implications of the Patient Protection and Affordable Care Act and other key areas of the health policy landscape.
  • Evaluate options in the design of new organizational structures and payment reform approaches.
  • Critique current policy and proposed reforms.
  • Advocate for health reform and needed change.
  • Apply the Saint Leo University core values of community, responsible stewardship, and integrity.

Assignments

 

 

 

 

 

Items to be Completed: Due No Later Than:
Read:— Larsson, S., Lawyer, P., Garellick, G., Lindahl, B., and Lundström, M.

— Laugesen, M. and Glied, S.

— Philipson, T., Eber, M., Lakdawalla, D., Corral, M., Conti, R., and Goldman, D.

— Schoen, C., Osborn, R., Doty, M., Squires, D., Peugh, J., and Applebaum, S.

— Schoen, C., Osborn, R., Squires, D., Doty, M., Pierson, R., and Applebaum, S. (2010).

— Schoen, C., Osborn, R., Squires, D., Doty, M., Pierson, R., and Applebaum, S. (2011).

Post an initial response to the discussion topic Thursday 11:59 PM EST/EDT
Post responses to at least two classmates Sunday 11:59 PM EST/EDT
Submit the Final Policy Paper (Final Examination) Sunday 11:59 PM EST/EDT

Assignments

 

 

 

 

 

 

 

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