Health Policy and Management Course (HPAM-GP)

Required for MPA Health students. This introductory course is designed to familiarize students with basic concepts and ideas concerning the distribution of health and illness in society, the organization of the health care system, and the relationship of one to the other. We begin by considering the evolution of the U.S. health care system and of health policy. We then present an international perspective on the U.S. health care system with an emphasis on the Affordable Care Act, alternative government roles, current challenges and the future of the health care system. In the second part of the course, we explore divergent perspectives for analyzing health and health care: clinical, epidemiological, economic, sociological/cultural and public health. In the third part, we focus on, selected issues in HPAM: the challenge of mental health, variations in medical practice and the quality of care, health care rationing and access to care. Finally, we conclude with a discussion of how practitioners in the field of HPAM should respond to the growing awareness of the social determinants of health and the growth of the medical-industrial complex for HPAM. Class readings cover major topics in the study of health and health care delivery: the organization and financing of health care systems; cost and access to health care; health policy challenges and the Affordable Care Act; the roles of government in health systems and policy; the epidemiology of health and medical care, economic and ethical issues related to health care rationing, the social determinants of health. Along with covering these subjects, we emphasize the value of understanding diverse disciplinary perspectives, the challenges of meeting the varied (and often conflicting) needs and motivations of health care system stakeholders, and the ways in which the United States health care system differs from those of other wealthy nations.

This course aims to improve your ability to effectively manage and lead health service organizations. We examine a range of key challenges that managers must address to optimize organizational performance, including questions of mission, vision, and strategy ("What areas or activities should we be working in?") and questions of organizational design and operations ("How can we perform effectively in this area?"). To deal effectively with these challenges, you will develop knowledge and skills in: setting and aligning goals with the organization’s mission; handling complex trade-offs between demand for services and resource constraints; defining measures of success; improving work processes; motivating diverse stakeholders; dealing with ethical dilemmas; leading organizational change; and managing in environments in transition. In short, the course emphasizes the multiple, related requirements of the leader/manager's job: analysis, problem-solving, and action.

Traditionally, governments have the ultimate responsibility for assuring the conditions for their people to be as healthy as they can be. In this sense one of the fundamental societal goals of health services may be considered the health improvement of the population served and for which the individual government is responsible. As our understanding of the multiple determinants of health has dramatically expanded, exercising this responsibility calls for a national health policy that goes beyond planning for the personal health care system and addresses the health of communities. Broader issues of political, economic, social, institutional, educational, and environment circumstances, among others, are now seen as important determinants of health. Of particular importance is the issue of equity of access to all these resources within a country. In the face of this added complexity, countries, especially developing countries and those in transition, face challenges from a number of global health threats. Their national health strategies may be compromised by the effects of globalization and global decision making on issues that affect health. Government leaders must not only address health problems within their borders, but those that come across their borders, whether specific diseases like HIV/AIDS, avian influenza, or the pressures of the global labour market that lead to movement of health professionals seeking better pay and working conditions from the developing to the developed world After discussing definitions of health in international agreements and the general influences of globalization on health and health equity, the course will explore the roles and responsibilities of national health leadership, primarily Ministries of Health and governmental institutions, in assuring the health of their populations and the different strategies and variable capacities of national governments in developed, developing and countries in transition. The role of regional and local governments, professionals, civil society, communities and individuals, will also be explored. We will then consider in some depth the role, functions and effectiveness of global organizations affecting health in the UN, NGO and business sectors as well as multilateral and bilateral donors and how they interact with each other and with national leadership. Finally we will look at emerging instruments for global health governance, how they operate and their effectiveness for promoting health action at the country level.

This course encourages students to think creatively about what it means for a healthcare organization to make quality the highest priority. We will explore the current forces driving the push toward quality outcomes and accountability at all levels and settings of healthcare, while focusing on the philosophy of continuous improvement through team work and statistical thinking. Students will use structural tools for analysis, decision making and performance measurement.

This graduate course is an introduction to major health policy issues and examines the role of government in the health care system. An important focus of the course is an assessment of the role of policy analysis in the formation and implementation of national and local health policy. Because much of government health policy relates to or is implemented through payment systems, emphasis will be placed on the discussion of the policy implications of how government pays for care. The role of the legal system with respect to adverse medical outcomes, economic rights, and individual rights is also discussed. Proposals for health policy reform at the national and local level are examined throughout the course, as well as Medicare and Medicaid reforms currently being implemented or considered.

In today’s healthcare environment, adapting to change is not enough. Healthcare executives and managers are tasked with leading change and driving results. This course will cover practical strategies leaders and emerging leaders can use to anticipate, plan, and respond to policy, regulatory, and practice changes in the industry.

Advanced Health Care Payment Systems is designed to familiarize students with the various health care payment systems that are used by various healthcare payers. The course focuses on Medicare's prospective payment systems for hospital and other provider type reimbursement. It also covers New York State Medicaid reimbursement issues and provides a general understanding of the healthcare charge structure. The course will also focus on the fundamentals of establishing a compliance program to identify and prevent fraud and abuse issues. Payment methods serve as a regulatory and market mechanism guiding the direction and activities of healthcare providers. It is essential that decision makers understand and assess the impact of reimbursement methodologies and the interaction between healthcare regulation, reimbursement methodologies and financial decision making. This course will familiarize students with payment methodologies as directed by current Federal and New York State health care regulations and market forces. The course focuses on reimbursement for institutional and professional services. The course includes analysis of actual reimbursement techniques and will familiarize students with the source documents and the process necessary for the analysis of Federal and New York State regulations. Current reimbursement topics will also be discussed and references will be made to newly released information from governmental agencies.

The Realities of Managing Complex Health Systems course is designed to provide students with an up close perspective of how large health systems operate. Using real life case studies, expert insight, and relevant reading materials the course will outline the problems, issues, and possible solutions for essential areas of management, operations, and finance such as: • Health System Finance and Revenue Cycle • Managed Care in a Complex Health System • Strategic Planning, and Building a Physician Network • Physician Recruitment & Compensation • Measuring Physician Productivity • Faculty Practice Operating Models and Governance Structures • Faculty and the Academic/Teaching Mission • Research in an Academic Medical Center • Human Resources & Labor Relations • Managing Physician Relationships • Risk and Quality Management • Population Health • Patient Experience Through interactive class discussion, evidence based research, and access to industry leaders with content expertise, each student will develop a detailed understanding of the realities of managing complex health systems. Given the continued consolidation and evolution of the national healthcare landscape, the need for such a course has never been greater. While these changes in the healthcare sector have grown, so to have the career opportunities, this critical course offering will provide the students at Wagner a competitive edge in the job market. In addition, this course will provide students tremendous networking opportunities by introducing them to various senior health system leaders from across the tri-state region.

What would the best healthcare system look like? How would you know it is the best? What systems in wealthy nations today come close to matching this ideal? We begin this class with short documentary films that cover some of issues raised by these questions. We read and discuss articles about conventional health system models around the world and alternative perspectives for studying them and evaluating their performance. We discuss how so much of the literature draws on selective evidence to evaluate health care systems in the U.S. and abroad. Finally, we discuss different approaches to the empirical analysis of health system performance, and examine the extent to which the available evidence supports or refutes widely shared views of different health care systems. In this final part of the class, using zoom, we will converse with experts in the U.S., Canada, France, Switzerland and Israel.

Building on the concepts introduced in the core financial management course (CORE-GP.1021), this course covers the fundamentals of financial accounting for healthcare organizations. It provides a look behind the financial statements used in all organizations and focuses on preparation of statements and the use of financial accounting in decision making. Topics include journalizing transactions into debits and credits, double-entry accounting, creating general ledger accounts (T-accounts), and accounts receivable (including aging schedules). Specific healthcare-related accounting issues will also be discussed.

The application of digital tools in healthcare has grown exponentially over the last several years. They are now firmly entrenched in the healthcare delivery model. However, after experiencing this explosive growth, the application and potential of healthtech tools remain uncertain and potentially unfulfilled. While originally embraced with much hype, much more thought has to be given to appropriate reimbursement, how to strategically integrate these tools into workflows, and how they could be used to effectively and efficiently address the unique needs of fragile or underserved populations. What are the impacts of these changes on the methods of care delivery and the quality of care? This course will take a hands-on approach to explore digital healthcare technologies and their impact on key stakeholder groups within the industry. Beginning from the patient perspective, we will examine the challenges and opportunities these evolving technologies create from a consumer, financial, regulatory, and legal standpoint. We will provide a practical approach to researching and understanding the needs of prospective clients in the healthcare industry to develop, market, and deploy/sell innovative digital healthcare solutions.

This course describes the growing involvement of government in stimulating and directing the development of information technology in healthcare organizations. Included is a discussion of attempts to exchange information for the purposes of improving the quality of personal healthcare and public health. Methods for determining the financial value of information technology are described. Techniques for insuring the security and privacy of health information are presented. How information systems and technology can improve the quality of service provided to consumers and the clinical quality of health care is examined. Prerequisites: HPAM-GP.4833 or permission of instructor

This course provides the core microeconomic theories and concepts needed to understand health and health care issues in both the developed and developing world. It describes how the markets for health and health services are different from other goods, with a particular emphasis on the role of government and market failure. In addition it discusses the theoretical and empirical aspects of key health economics issues, including the demand for health and health services, supply side concerns, health insurance, the provision of public goods, and related topics. The course encourages students to fundamentally and rigorously examine the role of the market for the provision of health and health services and how public policy can influence these markets. Prerequisites: CORE-GP.1011, CORE-GP.1018

Building on HPAM-GP.4830, this course examines US domestic health policy issues from an economics perspective. Topics covered will be influenced by the current policy topics under discussion in the US. We will focus on the tradeoffs and contrasts between a market-based versus a government-based system, with topics potentially including: choice and behavioral economics, payment policies/pay-for-performance, health insurance, relevant sectors of the US health care system (hospitals, etc), public health and innovation. There will be a strong focus on applying theoretical insights from P.114830 and interpreting the relevant empirical literature. Prerequisites: CORE-GP.1011, CORE-GP.1018

This course is designed to study the essential role of human resources management within health care organizations. It is required for health management students and recommended for health policy and finance students. In order to meet the challenges of the marketplace, organizations will need to improve the quality of the services they provide; streamline their clinical delivery and support systems, and transform their human resources management accordingly. The degree to which organizations manage the people issues will, to a great extent, determine the success of our health care institutions. This course serves as a comprehensive foundation for all aspects of human resources planning, development, and administration and is vital to both the human resources professional and the line manager. Through the text readings, journal articles, case analyses, and student presentations, we will explore key issues and concerns in the human resources field.

Sobering fact: 90% of startups fail! Whether you are a founder or working for a founder, you are an innovator and an entrepreneur. The Making of a Healthcare Entrepreneur is the course for current and future health care innovators interested in learning how to exploit gaps and opportunities in the evolving healthcare industry and launch meaningful, valuable companies as measured by customers and investors. It provides innovators with the essential steps needed to take their idea from concept to reality. By using real cases to demonstrate the various paths taken by others, students will not only understand how to start up a company, but they will gain valuable insights into what it takes to succeed with investors, how to build a customer pipeline, and how to avoid pitfalls that can derail a company. The healthcare sector is complex. Many entrepreneurs come to their chief idea not by having a full understanding of the sector, but rather by having a specific or personal understanding of, and passion for, the problem they are trying to solve. Moving from a good idea to a real company requires not only an understanding of the issue, but also an understanding of the targeted customer(s), the product, the pricing model, funding mechanisms, board relations, customer acquisition, and much more.

In today’s healthcare environment, adapting to change is not enough. Healthcare executives and managers are tasked with leading change and driving results. This course will cover practical strategies leaders and emerging leaders can use to anticipate, plan, and respond to policy, regulatory, and practice changes in the industry.

This course incorporates topics of planning and financial decision making as applied to health-care organizations. This course will cover two main topics: -Financial analysis both as a proactive exercise and a tool for organizational control. -Issues of budgeting, cost determination, pricing and rate setting in a healthcare environment. The course includes lectures, problem solving and a finance term project. Students should be prepared to discuss assigned problems and readings in class. The course integrates academic and practical approaches and perspectives on current health-care financial problems. Prerequisites: CORE-GP.1018, CORE-GP.1021

This course incorporates topics of capital planning and other finance issues making as applied to health-care organizations. This course will cover three main topics: -Public payer rate setting -Understanding risk and the costs of capital in making financial decisions. -Issues in working capital and investment management activities of healthcare organizations. The course includes lectures, problem solving and a term finance project. Students should be prepared to discuss assigned problems and readings in class. The course integrates academic and practical approaches and perspectives on current health-care financial problems.

This class will utilize a hands-on and practical approach to understanding reproductive healthcare in the context of policy and management. Students will have the opportunity to think through real-world case studies and engage with relevant reproductive healthcare topics. Such topics include contraception, abortion, forced sterilization, abuses of power, gender, and gender identity. This course aims to give students the opportunity to clarify and strengthen their own ideas, biases, and values related to reproductive healthcare. Our work in this class will culminate in a final presentation and opinion piece in which the student will advocate for something in which they believe in related to reproductive health. While it is not required that the student eventually submits their writing for publication, I encourage it.

Emergency events are disruptive. Whether acutely impactful and short-term, negligible and protracted, or any mix thereof, these incidents alter healthcare organizations’ abilities to consistently deliver safe and effective care. While potentially devastating, emergencies are also unique opportunities for exemplary leadership and unprecedented innovation. COVID-19, ransomware, and active shooters are, respectively, a few of the myriad natural, technological, and intentional emergency events that healthcare organizations, and their leaders, face. While clinical, operational and financial impacts of emergencies are countless, so too, are their solutions. This course explores the structures, processes and outcomes of healthcare emergency management through an applied leadership case study approach. Beginning with the fundamentals and origins of healthcare emergency management, we will explore, using peer-reviewed journal articles and case studies, a comprehensive, all-hazards leadership approach to managing events that negatively impact healthcare delivery. We will examine strategies to synthesize, evaluate and apply healthcare emergency management principles in the context of proven leadership techniques, from regulations and accreditation standards to Colin Powell’s, “My Thirteen Rules” and Peter Drucker’s, “What Makes an Effective Executive.”

This course will explore the role of ethics in management leadership and organization success in today's health care environment. Learning objectives include: - Foster critical awareness of the student's values and the underlying ethical issues - Identify and enhance knowledge and skills to respond to specific ethics encountered in today's environment - Promote competence in moral reasoning and skill in applying basic ethics concepts, including identifying, analyzing, and resolving ethics conflicts - Explore various ethical issues in health care management - Describe ethics resources and tools The course will focus on both recognizing and responding to contemporary ethical topics in health care management. Class sessions will explore the application of moral reasoning, based on various ethical theories to health care concerns encountered by healthcare administrators, policy makers and clinicians. The course will demonstrate the practical application of philosophy and specifically, moral reasoning to ethical conflicts in health care organizations. Emphasis will be on critical thinking, real-world application, and decision-making in a professional environment. Students should come to class prepared to participate in the discussion of major topics outlined for each course session. Each session will consist of faculty and student presentations, group discussion, and case studies. The course is of interest to all students, especially those pursuing careers in health care.