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COLLEGE OF HEALTH AND HUMAN SERVICES
California State University, Long Beach
Department of Health Care Administration
HCA 300 – The Health Care System
Fall 2015
Instructor: Jim Lott, PsyD, MBA
E-mail: [email protected]
Phone: (213) 324-3262 Fax: (213) 947-1602
(OK to call 9 am – 9 pm 7 days/week)
Office: TBD
Office Hours: Before class, by appt only.
Section Number: 5 Class Number: 11138
Class Meets: Aug 25th
– Dec 15th
Day/ Time: Tuesdays, 7:00 – 9:45 p.m.
Classroom: SPA-210
Additional Contact Information:
HCA Program Administrative Coordinator:
Deby McGill, [email protected], HHS2-118
Tel. 562/985-5694; fax 562/985-5886
Course Description
Overview and developmental summary of the American health care system and its driving
forces: Organizational forms; financing mechanisms; principal industry stakeholders;
professional groups and workforce issues; public health and government (Lecture).
Letter grade only (A-F).
Course Learning Objectives
Students who have completed this course should be able to:
1. Describe the organization, administration and financing of the U.S. health care delivery
system and the principal state (California) and local (county) health care programs and
administering agencies.
2. Describe the types and interrelationships of health care facilities, services and personnel
3. Know the major historical events that shaped the U.S. health care system.
4. Obtain, analyze and synthesize information relevant to major contemporary U.S. health care
issues.
5. Demonstrate competencies both in writing and oral communication skills.
Learning Objectives, Domain, Competencies and Assessments
The Health Care Administration Department has adopted a competency-based curriculum, based
on the American College of Health Care Executives (ACHE) Competencies Assessment Tool
and the Healthcare Leadership Alliance (HLA) Competency Directory. As HCA 300 is one of
the first courses that students majoring in Health Care Administration take, the emphasis is on
acquiring competencies in HLA Domain 4, knowledge of the healthcare environment, and in
communicating effectively on major local and U.S health care issues.
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The following table describes how the course learning objectives and related competencies could
be acquired and measured.
Learning
Objectives
Domain Competencies Activity (A1),
Assignment (A2) or
Assessment (A3)
1, 4, 5 Knowledge
of the Health
Care
Environment
Regulatory and administrative
environment in which the organization
functions (e.g., antitrust; Stark I and II;
accreditation; organized labor)
A1. Lecture & class
discussion
A2 & A3. Exam,
Research Paper
1, 4, 5 The interrelationships among access,
quality, cost, resource allocation,
accountability, and community
A1. Lecture & class
discussion
A2 & A3. Exam
2, 4, 5 Workforce issues
A1. Lecture & class
discussion
A2 & A3. Exam
1, 4, 5 Funding and payment mechanisms of the
healthcare system
A1. Lecture & class
discussion
A2 & A3. Exam,
Research Paper
2, 3 Governmental, regulatory, professional,
and accreditation agencies (e.g., CMS;
JCAHO; NCQA) related to healthcare
delivery
A1. Lecture & class
discussion
A2 & A3. Exam
1, 4, 5 Interaction and integration among
healthcare sectors
A1. Lecture & class
discussion
A2 & A3. Exam,
Research Paper
1, 4, 5 Legislative issues and advocacy
A1. Lecture & class
discussion
A2 & A3. Exam
1, 2, 4, 5 Organization and delivery of healthcare
(e.g., acute care, ambulatory care, medical
practice, ancillary services)
A1. Lecture & class
discussion
A2 & A3. Exam,
Research Paper
2, 3, 5 Socioeconomic environment in which the
organization functions
A1. Lecture & class
discussion
A2 & A3. Exam,
Research Paper
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Required Text:
Niles, N.J. (2015), Basics of the U.S. Health Care System (2
nd ed.). Burlington, MA: Jones &
Bartlett Learning
American Psychological Association (2009). Publication manual of the American Psychological
Association (6th
ed.). Washington, DC: Author.
Recommended:
Yesalis, C.E., Holt, H.D. & Politzer, R.M. (2013). Fundamentals of U.S. Health Care. Clifton
Park, NJ: Delmar Cengage Learning.
Strunk, Jr., W., & White, E.B. (2008). The elements of style: 50th
anniversary edition. Upper
Saddle River, NJ: Pearson/ Longman.
Course lecture notes and additional readings will be available on BeachBoard. Lectures will
include additional information from instructor’s explanations and current events.
Other Requirements: E-mail address and Internet access to use the online BeachBoard course
software system. If you have problems with BeachBoard, contact the CSULB Technology Help
Desk at 562-985-4959, via e-mail at [email protected] or in-person at the Horne Center.
Course Assignments:
Class Preparation, Participation and Attendance
The class format will be a limited lecture and interactive discussion of the assigned readings and
other relevant materials. You are expected to have read the assigned readings (text chapters
and web sites) before the class session, and to be prepared to discuss them. Lectures cover
highlights of the reading and supplementary information. If you have trouble understanding what
you read or hear, please ask for clarification in class or make an appointment with me to discuss
the problem area(s). Disabled students requiring special accommodations, please advise
instructor when you first attend class. Attendance policy conforms to University policy:
http://www.csulb.edu/divisions/aa/grad_undergrad/senate/documents/policy/2001/01/.
Research Paper (Written)
This assignment supports the following outcomes:
Describe the historical origins of the American healthcare system.
Outline the role of various healthcare delivery systems and the organizational structure of
these systems.
Discuss the financing of healthcare in the United States.
Analyze the social forces that influence healthcare today.
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Research current policies and issues related to healthcare in the United States.
Defend your preferred way of organizing and financing healthcare.
Deliverable. Write a research page paper on all of the following topics:
1. Introduction to healthcare
Explain why healthcare delivery has evolved from the traditional family doctor
providing the majority of the care to a team of healthcare professionals across a
continuum of care.
Describe the three basic elements of the American healthcare system: provider,
government, and insurer.
Describe your personal interest in working in healthcare.
2. Professions in healthcare
Compare the roles of two different healthcare professionals.
As a healthcare manager, how do you see yourself interacting with one of these
professionals?
3. Where healthcare is provided
Describe two sectors where healthcare is administered (e.g. public health, private
physicians, group practices).
Compare the advantages and disadvantages of each sector.
As a consumer of healthcare, which sector do you prefer? Why?
4. Who pays for healthcare
Describe the origins of health insurance.
In your opinion, was it necessary to implement the managed care system?
5. How healthcare is regulated
Select one of the following healthcare topics: HIPAA, medical ethics, or technology.
Research and describe a healthcare policy enacted within the last 10 years.
6. Social forces that influence healthcare today
Select one of the following areas of healthcare: (a) the development of medical
techniques; (b) advances in medicine and pharmacology; (c) financing of the
healthcare industry; or (d) preparation and training of healthcare professionals. In
your opinion, what social forces are influencing this area of healthcare? What is the
impact?
7. How healthcare should be organized and financed
In your opinion, based on what you have learned thus far, what is the most effective
way of organizing and financing healthcare today?
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Grading Criteria. Developing writing competence is an intensive process that includes
developing ideas and synthesizing source materials to support your thinking and reasoning on the
subject of your studies. Therefore, you will need to submit a research (term) paper. A rubric
will be provided.
Minimum/Maximum length = 3500/4500 words. That is a min/max of 10/13 type-written,
doubled-spaced pages, not counting cover/title pages, abstract or summary pages, reference
pages or any attachments or addendums. In addition, a minimum of 10 references from current
(2009 or later) sources in addition to the websites listed below. Failure to meet these
requirements will reduce your assignment value by 25 percent; that is, your earned score
for your final paper will be reduced by 25 points.
Use APA format consistently and correctly. Be sure to include a correctly formatted
title/cover page, but do not include dedications, keywords, abstracts or executive summaries.
Submit all deliverables through the BeachBoard DropBox. Turnitin is a plagiarism prevention
service available in BeachBoard. Students submit their papers electronically, and Turnitin
compares the text of those papers to the text in millions of other documents on the Internet, in
papers submitted by other students around the world, and in commercial databases of journal
articles and periodicals. Whenever similarities between the text in a student's paper and the text
in an existing document are found, Turnitin highlights those similarities, providing an annotated
document showing both the student's paper and the original source. The similarity index for
your papers should be less than 30%.
NOTE: In addition to uploading your research paper online, please bring a hard copy to class
for me on the dates due. Use a staple, but no fancy covers or binders needed.
Research Paper (Oral)
You will make an oral presentation of your research to the class during our Week 12 meeting
(November 10, 2015). Your presentation must be no less than 5 minutes but no greater than 10
minutes long. You may but are not required to deliver a PowerPoint presentation. A grade
rubric will be provided, but know that no greater than a “C” grade will be given if all or most of
your presentation is delivered from a script or notes read to the class. The key here is to know
and rehearse your material so that you present it with confidence and with minimum reliance on
your written notes.
Midterm and Final Exams
Most of the exam questions will be based on the textbook, supplemental readings and lectures
but exams may also include information from guest speaker and student presentations. Exams
will contain short-answer, fill-in-the-blank and multiple-choice questions. You may use your
hand-written and/or type-written notes (open-notes), but you may not use your text book or
pages copied and/or extracted from your text, and electronic devices may not be used.
Disabled students requiring special accommodations for exams, please advise instructor at the
beginning of the course.
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APA Quiz
You will be given an open-book, open-notes quiz on your knowledge and comprehension of
APA requirements for writing college papers. No electronic devices may be used. This will be
given at the start of class in Week Five, and it will be worth 20 points, 5 percent of your course
grade. You will be required to provide short answers to the questions I ask.
Assignment Policies and Grading:
ALL assignments are due by the start of class on the dates specified. Late assignments lose
10% of points for each day past the deadline unless otherwise specified. NO ASSIGNMENTS
ACCEPTED AFTER LAST DAY OF CLASS. Exceptions will be made if and only if either a
verifiable death in your immediate family occurred or you were ill and provide me with
verifiable (need phone number) note from a physician on his or her office letterhead or
prescription pad. Otherwise, submit all assignments through Beachboard when due. This also
applies for missing our scheduled midterm or final exam. Disabled students, who qualify for
alternative testing arrangements, please advise the instructor at least 2 weeks prior to the exams.
NOTE: Please do not take this class if you already know or believe you are at high-risk for
having to miss class sessions or need to reschedule exam dates. I will not make allowances for
your competing priorities, and that includes job commitments. Make certain your employer is
able to commit to your course schedule.
Other Class Norms:
1. Attendance will be graded (see ICE assignments) for the class session where we are not
having a quiz, exam or student presentations. Please do not sign in for a classmate who is
either expected to come to class late or is absent. So doing qualifies as fraud and the
perpetrator will have his or her entire course grade reduced by 25 percent, meaning that if
you are an “A’ student, the highest grade you will receive for the course is a “C” grade.
Repeat occurrences will result in the perpetrator receiving an “F” grade and referral to
University officials for further disciplinary action.
2. Cheating and Plagiarism. Please be aware of and ensure that your behavior conforms to
University Policy. See
http://www.csulb.edu/divisions/aa/grad_undergrad/senate/documents/policy/2008/02/
3. Withdrawal policy. Per University policy:
http://www.csulb.edu/divisions/aa/grad_undergrad/senate/documents/policy/2002/02/.
Withdrawal after 2nd
week and before final 3 weeks “permissible for serious and
compelling reasons;” instructor will evaluate student withdrawal requests on a case by
case basis.
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4. Key Class Norm: You must put away and not use your cell phone, smartphone, tablet
computer, laptop or any other electronic device during class meetings, except when you
are giving a presentation or if you require special accommodations with authorization
from the university. Please do not ask for an exception.
5. Please check and make certain that your email address is correct on BeachBoard, and
know that I will respond to all emails I receive within 24 hours of your having sent them.
Therefore, it would be correct for you to assume that I did not receive your
communication if you have not received a response from me within that timeframe. So,
please follow-up by calling me directly at (213) 324-3262; do not send another email. If
you receive my voicemail, slowly input your name, repeat your phone number twice,
and leave a good time for me to return your call.
Course Grades:
Assignment Due date Points Percent
APA Quiz Week 5 20 05
Research (Term) Paper (Written)
Research (Term) Paper (Oral)
Week 14
Week 12
100
40
25
10
In-Class Exercises (ICE) (10 @ 8 points each) Ongoing 80 20
Midterm Exam Week 8 80 20
Final Exam Week 17 80 20
Total 400 100
Final Course Grade Computation:
360+ = A 320-359 = B 280-319 = C 240-279 = D <240 = F
Commitment to Inclusion: California State University, Long Beach is committed to maintaining an inclusive learning community that values diversity and fosters mutual respect. All students have the right to participate fully in university programs and activities free from discrimination, harassment, sexual violence, and retaliation. Students who believe they have been subjected to discrimination, harassment, sexual violence, or retaliation on the basis of a protected status such as age, disability, gender, gender identity/expression, sexual orientation, race, color, ethnicity, religion, national origin, veteran/veteran status or any other status protected by law, should contact the Office of Equity and Diversity at (562) 985-8256, University Student Union (USU) Suite 301, http://www.csulb.edu/depts/oed.
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CLASS TOPIC AND ASSIGNMENT SCHEDULE
Week # -
Date
Topic/Activity Text, Reading
Assignments1
Tasks, Deliverable(s)
1 Aug 25 Course Overview; Introductions; APA
Presentation
Handouts
2 Sept 01 History of the U.S. Healthcare System;
County Profile Paper (Term Paper); Film
Chapter 01
3 Sept 08 The Affordable Care Act Review
Chapter 02 ICE #01
4 Sept 15 Organization of Health Services
Chapter 03 ICE #02
5 Sept 22 Government’s Role in U.S. Healthcare Chapter 04 APA Quiz 6 Sept 29 Public Health
Chapter 05 ICE #03
7 Oct 06 Inpatient & Outpatient Services
Chapter 06 ICE #04
8 Oct 13 Midterm Exam
Chps. 1-6; Weeks 1-7
9 Oct 20 U.S. Healthcare Workforce
Chapter 07 ICE #05
10 Oct 27 Healthcare Financing
Chapter 08 ICE #06
11 Nov 03 Managed Care
Chapter 09 ICE #07
12 Nov 10 Healthcare Information Technology Chapter 10 Oral Presentations
13 Nov 17 Healthcare Law & Ethics
Chapters 11& 12 ICE #08
Nov 24 Thanksgiving Holiday Break Enjoy! 14 Dec 01 Mental Health Services
Chapter 13
Research (Term)
Paper Due;
ICE #09 15 Dec 08 Health Policy; Course Recap
Handouts ICE #10
Dec 15 Final Exam Chps 07-13; Weeks 9-
16
1 In addition to the text chapter(s) and articles, review the websites for each topic listed in the bibliography.
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Pertinent Web Sites. Just a few of many web sites with information pertinent to this
course, by topic:
Topic Web Sites
Health policy (national) Department of Health and Human Services: www.hhs.gov/
Healthcare.gov: www.healthcare.gov/index.html
Medicare: www.medicare.gov
Office of Consumer Information and Insurance Oversight:
www.hhs.gov/ociio/index.html
Academy for Health Services Research & Health Policy: www.academyhealth.org/
Health Reform GPS: Navigating Implementation: http://www.healthreformgps.org/
Health policy (California) California HealthCare Foundation: www.chcf.org
Insure The Uninsured Project: www.itup.org
Health Access: health-access.org/
Public Policy Institute of CA: www.ppic.org
California Health Reform Implementation: http://www.healthcare.ca.gov/.
Health Consumer Alliance: http://healthconsumer.org Information resources National Library of Medicine: www.nlm.nih.gov
Virtual reference style manuals: www.csulb.edu/library/eref/vref/style.html
APA electronic citations: www.apastyle.org/apa-style-help.aspx. Health policy formation, agenda setting Robert Wood Johnson Foundation: www.rwjf.org
The Urban Institute: www.urban.org; Families USA: www.familiesusa.org
Center for Health Care Strategies: www.chcs.org
Center for Studying Health System Change: www.hschange.com
Policy implementation & modification National Academy for State Health Policy: www.nashp.org
UCLA Center for Health Policy Research: www.healthpolicy.ucla.edu
California HealthCare Foundation: www.chcf.org
Kaiser Family Foundation: www.kff.org; Rand Corporation: www.rand.org
Mathematica Policy Research: www.mathematica-mpr.com/ The Commonwealth Fund: www.commonwealthfund.org/Health-Reform.aspx
Financing health services Center for Medicare & Medicaid Services: www.cms.gov
Center on Budget & Policy Priorities: www.cbpp.org
CA Legislative Analyst's Office: www.lao.ca.gov
Healthcare Financial Management Assn: www.hfma.org
Managed care, insurance & benefits Employee Benefits Research Institute: www.ebri.org
America’s Health Insurance Plans: www.ahip.org
CA Assn. Of Health Plans: www.calhealthplans.com
CA Dept. of Managed Health Care: www.dmhc.ca.gov
CA Office of the Patient Advocate: www.opa.ca.gov/index.aspx
National Governors Association: www.nga.org/
National Association of Insurance Commissioners: www.naic.org/
Ambulatory health services
American Academy of Urgent Care Medicine: www.aaumc.com
National Association for Ambulatory Care: http://www.urgentcare.org/
Medical Group Management Association: www.mgma.com
Hospitals & health systems American Hospital Assn.: www.aha.org;
Blue Cross/Blue Shield Assn.: www.bluecares.com
Association for Community Health Improvement:
http://www.communityhlth.org/communityhlth_app/index.jsp
Long Term Care; Politics of Aging &
Disability American Association of Retired Persons: www.aarp.org
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Topic Web Sites
Disability Rights Education & Defense Fund: www.dredf.org
Mental health
National Institute of Mental Health: www.nimh.nih.gov
Bazelon Center for MH Law: www.bazelon.org
Medline Plus: www.nlm.nih.gov/medlineplus/mentalhealth.html
Pharmaceuticals Pharmaceutical Research & Manufacturers of America: www.phrma.org
American Society of Health-System Pharmacists: www.ashp.org/
Public health Centers for Disease Control & Prevention: www.cdc.gov
American Public Health Association: www.apha.org
Health professionals Am. Medical Assn.: www.ama-assn.org; Am. Nurses Assn. www.ana.org
Am. Academy of Physician Assistants: www.aapa.org
Am. Pharmaceutical Assn.: www.pharmacist.com Quality of care Institute of Medicine: www.iom.edu
National Committee for Quality Assurance: www.ncqa.org
Joint Commission (accreditation): www.jointcommission.org
California Healthcare Foundation Quality Initiative: www.chcf.org
Robert Wood Johnson Foundation: National Quality Directory:
http://www.rwjf.org/qualityequality/product.jsp?id=71857 Ethical issues Alliance for Health Reform: www.allhealth.org
Hastings Center: www.thehastingscenter.org
Bibliography (updated July 2012)
Books and Articles: Burke, S. (2011, June). The U.S. Congress and Health Policy. Retrieved from: http://www.kaiseredu.org/Tutorials-
and-Presentations/US-Congress-and-Health-Policy.aspx.
Campbell, C.G. & Zinner, D.E. (2010). Disclosing industry relationships - toward an improved federal research
policy. New England Journal of Medicine, 363, 604-606. DOI: 10.1056/NEJMp1006973
Craig, R.L., Felix, H.C., Walker, J. F., & Phillips, M. M. (2010). Public health professionals as policy entrepreneurs:
Arkansas’ childhood obesity experience. American Journal of Public Health, 100, 2047-2052. DOI:
10.2105/AJPH.2009.183939
Donabedian, A. (2003). An introduction to quality assurance in healthcare. Cary, NC: Oxford University Press.
(Classic)
Gawande, A. (2009, 1 June). The cost conundrum: What a Texas town can teach us about health care. The New
Yorker. Retrieved from: gawande.com/articles.
Hollingsworth, J.M., Ye, Z., Strope, S.A., Krein, S.L., Hollenbeck, A.T., & Hollenbeck, B.K. (2010). Physician
ownership of ambulatory surgery centers linked to higher volume of surgeries. Health Affairs, 29, 683-689.
Hsu, R.Y., Kellerman, A.L., & Shen, Y. (2011). Factors associated with closures of emergency departments in the
United States. Journal of the American Medical Association, 305, 1978-1985.
Illich, I. (1975). Medical Nemesis: The expropriation of health. New York: Pantheon. (Classic)
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Joynt, K.E., Orav, E.J., & Jha, A.K. (2011). Thirty-day readmission rates for Medicare beneficiaries by race and site
of care. Journal of the American Medical Association, 305, 675-681.
Kaye, H.S., Harrington, C. & LaPlante, M.P. (2010). Long-term care: Who gets it, who provides it, who pays and
how much? Health Affairs, 29, 11-21. DOI: 10/13777/hlthaff.2009.0535.
Kongstvedt, P. (2009). Managed care: What it is and how it works. Sudbury, MA: Jones & Bartlett.
Long, P. & Gruber, J. (2011). Projecting the impact of the Affordable Care Act on California. Health Affairs, 30, 63-
70. doi:10.1377/hlthaff.2010.0961
Metzl, J.M. (2010). The protest psychosis: How schizophrenia became a black disease. Boston: Beacon Press.
Meyer, H. (2011). Coding complexity: U.S. health care gets ready for the coming of ICD-10. Health Affairs, 30,
968-974. DOI: 10/13777/hlthaff.2011.0319.
Neumann, P.J. (2005). Using cost-effectiveness analysis to improve health care: Opportunities and barriers. New
York: Oxford University Press.
Picard, A. (2008). The making of the American mouth: Dentists and public health in the twentieth century.
Piscataway, NJ: Rutgers University Press.
Pipes, S. (2011). The truth about Obamacare. Washington, DC: Regnery Press.
Saranson-Kahn, J. (2011, November). Primary care, everywhere: Connecting the dots across the emerging health
landscape. Oakland, CA: California HealthCare Foundation. Retrieved from:
http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/P/PDF%20PrimaryCareEverywhere.p
df.
Sisko, A.M., Truffer, C.J, Keehan, S.P., Poisal, J.A, Clemens, M.K. & Madison, A.J. (2010). National health
spending projections: The estimated impact of reform through 2019. Health Affairs, 29, 1933-1941. DOI:
10/13777/hlthaff.201.0788.
Starr, P (2011). Remedy and reaction: The peculiar American struggle over health care reform. New Haven: Yale
University Press.
Warnock, M. & MacDonald, E. (2008). Easeful death: Is there a case for assisted dying? New York: Oxford
University Press.
Wilson, K.B. (2011, May). Health Care Costs 101, 2011 Edition. California HealthCare Foundation. Retrieved
from: http://www.chcf.org/publications/2011/05/health-care-costs-101.
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Journals: Most available online through COAST e-journal collections:
http://coast.library.csulb.edu/.
American Journal of Managed Care American Journal of Medical Quality
American Journal of Public Health Business and Health
Harvard Business Review Cambridge Quarterly of Healthcare Ethics
Evaluation and the Health Professions Health Education & Behavior
Health Affairs Health Care Financing Review
Health Policy Health Services Research
Health Technology Trends Inquiry
International Journal of Health Services J of the American Medical Assn. (JAMA)
J of Behavioral Health Svcs. & Research J of Health Services Research & Policy
Journal of Community Health Journal of Health and Social Behavior
Journal of Health, Politics, Policy and Law Medical Care Research & Review
Medicine and Health Milbank Memorial Fund Quarterly
New England Journal of Medicine Qualitative Health Research
Journal of Health Care Finance Family & Community Health
Frontiers of Health Services Management Hospital & Health Services Administration
Journal of Ambulatory Care Management J of Health Care for the Poor & Underserved
Public Health Reports Journal of Public Health Policy
Modern Healthcare2 J of the American Geriatric Society
Hospitals & Health Networks
2 Free student subscription available at: http://www.aupha.org/i4a/forms/form.cfm?id=51&pageid=3829&showTitle=1