Course Syllabus:

PBH/HE 510
Health Care Systems

Course Description

This course is designed to familiarize students with basic information about how
the health system works in America and to stimulate critical thinking about how
the system can be improved to meet the challenges of an aging society, rapid
expansion of new technology, ever growing costs of health care services, and
threats to health induced by poor behavioral choices such as diet, exercise and
tobacco use. The goal of the course is to form a base of understanding about the
dynamics of health and healthcare.

Teaching Methods

Goals of the course will be accomplished with the use of lectures, videos, case
studies, analyzing journal articles and text books, presentation of research
papers, interactive discussions.

Course Objectives

At the conclusion of this course, the student will be able to:

 Demonstrate critical thinking and problem solving skills related to policy

issues in health care systems.
 Comprehend the theoretical underpinnings of health care systems both
in the US and abroad.
 Apply economic principles to health care systems and scenarios. Use
economic models in discussion to support theories and arguments.
 Evaluate and critique health policy and health economics literature.
 Engage in discussion and debate in an on-line forum on major health
care system issues.
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PREREQUISITES:
Facility with the computer (Microsoft Office), Blackboard and the Internet

Course Text and Readings

Text: Jonas and Kovner’s, Health Care Delivery in the United States, 8th edition,
2008, Springer Publishing, NY, NY.

Journal Articles:

1--The Financial Impact of the Medicare Prospective Payment System on Long-Term

Acute Care Hospitals
Hatem Saqr, Osama Mikhail, James Langabeer II. Journal of Health Care Finance. New
York: Fall 2008. Vol. 35, Iss. 1; pg. 58, 12 pgs.

2--What We Know and Do Not Know About Tiered Provider Networks

J William Thomas, Gino A Nalli, Andrew F Coburn. Journal of Health Care Finance.
New York: Summer 2007. Vol. 33, Iss. 4; pg. 53, 15 pgs

3--Medicare and Medicaid: The Past as Prologue

Edward Berkowitz. Health Care Financing Review. Washington: Spring 2008. Vol. 29,
Iss. 3; pg. 81, 13 pgs

4--Medicare Disease Management in Policy Context

Ariel Linden, Julia Adler-Milstein. Health Care Financing Review. Washington: Spring
2008. Vol. 29, Iss. 3; pg. 1, 11 pgs

5--THE PRESCRIPTION FOR GOOD HEALTH MAY NOT BE FOUND IN ACCESS TO

THE HEALTH CARE SYSTEM
Bridget M Costello, Bernard J Healey, Michele McGowan. Academy of Health Care
Management Journal. Cullowhee: 2007. Vol. 3, Iss. 1/2; pg. 29, 19 pgs

6--Emerging Issues of Pay-for-Performance in Health Care

Frederick G Thomas, Todd Caldis. Health Care Financing Review. Washington: Fall
2007. Vol. 29, Iss. 1; pg. 1, 4 pgs

7--Financial Gains and Risks in Pay-for-Performance Bonus Algorithms

Jerry Cromwell, Edward M Drozd, Kevin Smith, Michael Trisolini. Health Care Financing
Review. Washington: Fall 2007. Vol. 29, Iss. 1; pg. 5, 10 pgs
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8--Hospital Multifactor Productivity: A Presentation and Analysis of Two Methodologies

Jonathan D Cylus, Bridget A Dickensheets. Health Care Financing Review.
Washington: Winter 2007/2008. Vol. 29, Iss. 2; pg. 49, 15 pgs

9--Impact of Resource-Based Practice Expenses on the Medicare Physician Volume

Stephanie Maxwell, Stephen Zuckerman. Health Care Financing Review. Washington:
Winter 2007/2008. Vol. 29, Iss. 2; pg. 65, 15 pgs

10--Medicare Physician Group Practice Demonstration Design: Quality and Efficiency

Pay-for-Performance
John Kautter, Gregory C Pope, Michael Trisolini, Sherry Grund. Health Care Financing
Review. Washington: Fall 2007. Vol. 29, Iss. 1; pg. 15, 15 pgs

11--Multifactor Productivity in Physicians' Offices: An Exploratory Analysis

Charles Fisher. Health Care Financing Review. Washington: Winter 2007/2008. Vol.
29, Iss. 2; pg. 15, 12 pgs

12--Productivity Adjustment in the Medicare Physician Fee Schedule Update

Joseph P Newhouse, Anna D Sinaiko. Health Care Financing Review. Washington:
Winter 2007/2008. Vol. 29, Iss. 2; pg. 5, 10 pgs

13--Profiling Efficiency and Quality of Physician Organizations in Medicare

Gregory C Pope, John Kautter. Health Care Financing Review. Washington: Fall 2007.
Vol. 29, Iss. 1; pg. 31, 13 pgs

14--Prescription Drug Coverage Among Medicare Beneficiaries

Joseph F Regan, Cara A Petroski. Health Care Financing Review. Washington: Fall
2007. Vol. 29, Iss. 1; pg. 119, 7 pgs

15—Testing Consumers' Comprehension of Quality Measures Using Alternative

Reporting Format
Margaret Gerteis, Jessie S Gerteis, David Newman, Christopher Koepke. Health Care
Financing Review. Washington: Spring 2007. Vol. 28, Iss. 3; pg. 31, 14 pgs

16--Health Care Quality Reporting: Changes and Challenges

David J Miranda. Health Care Financing Review. Washington: Spring 2007. Vol. 28,
Iss. 3; pg. 1, 4 pgs

17--Hospital Response to Public Reporting of Quality Indicators

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Mary Laschober, Myles Maxfield, Suzanne Felt-Lisk, David J Miranda. Health Care
Financing Review. Washington: Spring 2007. Vol. 28, Iss. 3; pg. 61, 16 pgs

18--Medicaid and Health Information: Current and Emerging Legal Issues

Sara Rosenbaum, Patricia MacTaggart, Phyllis C Borzi. Health Care Financing Review.
Washington: Winter 2006/2007. Vol. 28, Iss. 2; pg. 21, 9 pgs

19--Valuing Hospital Investment in Information Technology: Does Governance Make a

Difference?
Stephen T Parente, R Lawrence Van Horn. Health Care Financing Review.
Washington: Winter 2006/2007. Vol. 28, Iss. 2; pg. 31, 13 pgs.

20—Consumer-Driven Health Plans: Their Impact on Medical Utilization, Pharmacy

Utilization, and Expenditures
Kavita V Nair, Vahram Ghushchyan, Joseph J Saseen. Journal of Health Care Finance.
New York: Fall 2008. Vol. 35, Iss. 1; pg. 1, 12 pgs

Videos as assigned: See Weekly Assignments posted on Blackboard

Case Studies: See Weekly Assignments posted on Blackboard

Be sure to use APA format to list your required text and/or readings. If possible,
include the ISBN number as well.

Contact Information

Office telephone = 610-490-9144 Cell phone = 610-291-4837

email = hughesm@arcadia.edu
Office hours: call for appointment

School Cancellation Information: KYW – Day#338, Eve#2338

Email and Blackboard

We will be using Arcadia e-mail and Blackboard. Make certain your account is
active and accessible. Check it routinely for announcements, course
information, etc.
Weekly assignments will be posted on Blackboard
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About your Instructor: Maryann C. Hughes MBA

I have a Bachelor’s degree in Medical technology from Hahnemann University now a

division of Drexel University as well as an MBA in Health Administration from Widener
University. My professional experience of 25 years has spanned a wide spectrum of health
care. I have worked in a hospital association, hospital systems, and the pharmaceutical
industry. My background includes work in education program development, marketing and
Medical Practice Administration and has given me a perspective on both the non profit and
for profit elements of health care.

Competency Assessment

You will have several opportunities to demonstrate your competence in this

course. The following describes the assignments required for completion of the
course.

There are 14 units in this course condensed into a 7 week period. Each unit will
require readings from the text and a combination of some or all of the following:
evaluation of on-line journal articles, review of on-line videos, and analysis of
case studies by answering questions posed. On weeks where a case study is not
assigned, answers to the discussion questions at the end of the chapter will be
required. These discussion questions will be part of the discussion board
presentation for that week.

Case studies will describe a health care environment scenario and will be
accompanied by specific questions to be answered within your analysis. The
case studies are accompanied by suggested additional references. These are
just suggestions. Case studies should be 3 to 4 pages in length.

Journal articles will be accessed on-line and evaluated and compared to text
readings, videos or other articles from reputable sources with discussion to be
posted. Videos will also be evaluated, compared and contrasted to the text, to
journal articles, or other videos from reputable sources. Students will be able to
access journal articles and video through the appropriate link or “url” connected
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to each article and video. These links and “urls” will be found in each weekly
assignment folder. Discussion questions are found at the end of each chapter.

Evaluation of text, journal articles, and videos will be posted on the discussion
board. You must reply to at least 3 of your classmate’s postings each week.

Students are expected to demonstrate their competency in accessing and

searching the Arcadia library on-line when doing their independent research for
case studies and the research paper.

Opinions and analysis stated during discussion boards, case studies and
research should not be based on hearsay and online anecdotal experience but on
respected sources of information.

A research paper on the Obama Health Care Plan taking into consideration the
issues discussed during the course will be required but due 4 weeks after the
conclusion of the course. The paper should be 10 to 15 pages in length. An
abstract of your paper is required to be posted on the discussion board. You
must comment on each of your classmates abstracts on discussion board. One
paragraph for each is sufficient.

Points Schedule

All assignments will be due on or before 1 week after the assignment date.

Assignment Points Each Total Points

Case Studies 10 40

Video Discussion Board 5 35

Internet Discussion Board 5 35

Research Paper 30 20

Abstract of Research 5 5

Total 135

Weekly Schedule

Assignment Weeks Point Value

Text: Chap. 3,4 1 Total for Week – 15 points

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Articles # 1,2

2 points(Evaluate and
compare journal articles
to text and/or videos –
post evaluation on
Discussion Board)
Videos: Health Care
Reform

Judy Waxman,NWLC 3 points(Evaluate and

compare the videos to
Nancy Neilson,AMA text and/or articles –post
evaluation on Discussion
Karen Ignani, AHIP
Board)
Case Study – Chap 3

10 points ( 3 to 4 pages in
length; Analysis must
answer questions posed
at the end of the case
study; must use
references)

Text: Chap. 5,6 2 Total for Week – 15 points

Case Study – Chap 5 10 points ( 3 to 4 pages in

length; Analysis must
answer questions posed
at the end of the case
study; must use
references)
Videos: 3 points (Evaluate and
compare videos to text
Linda Stierle, ANA
and /or journal articles –
Health care Leaders post evaluation on the
Debate Discussion Board)

Article # 3 2 points (Evaluate and

compare article to text
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and/or videos –post

evaluation on the
Discussion Board)

Text: Chap 7,8 3 Total for Week – 5 points

Chapter 7 discussion 2 points - Answer the

questions discussion questions at
the conclusion of
Chapter 8 discussion chapters 7 and 8 and post
questions on the Discussion Board
–do not need to
reference; use of text is
Videos: sufficient

Richard Umbenstock, 2 points - Evaluate and

AHA compare videos to
journal article and/or text
Ken Thorpe, PFCD
–post evaluation on
Discussion Board

Article #4 1 point - Evaluate and

compare article to videos
and/or text – post
evaluation on Discussion
Board

Text: Chap 9,10 4 Total for Week - 15 points

Case Study Chap 9 10 points ( 3 to 4 pages in

length; Analysis must
answer questions posed
at the end of the case
study; must use
references)

Videos: 3 points - Evaluate and

compare videos to
Nursing Home Reform
journal article and/or text
–post evaluation on
Discussion Board
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Article: #5 2 points - Evaluate and

compare article to videos
and/or text – post
evaluation on Discussion
Board

Text: Chap 11,12 5 Total for Week - 15 points

Articles #6 thru 14 3 points - Evaluate and

compare articles to
videos and/or text – post
evaluation on Discussion
Board

2 points - Evaluate and

Videos: Big Pharma(3) compare videos to
articles and/or text – post
evaluation on Discussion
Board

Case Study, Chap 12 10 points ( 3 to 4 pages in

length; Analysis must
answer questions posed
at the end of the case
study; must use
references)

Text: Chap 13,15 6 Total for Week – 5 points

Chapter 13 Discussion 2 points - Answer the

Questions discussion questions at
the conclusion of
Chapter 15 Discussion chapters 13 and 15 and
questions post on the Discussion
Board –do not need to
reference; use of text is
Article: # 15 thru 19 sufficient

2 points - Evaluate and

compare article to videos
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and/or text – post

evaluation on Discussion
Board
Videos 1 point - Evaluate and
Video: Jack Lewin ACC compare videos to
articles and/or text – post
Video: RFID Technology evaluation on Discussion
Board

Text: Chap 16,17 7 Total for Week – 5 points

Chapter 16 Discussion 2 points - Answer the

Questions discussion questions at
the conclusion of
Chapter 17 discussion chapters 16 and 17 and
questions post on the Discussion
Board –do not need to
reference; use of text is
Article # 20 sufficient

1 points - Evaluate and

compare article to videos
and/or text – post
evaluation on Discussion
Board
Videos
2 points - Evaluate and
Video: Renee Jenkins compare videos to
articles and/or text – post
Video: Ted Epperly
evaluation on Discussion
Video: Todd Stotlemeyer Board

FINAL PROJECT Due 4 weeks after Total Points 25

conclusion of classes
Research paper analyzing 20 points- Research
the Obama Health Care paper should be 10 to 15
Plan pages in length. Analyze
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the Obama Health Care

plan taking into
consideration the issues
considered in this course.
Must use reputable
references.

Abstract of paper posted 5 points

on Discussion Board and
comments on
classmates’ abstracts

Attendance & Participation

You will lose points for not participating each week ( 5 points per week for not
participating in the week’s activities.)

Late submission of Case Studies and Research Paper must be discussed with
instructor prior to submission date, otherwise there is an automatic 2 point
deduction for Case Studies and 5 point deduction for research project. Please
remember the entire course is worth 100 points. For example an “A” grade is 94
points to 100 points.

Final Grade

100% – A 93% – 0% A-
94%
89 - 87 B 86%– B 83% – 80% B-
+ 84%
79 – 77 C 76%– C 73% – 70% C-
+ 74%
69 – 67 D 66%-64% D 63% – 60% D-
+
< 59 F

Class Policies
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Editorial Format for Written Papers:

All written assignments are to follow the APA writing style guidelines for
grammar, spelling, and punctuation. Visit the following websites to
www.apastyle.org and http://www.liunet.edu/cwis/cwp/library/workshop/citapa.htm for
guidelines.

Late Assignments:
Student must alert me if an assignment will be late or forfeit points.

Code of Academic Responsibility:

Each student accepts the responsibility of maintaining high standards of integrity
in his/her academic performance. It is the responsibility of all students to uphold
the code through the procedures set forth by the University as outlined in the
Student Handbook.

Student Handbook: Please refer to your student handbook for all university
regulations.