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THE HELLER SCHOOL FOR SOCIAL POLICY AND MANAGEMENT

BRANDEIS UNIVERSITY

HS518
Management of Health Care Organizations
Fall 2006

Jon Chilingerian & David Rosenbloom Wednesday 6:30 - 9:30 PM

Jon (718) 736-3828; David (617) 437-1500 Office Hours: Wed. 2– 4:00; Tues. 10:30- 2:00
Email: Chilingerian@brandeis.edu: David@Jointogether.org
TA: Laura Lorenz llorenz@brandeis.edu

Course Description: The purpose of this course is to enable Masters and Ph.D. students to
frame and analyze health care management issues, to assess the managerial skills needed to
manage a health care organization, and to prepare students for a variety of careers in the health
care industry. Although students are introduced to the medical care production process and the
service delivery system, the focus is on management innovations that can control health care
costs and/or improve services, strategies for organizations and delivery systems to serve the new
consumers and customers, and the uncertainties facing organizations that develop scientific
innovations in pharmaceutical, biotechnology, and information technology for health
organizations.

The course has been designed to introduce students to the management theories, analytic
concepts, tools and approaches to managing in health care. One objective will be to familiarize
students with internal problems of managing health organizations as delivery systems from the
perspective of the “service” manager. There will be a strong emphasis on how corporate
strategy, organizational structures, physician clinical decision-making, and internal management
control systems affect organizational performance. Another objective is to teach students to
think strategically about opportunities in a “health policy context.” In order to study health care
management, students should be prepared to integrate the management concepts and tools across
traditional functional areas (operations, organization behavior, marketing, strategy, accounting,
and so on).

Management Discipline Skills and Competencies: By the end of the course, students should
learn how to: (1) map out the relationships among the major players and analyze a health care
setting (stakeholders, policy issues, and so on); (2) understand the difference between corporate
and competitive strategy in health care; (3) understand the elements of competitive strategy and a
strategic service vision; (4) employ organizational analysis to diagnose health care management
problems; (5) apply management knowledge to solve health care management problems; (6)
evaluate new entrepreneurial ventures in health care; and (7) prepare/evaluate a business plan.

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To achieve the course objectives, the course will focus on three areas:
• Learning how to create corporate and competitive strategies and entrepreneurial ventures in
health care
• Learning to organize and manage health care organizations and professionals
• Learning to manage strategic innovation and change in traditional health care organizations
and allied organizations such as: pharmaceutical and bio-technology organizations

Audience: This course will benefit MBA, MM, and Ph.D. students with career and research
interests aimed at a wide variety of industries and organizations: (1) Health Care Delivery
Systems, (such as HMOs, hospitals, nursing homes, physician and dental practices, and other
health services providers); (2) Health Care Supplier Industries, (such as pharmaceutical, medical
device, medical supply, and bio-technology industries); (3) Third party payors and Insurers,
(such insurance companies, sickness funds, government agencies); (4) Government Agencies,
(such as planning and regulatory agencies and social welfare agencies); (6) Financial Services
such as venture capital, investment banking, and commercial banking; and (5) Non-Profit Human
Service Organizations.

Organization of the Course:

A. Content: In this course we will use a mixture of readings (from journal articles and books)
and business cases. The cases will be used to illustrate the concepts and premises of
management theory, the values they represent, and their application in health care situations.

B. Structure: The class meets for 13 sessions. Normally the first 55 to 75 minutes of each
session will be lecture/case discussion, and the last 15-20 minutes will be wrap-up or
presentations. When there are two cases assigned, at least 40 minutes will be allocated to
each case discussion. All readings and cases should be completed before the class in which
they will be discussed. Students can expect to be called upon to present aspects of the case
being discussed. When student cases are assigned, 20-30 minutes will be allocated to those
discussions.

Course Requirements:

1. Constructive participation in class and comments on readings* 40%

2. IDEO Challenge & Presentation (September 28) 30%
3. Case project (sign-up after second class) 30%

• *Student should be prepared to discuss the cases in class. Each student should
lead several case discussions.
• By the second class, students should identify an original health care management
case study that they will develop for class analysis. This must represent an original
case, developed by the students. Students can work individually or in teams (of 3-5
people) to write a health management case analysis. There will be no more than five
people on a team.

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• To receive full credit, students must provide their case to the class in writing one
week before the presentation is made. If you require assistance in copying, please
give support staff at least a two-day notice.
• The case study should be short (3-5 pages) and on the day of the presentation
should include a teaching note to be handed in only to the instructors. The case study
should report an event (i.e., crisis, hiring/firing decision, strategic change) or other
health case management issue/problem in a real-life setting. Each student/team will
lead a 20-30 minute class discussion on his or her case and will be expected to use the
case to illustrate theories and concepts from the readings. Topics may be selected
from the subject matter on the syllabus. The specific case problem may have
happened in your place of employment, or be a situation with which you are familiar.
It should represent new work, not a recycled case.

Provisions for Feedback:

• The case will be graded based on its ability to generate a provocative and lively class
discussion. Although the papers will not be graded, the presentation will be given a
grade. After the presentation, the students should meet with Jon or David to discuss
how their presentation went.

Required Texts:**

Paul Levy: Taking Charge of the Beth Israel Deaconess Medical Center MultiMedia Case 9-303-
058, Cambridge, MA: Harvard Business School Press (2003)

Service is Front Stage: Positioning Services for Value Advantage. By James Teboul. INSEAD
Business Press. New York: Palgrave Macmillan (2006)

The Leadership Challenge. 3d edition, James Kouzes, and Barry Posner, San Francisco: Jossey
Bass (2002)

The Value Profit Chain James Heskett, W. Earl Sasser, Leonard A. Schlesinger, The Free Press:
New York, (2003)**

Restructuring Health Care: The Patient Focused Paradigm J. Philip Lathrop, Josey Bass: San
Francisco (1993)**

Recommended Texts:*

Health Care Management: Organizational Design and Behavior (4th edition) Stephen M. Shortell
and Arnold Kaluzny, Delmar: Thompson Learning (2000)*

Performing an Operational and Strategic Assessment for a Medical Practice, Reed Tinsley and
Joe Havens, New York: John Wiley & Sons, (1999

Women and Leadership in Health Care; Catherine Robinson-Walker, San Francisco: Jossey
Bass, (1999)*

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Market-Driven Health Care: Who Wins, Who Loses in the Transformation of America’s Largest
Service Industry Regina Herzlinger, Reading, MA: Addison Wesley (1997)*

Measuring and Improving Patient Satisfaction Patrick Shelton, New York: Aspen Publishing,
(2000)*

Academic Integrity: Academic integrity is central to the mission of educational excellence at

Brandeis University. Each student is expected to turn in work completed independently, except
when assignments specifically authorize collaborative effort. It is not acceptable to use the
words or ideas of another person- be it a world-class philosopher or your classmate – without
proper acknowledgement of that source. This means that you must use footnotes and quotation
marks to indicate the sources of any phrases, sentences, paragraphs or ideas found in published
volumes, on the internet, or created by another student. Violations of university policies on
academic integrity, described in Section 3 of Rights and Responsibilities, may result in failure in
the course or on the assignment, and could end in suspension from the University. If you are in
doubt about the instructions for any assignment in this course, you must ask for clarification.

Notice: If you have a documented disability on record at Brandeis University and require
accommodations, please bring it to my attention prior to the second meeting of the class. If you
have any questions about this process, contact Doina Iliescu, disabilities coordinator for The
Heller School at x 63810, or at diliescu@brandeis.edu.

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PART I. STRATEGIC LESSONS IN HEALTH CARE

Session 1 Topic and Assignment

September 6 I. The Innovation Process in Health Care Organizations
Case: M&M Conference
Video Case: IDEO

Session 2 Topic and Assignment

September 13 II. Some Fundamentals of Health Care Management: Markets and the
New Consumer
Case: Lipitor Case (A)
Case: Eli Lilly and Company: Innovations in Diabetes

Session 3 Topic and Assignment

September 20 III. The Patient’s Perspective
Video: Lorenzo’s Oil
Guest Speaker: Laura Lorenz

Session 4 Topic and Assignment

September 27 IV. Redesigning Health Services
Case: IDEO: Service Design (B)
Case: Johnson Case

Session 5 Topic and Assignment

October 4 V. The Specificity of Services and Service Visions
Case: Benihana UK (Ltd.)

Session 6 Topic and Assignment

October 11 VI. Health Care Strategy
Case: Beth Isreal
Video Case: Aravind Eye Hospital

Session 7 Topic and Assignment

October 18 VII. Corporate Strategy: Strategic Alliances and Diversification
Case: Partners Health Care (A)

Case: Quitnet

Session 8 Topic and Assignment

October 25 V. Aligning Operating Strategy, Competitive Strategy, and Corporate
Strategy
Case: Managing a Transplant Decision at Leuvan Medical Center (B)

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PART II. LEADERSHIP & THE DESIGN AND MANAGEMENT OF

HEALTH CARE OPERATIONS

Session 9 Topic and Assignment

November 1 I. Becoming a Health Care Manager
Case: Berndt Sterzel and the Ivth Medizinische Klinik
Management Style Questionnaire

Session 10 Topic and Assignment

November 8 II. The Challenge of Change: Examples from Two Health Delivery
Organizations
Case: Paul Levy Taking Charge of the Beth Israel Deaconess Medical Center (A)

Case: Karolinska Sjukhuset in Sweden

Session 11 Topic and Assignment

November 15 III. Approaches to Managing Patients and Physicians: The Past and the
Future
Case: Dr. Baggins and the Cardiac Catheterization Lab
Case: Intermountain Health Care

Session 12 Topic and Assignment

November 22 IV. Managed Care and Managing Professionals
Case: Tufts Health Plan

Session 13 Topic and Assignment

November 29 V. Quality: What Is It? How Do We Measure It?
Case: Children’s Hospitals and Clinics
Video: Children’s Hospitals and Clinics