School of Policy Planning and Development



School of Medicine Department of Preventive Medicine

University of Southern California

MPH Program

PM 508: Health Service Delivery in the United States

FALL 2011

Thursdays 9 AM to 12:30 PM

Class Location: TBD

Instructor: Michael R. Cousineau, Dr. PH cousinea@usc.edu

Office Hours: Thursdays, 8 AM to 9 AM and 1-3 PM, or by appointment.

Office Location: HSA (Alhambra) Building A7, Room 7406

Phone: (626) 457-4010.

Teaching Assistant: NNNNNNNNNNNNNNNNNNNNNNNNNNN

 

Accessing Blackboard:

OVERVIEW

This course is a core class for the MPH degree. The goal is to provide students with information and skills to become on going participants in efforts to improve the health care system. The health care delivery system will be examined broadly in order to understand contemporary issues affecting the health of the American public and the institutions that provide health services and protect health. The course will include the historical development of the American health care system, determinants of health and health disparities, health care utilization, the role of health care providers, health policy formation and implementation, health politics, health care financing, public health, mental health, and the interactions among components of the system. The course content will emphasize the policy implication of key public health problems in the U.S. Issues in the recent enactment of health reform in the US will be examined.

COURSE OBJECTIVES

Upon completing the course, the student will be able to:

1. Understand the major trends of the history of medicine and public health and be able to relate them to current events.

2. Identify the primary determinants of health, including health risks and the effects of health care services on health status.

3. Describe the components of the health care delivery system and how they work together or fail to work together to solve health problems.

4. Understand the basic components of health care financing including the different ways of paying for care, the use of incentives and disincentives in influencing the behavior of providers, the fundamentals of 3rd party insurance coverage, different types of payers..

5. Compare the US system to that of other nations.

6. Understand the basic elements of health policy and politics in the United States including the roles of various levels of government and interest groups, health policy formation and implementation, and major statutes and court cases affecting health.

7. Describe contemporary policy issues in health care delivery including the role of managed care, accountable care organizations, patient -centered medical home, quality of care, privacy and consumer protection.

8. Understand the functioning of major institutions and providers groups in the including physicians, hospitals, nurses, and mental health, long term care and pharmaceuticals industries.

9. Understand the principle elements that determine ethical choices in health care and recognize the presence of ethical considerations in the health care field.

10. Understand the issues confronting safety net providers

11. Understand the basic concepts and issues in efforts to reform the health care system.

12. Understand where to get data and information about the health care system in the U.S.

Course Competencies

Upon completing the course, the student will be able to:

1. Identify and prioritize the key dimensions of a public health problem by critically assessing public health literature – both quantitative and qualitative sources

2. Function as collaborators on public health projects with the ability to assume leadership roles in the development, implementation, and/or evaluation of programs

3. Demonstrate the ability to select, apply and interpret intermediate-level statistical techniques to the assessment of community needs and program outcomes

4. In planning community-based programs and/or program changes, demonstrate an appreciation of the interactive nature of the political, organizational and economic context of public health programs; of funding patterns and priorities; and the possibility of multiple agendas and conflicting goals

5. Articulate the relationship between health care delivery and financing, public health systems and public policy

6. Identify the main components and issues of the organization, financing and delivery of health services and public health systems in the US.

7. Describe the legal and ethical bases for public health and health services.

8. Apply the principles of program planning, development, budgeting, management and evaluation in organizational and community initiatives.

REQUIRED TEXTBOOK. Jonas and Kovner, Health Care Delivery in the United States, 10th Edition, Springer Publications, New York: 2011

Other readings- available on line or will be distributed

DISABILITY SERVICES AND PROGRAMS

Any student requesting academic accommodations based on a disability is required to register with Disability Services and Programs (DSP) each semester. A letter of verification for approved accommodations can be obtained from DSP. Please be sure that the letter is delivered to me as early in the semester as possible. DSP is located in STU 301 ((213) 740-0776).

STATEMENT ON ACADEMIC INTEGRITY

USC seeks to maintain an optimal learning environment. General principles of academic honesty include the concept of respect for the intellectual property of others, the expectation that individual work will be submitted unless otherwise allowed by an instructor, and the obligations both to protect one’s own academic work from misuse by others as well as to avoid using another’s work as one’s own. All students are expected to understand and abide by these principles. Scampus, the Student Guidebook, contains the Student Conduct Code in Section 11.00, while the recommended sanctions are located in Appendix A: . Students will be referred to the Office of Student Judicial Affairs and Community Standards for further review, should there be any suspicion of academic dishonesty. The Review process can be found at: . Students may be asked to submit their papers through on line programs that screen for plagiarism and other infractions.

REQUIREMENTS OF THE COURSE

The success of the course depends upon students’ preparation and involvement in all aspects of the class. Thus, students are expected to complete all assigned readings, attend lectures and participate in both in-class and on-line discussions led by the instructor, guest speakers, and students.

OBTAINING INFORMATION.

Employers place high value on graduates who are capable of locating current information, placing that information into the context of the problem being examined, proposing alternative options and evaluating those options in terms relevant to the realities confronting the organization. It is expected that the students will be conversant with the use of government and private resources and website as references. These are listed on the course webpage.- They should make optimal use of data and statistics from these sites in their papers and presentations, as this will stand them in good stead during their professional career.

It is recommended that students sign daily/weekly e-mail services. Links are on the Course web page. The best is California Healthline, published by the California Healthcare Foundation a free daily e-mail service that provides news of current events within the health care field, focusing primarily on California. Kaiser Health News and the Deans Council on Health Care Reform.

ASSIGNMENTS

1. Individual Readings and on line discussion. Students are expected to complete all assigned readings so that they can participate in a meaningful discussion about the topic for the day. Three times throughout the semester, the instructor will post questions for discussion on the discussion group tab on Blackboard based on the readings. The purpose is to provide a place for on line discussion of these issues. Each student will then post one comment in response to the question or post another question that come from the readings. Students can post their own question or comment independent of what the instructor or TA might post. The discussion board interactions will contribute to participation grade in the class.

2. Special on line discussion. On Thursday, Sept 8, we will not be holding an in person class and instead, we will be holding class on line using the discussion board function in BlackBoard.

3. Identify elected officials. By September 1, submit a list of the names and contact information for your personal elected officials. Include your congressional representatives, your state legislative representatives, city council, and/or county supervisors. These should reflect where you currently live and registered to vote. For those who are legal residents of other countries, tell us the information from where you are from or those representing the area in which you live right now.

4. Health insurance project (1-2 page maximum) Examine your own health insurance plan. Describe how the benefit and financing works for you and your family. Your analysis should include:

• copayments and co insurance

• caps on benefits or life time, if applicable

• benefits covered and not covered

• restrictions (for example, pre existing conditions)

• waiting periods, if any

• choice of doctor or hospital and pharmacy

• your experience in using your benefits if any.

Due September 29, in class.

5. Community Assessment Project The community diagnosis project is a small group assignment with 5 people. The purpose of the assignment is to help students understand the community context of the patients served by a clinic and the LAC USC hospital. The assignment is an environmental scan designed to develop a better understanding of the problems of access to care and good health from the perspective of people living in a specific target community. See attached for detailed description.

Community Assessment will be dues as an e-mail attachment to the TA, Thursday, October 20th BY 5 PM. Presentations will be scheduled.

Policy Project (Bill Analysis) There are several health policy issues that have been debated in Congress, or the California Legislature over the past few years. These are listed in the course web page under: group topics and legislation. The purpose of this project is to develop a policy memo on a current issue that has been the subject of legislation (Bills or Laws) or regulatory change or court decision. These we call policy actions.

Your assignment is to investigate this topic write a 5 page (maximum) analysis of a bill, statute, regulation or court case related to the topic. The purpose is to gain experience in examining a complex health policy issue and write a brief memo outlining the problem and the various policy options for solving the problem. You are to work with the TA to identify the bill or bills, regulation or court case. See attached for detailed description.

Policy memo will be due as an e-mail attachment to the TA, Thursday, NOVEMBER 17th BY 5 PM.

6.

FINAL EXAMINATION.

There will be an in class final examination covering all the topics in the course. It will test your knowledge of the course content presented in the class and in the readings. It will be held on December 8th. The exam will be comprised of short answer questions. There will also be a take home portion which will be one short essay (1 page maximum which will be).

BASIS FOR GRADING

Representatives project 5%

Health Insurance Project 5%

Community Project 30%

Policy Memo 30%

Participation 10%

Final Examination 20%

*Participation will be assessed by monitoring your contributions to the 4 papers (see 1 above) and your contributing reviews and critiques of the group projects.

University policy allows instructors to grant an incomplete only in cases of emergency or serious illness. Plan your work throughout the entire 16 weeks so that job and family pressures can be accommodated should they occur at the end of the course.

COURSE SCHEDULE AND TOPICS

PM 508

FALL 2011

AUGUST 25 COURSE OVERVIEW AND THE STRUCTURE OF THE US HEALTH CARE SYSTEM HEALTH OF THE US POPULATION

Course overview and expectations

Health Care as a right

History of health and medicine

The structure and operation of health care delivery in the United States

SEPTEMBER 1: HEALTH POLICY AND POLITICS AND THE ROLE OF GOVERNMENT

Fundamentals of health policy formation and implementation in the U.S.

• The evolution of health policy in the US: federal, state and local

• Stakeholders

SEPTEMBER 8: HEALTH STATUS

10 Measuring health

11 Health Disparities

12 Chronic conditions

*Your choice of topic for the individual paper is due today

SEPTEMBER 15: HEALTH COST: PUBLIC AND PRIVATE HEALTH INSURANCE PROGRAMS

Understanding health insurance and the concept of risk

Public and private health insurance programs

SEPTEMBER 22: HEALTH COSTS: HEALTH CARE EXPENDITURES AND REVENUES, COST CONTAINMENT

Where and how we spend our health care dollars

• Why health care costs so much

• Comparative health care systems

SEPTEMBER 29: ACCESS: THE CASE FOR HEALTH REFORM: ACCESS TO CARE AND COVERING THE UNINSURED

Health Insurance Project Due

OCTOBER 6: HEALTH REFORM: MODELS AND COMPONENTS OF THE PATIENT PROTECTION AND ACCOUNTABLE CARE ACT (ACA)

Components of the ACA

*Group project proposal / outline due

*508 concept paper due OCTOBER 9th

OCTOBER 13: QUALITY: THE ORGANIZATION AND DELIVERY OF HEALTH CARE

How is care organized: primary, secondary and tertiary;

Managed care:

• Chronic disease management

• Medical home

• Integration of care

*508 concept paper due OCTOBER 9th

OCTOBER 20: QUALITY IMPROVEMENT AND HEALTH CARE SYSTEMS

Hospital mergers

For profit institutions

• Accountable Care Organizations

OCTOBER 27: ORGANIZING HEALTH SERVICES FOR VULNERABLE AND SPECIAL POPULATIONS: The HEALTH CARE Safety Net

• Public Hospitals

• Community Clinics

NOVEMBER 3: PRESCRIPTION DRUG COVERAGE AND COMPARATIVE EFFECTIVENESS

Controlling pharmaceutical costs

NOVEMBER 10: HEALTH INFORMATION TECHNOLOGY

Electronic medical records

NOVEMBER 17: Health Care Work force

Physicians, nurses, physician assistants, allied health professionals, dentists and mental health providers

Primary care and specialties

Under represented minorities in the health professions.

DECEMBER 1: PUBLIC HEALTH AND PUBLIC HEALTH DEPARTMENTS

• Public health departments

• The role of prevention in health reform

*Individual projects due

a special two hour session will be set at a mutually agreeable time for this time slot to account for Thanksgiving

TO BE DETERMINED: THE FUTURE OF HEALTH CARE AND REVIEW

DECEMBER 8: FINAL EXAMINATION

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download