University of Massachusetts Lowell School of Health and Environment Department of Community Health and Sustainability

SYLLABUS 32.625. 201- HEALTH POLICY COURSE INFORMATION

Instructor Bob Holmes, Ph.D., M.B.A. E-mail: bobhom@att.net Classes Face to Face Online Office (978) 549-3344

Saturday 1:00p 4:00p Saturday 1:00p 2:30p

Office Hours By Appointment

Catalog Course Description

This course provides students with a basic framework for health policy analysis and examines major strands of U.S. health policy. Detailed consideration and discussion are given to the relationship of national policy to the planning, implementation, and funding of health care services, with particular emphasis on low-income and minority populations. This course will cover topics such as the healthcare policy environment in the U.S, government-funded health care through Medicaid and Medicare, and the Massachusetts health care reform (3 credits).

Course Rationale
This course provides students with an overview of contemporary health policy in the United States and will prepare them to participate in local, state, and national health policy debates as professionals and consumers. Depending on interest, we may also discuss international health policy issues by the end of the semester. This course is a seminar that will depend heavily on readings and class discussion about them.

Course Goals
Students who have met the goals for this course will be: 1. Able to apply health policy concepts commonly discussed in current health care and public health policy debates. 2. Able to understand healthcare and health system organizations within a set of policy frameworks, including health promotion, primary health care (as set forward through WHO forums) and human rights. 3. Able to understand major policy issues facing the U.S. and Massachusetts health care systems.

Course Objectives
By the end of the course students will be able to:

Identify barriers and opportunities to participate in the process of health policy formulation at the local, state, and federal levels. Describe the organization of health care in the United States and the main methods of reimbursement for delivery of services. Understand the challenges faced my vulnerable populations, such as children, minorities, elderly, and low-income populations to get health care coverage. Assess the pros and cons of the Massachusetts health care reform and link them with national health care policy debates regarding health care reform.

Required Book
Joel B. Teitelbaum and Sara E. Wilensky, Essentials of Health Policy and Law, 2nd Edition, Jones & Bartlett, 2013.

Selected Readings (I will provide the specific chapters)

Policy Challenges in Modern Health Care. Edited by David Mechanic, Lynn Rogut, David Colby and James Knickman. Published by Rutgers University Press, New Brunswick, New Jersey, 2005. Readings from current newspaper articles, government and foundation reports, journals, and other articles will be posted on the course website with reading instructions. These are subject to change as relevant subject matter becomes available. List of Interesting Websites with Health Policy Content Kaiser Foundation Electronic Policy Network American Public Health Assoc Robert Wood Johnson Foundation The Commonwealth Fund The Access Project EINO Everybody In Nobody Out www.kff.org and www.kaiseredu.org www.epn.org www.apha.org www.rwjf.org/publications/otherlist.jsp www.cmwf.org http://www.accessproject.org/about.html http://www.everybodyinnobodyout.org/

Interaction Guidelines
Participation by both the student and instructor is vital for a blended online/face to face course to succeed. The online component is the electronic classroom" of our course, and so our communication and participation in that component will also be handled electronically. There are three (electronic) methods of communication available to us in this course: Email, Chat, and Discussion Board.

Email
Electronic mail should be reserved for private or personal issues. You may email me at any time, and I will try to respond within 24 hours. I usually check my email daily. Please note that Blackboard Vista works with its own internal mail system, which means that all messages are sent, stored, and read within your course, not through your own external mail. To access email, you have to log on and go to your course, and click on the mail icon on the menu on the left side of your screen. It is recommended that you check your course email often, so that you dont miss important announcements and communication with me and other students.

Discussion Board
Each Learning Module (week) has its own discussion board. Contributions to the discussion board are not mandatory but you should consider them as an important part of your participation in the course. The discussion board is the place for asking and answering questions. It will be our electronic space to talk to each other. Therefore, it should be viewed as our electronic classroom. Please post all questions to the discussion board, and I will try to answer them as soon as possible. I will check the discussion board often. Please do not email me your questions because chances are that if you have a question related to Blackboard Vista and/or course materials, someone else may have the same question. Many students can benefit from your question and our answers to it. Please feel free to respond to one anothers questions. The discussion group is a great place to interact in this electronic environment. Throughout the course I will post a variety of topics to be discussed in the discussion board. Questions will be posted by Friday afternoon, and you will have until Thursday morning to respond, unless I let you know otherwise. There will be a total of seven discussion board topics throughout the course.

Assignment Guidelines Course Components and Grade Distribution

Your final grade will be based on the following items: Midterm Final Written assignment/Presentation Class Participation (face to face and online) 20 points 20 points 32 points 28 points Total: 100 points

Grading
Grading will follow the following scheme:
Grade A AB+ B BC+ GPA Equivalent 4.0 3.7 3.3 3.0 2.7 2.3 Numeric Range 93-100 90-92 87-89 83-86 80-82 77-79 Grade C CD+ D F GPA Equivalent 2.0 1.7 1.3 1.0 0.0 Numeric Range 73-76 7072 65-69 60-64 >60

Exam /Written Assignments Schedule

You will be required to complete a midterm exam and a final exam in this course. Each student will also have to complete and present a written assignment during the course. The schedule for the exam and assignment follows. The midterm exam will be posted on October 12th and due by 5:00pm on October 19th. The midterm exam will be take home exams consisting of a set of 3 or 4 open-ended questions. The exam will cover the content of the book and include information from the readings, and online material. The final exam will be a take home exam posted on December 7th and due by 5:00pm on December 14th. The written assignment presentation will be done on different dates during the semester. I will schedule those in our on campus class on _September 28th_____. Your written assignment will consist of an analytic report of a peer-reviewed article that involves a health policy issue/problem. The articles will be assigned the first or second week of class. The analytic framework will be discussed in more detail on week 3. You will be asked to present your findings (using power point) during our on campus classroom discussions, depending on the date your assignment is due. I expect your answers to be grammatically correct regarding sentence and paragraph structure, punctuation, and spelling. If your answer lacks on any of those aspects, I will deduct points from your assignment. Late assignments will be accepted, but only if arrangements are made prior to the due date/time or in the event of a significant emergency life event. Obviously, I would prefer assignments to be submitted when due. The key here is that I am not willing to have my workload made more difficult in order to accommodate you, but I am willing to negotiate terms that are mutually acceptable.

Class Requirements
It is the student's responsibility to attend all classes and frequent absences will be reflected in the final course grade. Students are responsible for obtaining lecture notes or PowerPoint Presentations in the Blackboard Vista website and class handouts for missed classes. If you are aware in advance of a class that must be missed, the courtesy of informing me would be appreciated (in-person, phone, or e-mail). Missed exams can not be made up unless prior arrangements have been made with me. In addition, I suggest the following ground rules for our course: I expect that you and I will be respectful of everyone in the class, keeping an open mind and listening to all perspectives. We will, individually and collectively as a group, work to ensure that time, space, and support is available for everyone to contribute their perspectives and opinions. We will all restrain ourselves from dominating class discussions. We will keep our humor, and work to make this learning experience fun and interesting. I commit to being open-minded and receptive to your criticisms of the class and my teaching. I expect you to commit to making such criticisms in a respectful and thoughtful manner.

I encourage you to present criticism as a group. I commit to a policy of non-retaliation for any criticism of the course and my teaching.

Note: If you have any special considerations that you believe I should be aware of, please do not hesitate to speak with me about them. I am flexible and will try to accommodate any special needs as best I can.

Class Participation
Class participation is the key to your success in this course. If you participate in our class, you should do well on the written assignments and take home exams. The topics covered in this course are enhanced considerably by interactive student dialogue and discussion. The discussion may include questions, comments, debate, argumentation, and all other forms of civil interaction.

Honesty
Academic dishonesty is prohibited in all programs of the University. Sanctions will be imposed on any student who has committed a proven act of academic dishonesty. For example, if any of your exams or assignments include plagiarism of work published without due reference to the authors, you will automatically get a 0 in that exam or assignment. Academic dishonesty includes but is not limited to: Cheating - use, or attempted use, of trickery, artifice, deception, breach of confidence, fraud, or misrepresentation of one's academic work. Fabrication - falsification or invention of any information or citation in any academic exercise. Plagiarism (whether from published sources, unpublished sources or the Internet) is absolutely not allowed in preparation of written assignments. A first offense will mean a letter reduction in your grade for the entire course; a second offense will result in your failing the course. It is incumbent on you (the student) to learn and understand what is meant by plagiarism and act accordingly. I encourage you to read http://en.wikipedia.org/wiki/Plagiarism. No extenuating circumstances will be allowed, and no second chances will be given. If I find that so much as a single sentence is copied without attribution (even if a word or two is changed), the above sanctions will be applied. Facilitating dishonesty - helping or attempting to help another commit an act of academic dishonesty, including substituting for another in an examination, misrepresenting oneself, or allowing others to represent as their own one's papers, reports, or academic works. Please refer to: http://www.uml.edu/catalog/undergraduate/policies/academic_dishonesty.htm for additional information. Religious Holidays: Students will inform me, as early in the semester as possible, of any potential conflicts between their religious observance and course due dates/examinations. I need a written statement of the day(s) when you will be absent. Although you have given me this notice, please also remind me prior to the day(s) that you will be absent for religious reasons. I will work with you to come up with a reasonable alternative deadline or exam date.

Partial List of Professional Peer-Reviewed (Refereed) Journals in Health Care Policy

A peer-reviewed journal is one in which all articles have been submitted by the authors for review and acceptance by a panel of outside experts who are their peers. Peer-review is usually considered to be the last

step in disseminating the news in health policy. A representative list of peer-reviewed journals is found below, but there are many others. American Journal of Public Health British Medical Journal Canadian Journal of Public Health Health Affairs Health Policy Health Policy Quarterly International Journal of Health Services Issues in Science and Technology Journal of Aging and Social Policy Journal of Community Health Journal of Health and Social Policy Journal of Health and Human Behavior Journal of Health Economics Journal of Health, Politics, Policy and Law Journal of Medical Ethics Journal of Public Health Policy Journal of the American Medical Association Lancet, The Law, Medicine and Health Care Medical Care Medical Care Review Medical Group Management Milbank Quarterly (Formerly, Milbank Memorial Fund Quarterly) New England Journal of Medicine New Solutions Public Health Reports Social Policy Social Science and Medicine Social Security Bulletin (SSA publication, government documents section) Social Work and Health Care Topics in Health Care Financing

Course Calendar
Class Date Class 1 Location Read for 9/7 Topics/Assignments Essentials Chs. 1 and 2 Handouts Introductions- Intro to the book, syllabus, etc. Definition of Health and Health Policy Who Makes Health Policy How Laws are Made Essentials Chs. 3 an 4 Policy Challenges Ch. 1 Morality, Politics, and Health Policy History of U.S. Health Policy The U.S. Health Care Delivery System Essentials Chs. 13 and 10 Medicare and Medicaid at Forty KFF-Medicare Primer Steps in Policy Analysis Medicare Essentials Ch. 10 CEPR The Impact of Part D on Spending The Basics of the Mass. Medicaid Program Medicare Managed Care Medicare Prescription Drugs and the MMA

9/7

Winchester Hospital

Class 2 Read for 9/14 Online 9/14 Class 3 Read for 9/21

9/21 Class 4

Online Read for 9/28

9/28 Class 5

Winchester Hospital Read for 10/5

Essentials Ch. 10 Challenges Ch. 11 KFF-Medicaid Primer Sommers-SCHIP and Crowd Out Medicaid SCHIP Essentials Chs. 7 and 8 Policy Challenges Ch. 3
The Employer-Based Health Insurance System: Mistake or Cornerstone?

10/5 Class 6

Online

Read for 10/12

10/12

Online

Gruber Material KFF Primer Gladwell-The Moral Hazard Myth Nichols-Delivering HC through Market Forces Mid-Term Assigned Private Sector Health Insurance Economics of Health Insurance

Class 7 Read for 10/18 Essentials Ch. 6 Policy Challenges Ch. 5, 8, and 9 KFF Uninsured Primer The Uninsured Health Inequality and Disparities Mid-Term (Due Oct. 18th)

10/18

Winchester Hospital

Class 8 Read for 10/26 Essentials Ch. 11 McKinsey-Why Americans Pay More KFF-Cost Primer PI-Quality and Cost Comm. Hosp versus AHCs Health Care Costs Health Care Quality Health Care Technology

10/26 Online Class 9 Read for 11/2 Winchester Hospital Read for 11/9 Online 11/9 Class 11 Read for 11/16 HSC Mass Health care reform Holohan-MA HCR A Look at the Issues BCBS Mass HCR Law Summary Gruber-MA HCR 2006 Heritage Found-Mass Approach Mass Health Care Reform-The Law Presentations

11/2 Class 10

Presentation McKinsey-Universal Principles of HCR TBA Health Care Reform-National Proposals

11/16 Class 12

Winchester Hospital

Read for 11/23

OIG Status Report on MA HCR Institute for Americas Future MA HCR Massachusetts Health Care ReformHows it Working?

Online 11/23

Class 13 Read for 12/7 Handouts

TBA

12/7 Online Class 14 Read for 12/14

Value Purchasing in Health Care Payment Methods

Handouts

12/14 Winchester Hospital The Social Contract Final Assigned (December 7th) Final Due (December 14th) Presentations