Course Number & Complete Course Title: PH 7250 – Healthcare Financing
CRN: 87352
Instructor’s Name: Lee Rivers Mobley, PhD
Division: Health Management and Policy (HMGP)
Faculty Accessibility
Course Basics
Semester: Fall
I.
Year: 2014
Class Day/Time:
Mondays 1:00-3:30
Class Location:
320 Sparks Hall
School of Public Health, GSU campus, Atlanta GA
Prerequisite(s):
PH 7160 Introduction to Health Care System
Required Course Materials
Required Text: Health Economics and Policy (with economic
applications) by James W. Henderson, 5th Edition (2011), published by
South-Western, Cengage Learning.
Instructor(s) of Record:
Lee Rivers Mobley, PhD
Office Location:
Rm. 716, One Park Place
Phone Number(s):
(404) 413-2338 (infrequently monitored)
Email:
lmobley@gsu.edu (preferred contact mode)
Office Hours/Availability:
Office hours by appointment on Mondays or Fridays
Course Description:
The course will provide and introduction to health care finance with a particular
emphasis on the various meanings of ‘cost’, and public health issues. Students will be
presented with the foundations of public and private health care financing, program
operations and parameters with respect to coverage and payment, and the role the
states play in federally supported programs. The course will familiarize students with
federal, state, and local funding mechanisms and outline the tools used to evaluate the
impact of insurance programs on the health care delivery system. The problems of the
uninsured, health care coverage and access, scarce health care resource allocation, and
cultural challenges will be discussed, with an emphasis on learning how or if public and
private funding and insurance programs can successfully address such problems.
II.
Course Objectives / Competency / Assessment of Student Learning:
This course is designed to support students in acquiring competence in the following two
areas, as indicated in the GSU School of Public Health MPH Core Competencies document.
MPH CORE 10. Identify and critically discuss the organization and financing of the health
services and public health systems in the United States, with emphasis on the
consequences for vulnerable populations.
MPH CORE 11. Apply evidence-based principles to critically evaluate current policies and
practices in healthcare delivery and in public health systems including present and
future healthcare reform proposals to address the quality, accessibility and cost of our
health systems.
Students in the Master of Public Health program with a concentration in Health Management &
Policy will be expected to demonstrate competence in the following areas:
HMGP 1. Demonstrate the skills of effective communication.
HMGP 2. Demonstrate team building, negotiation, and conflict management skills.
HMGP 3. Demonstrate knowledge of strategy development and change management
principles
HMGP 4. Describe the attributes of effective leadership and the skills of effective
leadership including decision making, vision setting and mentoring.
HMGP 5. Describe the legal bases for public health services.
HMGP 6. Explain principles of ensuring community health safety including emergency
preparedness and response.
HMGP 7. Describe alternative strategies for collaboration and partnership among
organizations focused on public health goals.
HMGP 8. Apply commonly used frameworks for policy analysis to prominent,
contemporary public health issues.
HMGP 9. Utilize theories of policymaking to develop policy proposals that address public
health challenges.
HMGP 10. Demonstrate application of economic principles to analyze and characterize
public health and health service policies and issues.
HMGP 11. Identify and discuss the main components of the healthcare system in the
United States, the underlying sources of market power, and in the context of
interlocking market segments and market power held by different players,
how these components will be impacted by current reform proposals.
This course is designed to assess students in acquiring competence in the following HMGP
areas:
Course Objectives
Program Competency
Demonstrate
HMGP 10
application of
economic principles to
analyze and
characterize public
health and health
service policies and
issues.
Identify and discuss the HMGP 11
main components of
the healthcare system
in the United States,
the underlying sources
of market power, and
in the context of
interlocking market
segments and market
power held by different
players, how these
components will be
impacted by current
reform proposals.
Assessment Method(s)
Written exams and paper
Written exams and paper
In addition to the above, upon completion of this course, you should specifically be able to:
1. Write critically and cogently using an economic perspective to examine historical
evolution of the healthcare policies in the Unites States, and how they compare to those
systems in other developed nations.
2. Write critically and cogently using an economic perspective to examine current health
policy issues.
3. Critique the various components of the U.S. health care system from the economic
perspectives of efficiency and equity.
4. Analyze how different market segments in the healthcare system are impacted by
various policies and regulations.
5. Understand of the concept of market power, who holds it and why, and how current
reform initiatives will affect the balance of market power that exists among major
sectors of the healthcare market.
6. Express cogent and critical comment on the consequences of current health care
policies in the United States on health status of vulnerable populations.
7. Synthesize the perceived issues in the U.S. health care that are driving current policy
reforms.
8. Apply economic principles and knowledge in analysis of the Medicare Modernization Act
of 2003, Medicare Part D implementation in 2006, and the Patient Protection and
Affordable Care act of 2010, and other reform initiatives.
9. Understand how the healthcare system in the United States compares to systems in
other nations, from the economic perspectives of efficiency and equity.
Course Objectives and Textbook:
The required textbook thoroughly demonstrates how economic principles apply to health care
delivery and its policies. The author explains how the theories work and how health care
financial systems operate in the real world. You'll develop an understanding of the social,
political, and economic contexts of health care delivery, as well as the changing nature of
health care. While you explore the changing nature of health care, as well as the social and
political sides of issues, you will learn to analyze public policy from an economic perspective.
The course syllabus will follow the organization of the chapters in the book, and we will cover
most chapters. Additional readings will be assigned to augment the text, and a final report and
in-class presentation will be required on a current topic in US Health Policy, or global
comparisons of health systems across countries.
III.
Course Assignments and Requirements
Required Text: Health Economics and Policy (with economic applications) by James W.
Henderson, 5th Edition (2011), published by South-Western, Cengage Learning.
This course assumes substantial and informed student participation. General discussion of
theory and practice is encouraged and expected of all students. At a minimum, being informed
requires class attendance, completion of assigned readings and homework, and attention to
health care news and world events. Class attendance and thoughtful participation are
important and will be reflected in part in the final grade.
Course requirements will contribute to grade as follows:
Issue Paper (due Dec 1)
Take-Home Midterm Exam (due Oct 13)
Take-Home Final Exam (due Dec 15)
Class Participation and Homework/Readings
30%
30%
30%
10%
Exams and Issue Paper are required to be original work, submitted for completion of course
requirements in this class only. Duplicative efforts among students or recycling of work
within students across courses will be heavily penalized. This will be assessed using the
‘originality’ checking software available to Instructors in Desire2learn. This software
compares across students in all classes at GSU that are using dropbox assignments in
Desire2learn.
Issue Paper: Each student will individually submit a paper that is to be 6-10 pages in length
(excluding bibliography), double spaced, 12 point font with 1 inch margins (left, right, top and
bottom). The paper should be supported by research published in 4 peer-reviewed sources and
from up to 6 additional professional sources. Up to 5 percentage points will be deducted if the
formatting guidelines are not met, and up to an additional 5 percentage points will be deducted
if the sources are not credible.
Papers will be submitted via dropbox in the Desire2Learn system, where ‘originality’ will be
readily assessed via the system software. Plagiarism is not ethical and can be criminal,
punishable by fines and sanctions in the professional world. Learning how to paraphrase and to
correctly cite or quote source material is a very important aspect of your MPH training. You will
be able to determine how ‘original’ your work is when you view your graded manuscript in the
Desire2Learn system, and what aspects of it are not original. I recommend that you submit a
draft of your paper before the deadline, examine the originality content, and then update the
paper to be sure unoriginal portions are correctly cited or quoted, before finalizing your
submission.
Your paper should include the following sections labeled with headings specifically listed
below. These page limits are suggestions:
1. Introduction (½ -1½ pages)
a. Briefly describe the topic you are going to address.
b. Why it is important? If relevant provide a brief background and relevant health
or economic statistics as cited in recent literature.
c. Specifically state the question or hypothesis to be addressed in the literature
review.
2. Literature Review (3-4 pages)
a. Discuss at least 4 primary original research articles in peer-reviewed literature
that answer the question or hypothesis from your introduction.
b. Briefly describe the methodology and conclusions of the article paraphrased in
your own words (please do not cut and paste from the abstract).
c. In addition to 4 primary original research articles you may describe other existing
material from up to 6 professional sources that seem credible to you.
d. If you discuss primary research articles cited in any reviews of the literature,
please do not simply cite the article that cites them. Instead, add a correct
citation of any original article that you describe or discuss.
e. For citations of secondary supplemental articles from professional sources,
please include URLs for any articles retrieved from online sources, and the date
that you accessed the article.
3. Strengths and Limitations of the Literature (1– 1½ pages)
a. Please describe the strengths and limitations of the primary articles cited,
paraphrased in your own words.
b. Please describe the strengths and limitations of the other supplemental articles
cited, paraphrased in your own words.
c. What is it we do not yet know or understand about the topic you have chosen?
d. What additional research is needed to more completely answer questions
related to your topic?
4. Policy or Practice Implications (1-1½ pages)
a. Describe the implications of the literature you have reviewed from an applied
economics perspective. What principles of economics discussed in this course
are relevant for the topic you have chosen?
5. Conclusion (½ – 1 page)
a. Briefly summarize your paper.
b. State overarching conclusion, or if none, what is needed to advance
understanding in future research.
6. References
Midterm Examination: The midterm examination is cumulative and will be a take home test,
due at noon of the Class 7 date via the Desire2Learn dropbox. The exam will be discussed
during the class period of Class 7 ( October 13, 2014) and your participation is required.
Final Examination: The final examination is cumulative and will be a take home test. The final is
due noon of the Class 14 date (December 15, 2014) via the Desire2Learn dropbox.
Example Websites for obtaining professional secondary papers or articles:
The Commonwealth Fund
www.cmwf.org
The Kaiser Family Foundation
www.kff.org
The Robert Wood Johnson Fund
www.rwjf.org
Paul Krugman, columnist at the New York Times
Example Peer Reviewed Journals:
Health Affairs
www.healthaffairs.org
New England Journal of Medicine
http://content.nejm.org/
Milbank Quarterly
http://www.milbank.org/quarterly.html
Example Peer Reviewed Governmental sources:
US Preventive Service Task Force
www.uspreventiveservicestaskforce.org
Community Guide
www.thecommunityguide.org
IV.
Grading Policy
Grading Scale:
94 – 100
90 – 93
87 – 89
83 – 86
80 – 82
77 – 79
73 – 76
70 – 72
60 – 69
Below 60
A
AB+
B
BC+
C
C-
D
F
Withdrawals: A student who withdrawals at any time up to the mid-point of the quarter will be
assigned a W or WF depending upon whether he/she is doing satisfactory work at the time of
withdrawal. An average grade of D or F at the time of withdrawal will be assigned a grade of
WF. After the mid-point of the quarter, the Registrar’s Office will assign an automatic WF to
any student who withdraws from the course without a hardship withdrawal. If a student
receives permission to withdraw under hardship, the Instructor will assign a W or WF grade
depending upon the student’s work up to the point of time that the student withdrew.
The following is the formal policy at Georgia State University:
Effective Fall 2001, Instructors must on a date after the mid-point of the course to be set by the
Provost (or his designee),
1. give a WF to all those students who are on their rolls but no longer taking the class and
2. report the last day the student attended or turned in an assignment.
Students who are withdrawn may petition the department chair for reinstatement into their
classes.
Incompletes: A student will be given the grade I only if nonacademic circumstances beyond the
student’s control prevent the student from completing a small segment of the course—e.g., the
final examination. For a student to receive the grade of I, he/she must be doing satisfactory
work (an average grade of C or better) up to the point that he/she could not continue.
Arrangements must be made with Instructor to remove the incomplete grade within one
quarter.
V.
Attendance and Class Participation Policy
This course assumes substantial and informed student participation. General discussion of
theory and practice is encouraged and expected of all students. At a minimum, being informed
requires class attendance, completion of assigned readings and homework, and attention to
health care news and world events. Class attendance and thoughtful participation are
important and will be reflected in part in the final grade.
VI.
Late Assignments and Make-up Examination Policy
Make-up exams are not provided, except in hardship cases that should be discussed in advance
with the Instructor. Any assignment turned in late may have points deducted up to one letter
grade for each day the assignment is late or fraction thereof. There is no scheduled make-up
time for exams. If a student cannot take an exam, they must consult with the Instructor on
scheduling the make-up. The instructor reserves the right to prepare a different exam for
make-up situations.
VII.
Syllabus Deviation Policy
The course syllabus provides a general plan for the course; deviations may be necessary.
Additional or substitute reading materials may be required and made available to students
via handout or other means.
VIII. Student Code of Conduct and Policy on Academic Honesty
All students at this University are expected to engage in academic pursuits on their won
with complete honesty and integrity. Any student found guilty of dishonesty in any phase of
academic work will be subject to disciplinary action. The complete Academic Honesty policy
is located in the GSU Graduate Catalog, Section 1350: http://enrollment.gsu.edu/catalogs/.
Students and faculty are expected to review and conform to the university’s policy on
academic honesty. Information on the Student Code of Conduct and related policies and
procedures are available at: http://codeofconduct.gsu.edu/.
Special attention should be paid to the sections on plagiarism and multiple submissions:
Plagiarism. Plagiarism is defined as, “appropriating and putting forth as one’s own
the ideas, language, or designs of another” (The Living Webster, 1975) – and it is
strictly forbidden. Written and oral presentations must be a student’s own work.
Students plagiarizing or cheating in any form will face disciplinary action which could
result in an “F” in this course and suspension or expulsion from the University.
Copying from written materials, presentations, websites, etc. without source
acknowledgment and referencing is plagiarism. Read it, appreciate it, learn from it,
and make sure you source it – and then reflect it with your own thoughts and words!
If you are uncertain about what constitutes plagiarism, please contact the instructor.
Multiple Submissions. It is a violation of academic honesty to submit substantial
portions of the same work for credit more than once without the explicit consent of
the faculty member(s) to whom the material is submitted for additional credit. In
cases in which there is a natural development of research or knowledge in a
sequence of courses, use of prior work may be desirable, even required; however,
the student is responsible for indicating in writing, as a part of such use, that the
current work submitted for credit is cumulative in nature.
IX.
Disability Accommodations Policy
Students who wish to request accommodation for a disability may do so by registering with
the GSU Office of Disability Services. Students may only be accommodated upon issuance
by the Office of Disability Services of a signed Accommodation Plan and are responsible for
providing a copy of that plan to instructors of all classes in which an accommodation is
sought. The Office of Disability Services is located in the GSU Student Center, Suite 230 and
online here: http://disability.gsu.edu/.
X.
Course Evaluations Statement
Your constructive assessment of this course plays an indispensable role in shaping
education at Georgia State. Upon completing this course, please take time to fill out the
online course evaluation.
XI.
Career Services
The School of Public Health provides career services & student leadership opportunities
(student clubs & organizations) to all current SPH students and alumni. SPH Career Services
can help students with resume writing, interviewing, job searching, internship development,
and professional networking. Students are invited to attend our career events and
workshops, and individualized career counseling appointments can be arranged. To see
what career panels, career fairs, and events are available this semester, please visit:
http://publichealth.gsu.edu/students/career-resources/. The SPH Career Services office is
co-located with the Office of Academic Assistance in room 640 at One Park Place.
XII.
Additional Instructor Policies
Communication
Students may use email to make an appointment to meet with the Instructor on class
concerns. The Instructor’s office hours are by appointment on Mondays or Fridays. Should
you wish to contact the Instructor about your grade, please email for an appointment to
meet in person, or submit them in writing (on paper) to the Professor’s faculty mail box.
Please do not use e-mail to communicate your concerns about your grade. Students may
use the chat room in Desire2Learn, but Professor Mobley will not be using the chat room or
any form of social media.
General Expectations
PH 7250 is a graduate level course, and student behavior is to be in keeping with that
expected of graduate students and professionals. Students are expected to show courtesy
and respect for classmates and faculty. Cell phones, Blackberries, pagers and other
electronic devices are to be turned off prior to the beginning of class, and there should be
no food consumption during class which will disrupt other students, presenters or the
Instructor.
All work presented for course credit should be neatly typed, with name, date and page
number on each page. All citations and references in written work should conform to the
current edition of the Chicago Manual of Style (15th edition or later) or APA (5th edition or
later) style.
Copyright Policy
“For the purpose of copyright, students must adhere to the following rules:
1) Materials in the course reserves may only be accessed by a passcode or password by
students enrolled in that course, and only for the semester of course enrollment
2) Students may not distribute copies of course reserves materials to other students
Grade Point Average Requirements
An overall grade point average (GPA) of 3.0 or better must be earned to receive the MPH
degree. All core courses must be completed with a grade of B or better, and no more than
six semester hours of grades less than B will be accepted for the degree. No grade below a C
will be accepted toward the degree. Please refer to the School’s academic standing policy
on Academic Warning and Suspension described in the School of Public Health section of
the Graduate Catalog:
http://catalog.gsu.edu/graduate20142015/institute-of-public-health/#program-anddegree-regulations
XIII. Tentative course schedule, topics, and readings
Date
1. August 25
XX. September 1
2. September 8
Topic
U.S. Medical Care: A System
in Transition
no class
Using Economics to
Study Health Issues
Readings & Assignments
Chapter 1
Labor Day Holiday
Appendix Chapter 1 and
Chapter 2
3. September 15
Analyzing Medical Care
Markets
4. September 22
What is Economic
Evaluation?
Demand for Health and
Medical Care; The Market
for Health Insurance
Managed Care Health
Insurance
5. September 29
6. October 6
October 8
7. October 13
8. October 20
9. October 27
10. November 4
11. November 11
The Market for Health Care
Professionals; The Market
for Hospital Services
Confounding Factors
Chapter 3 and Appendices,
with special emphasis on
“costs”
Chapter 4 , Readings #1
Chapters 5-6
Chapter 7, Supplemental
reading to be provided in
Desire2learn as a handout,
on evolution of competition
and efficiency in healthcare
industry:
Mobley, L., and H.E. Frech III
(February 2007).
“Health Insurance:
Designing Products to
Reduce Costs.” Chapter
6, In Tremblay, V., and
C. Tremblay (Eds.),
Industry and Firm
Studies. Armonk, NY:
M.E. Sharpe.
Midterm exam available in
Desire2learn.
Your completed midterm
exam is due in dropbox at
noon. Chapter 8
Class period will include
discussion of exam, and
paper topics and
requirements.
Chapters 8 and 9
Chapter 11 (we will skip
Chapter 10)
Chapters 12&13
Policies That Enhance
Access; Policies That Contain
Costs
Medical Care Systems
Chapter 14
Worldwide –
(in Seven Developed
Nations
including the US)
--------------------Two Week Hiatus-------------------XX. November 17
No Class
APHA Conference
Work on Issues Papers – read Chapter 15 on your own for possible ideas.
Office hours on Friday only this week, by appointment.
XX. November 24
No Class, No office hours this Thanksgiving Holiday.
week.
--------------------Two Week Hiatus-------------------12. December 1
Lessons for Public Policy
Issues Papers due in dropbox
at noon. In-class
presentation and discussion
of half of the Issues Papers in
class.
13. December 8
Lessons for Public Policy
In-class presentation and
discussion of remainder of
the Issues Papers in class.
Review topics for exam in
Chapter 16. Final Exam
available in Desire2learn.
14. Your completed final exam is due in dropbox at noon on December 15, 2014.