NEW YORK UNIVERSITY
ROBERT F. WAGNER GRADUATE SCHOOL OF PUBLIC SERVICE
HPAM-GP 4833(001) – HEALTH CARE MANAGEMENT I:
CONTROL & ORGANIZATIONAL DESIGN
COURSE SYLLABUS – Spring 2015
Faculty:
Tony Kovner
anthony.kovner@nyu.edu
Jon Sendach
jon.sendach@nyu.edu
Administrative Aide: Christopher Harris
christopher.harris@nyu.edu
Office hours by appointment; students are encouraged to e-mail at any time.
Meeting Days/Times:
Wednesdays, 4:55--6:35pm
January 28—Mar 11, 2015
Location:
GCASL, 238 Thompson Street, Room 261
Credits:
2 points
Pre-requisites:
CORE-GP 1020 Managing Public Service Organizations
HPAM-GP 1830 Introduction to Health Policy & Mgmt
Students who have not completed the prerequisites must have work experience in
health care organizations and must obtain permission to enroll in the course.
COURSE DESCRIPTION
HPAM-GP 4833 Health Care Management I: Control and Organizational Design is Part 1
of a two-part, 14-week course on health care management. Part 1 can be taken
separately or with Part 2 (HPAM-GP 4834 Health Care Management II: Adaption and the
Professional Manager). All MPA students specializing in health care management are
required to complete 4833 and 4834. This course is intended for graduate students and
is designed to build an understanding of managing health care services and health care
delivery organizations.
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KEY COMPETENCIES ADDRESSED IN THE COURSE1
Core Focus:
 The ability to manage teams, projects and people; to work in change-oriented
healthcare organizations; and mentor a diverse and changing work force
(TP/CSD)
 The ability to hold people accountable to standards of performance and assure
organizational, professional and ethical compliance (IP/CSD)
 The ability to draw implications and conclusions to develop an evolving vision
that leads to organizational viability (IP/TP/CSD/CP)
 The ability to use information systems and evidence-based management
principles for problem-solving, strategic planning and decision-making, and
measuring change (IP/TP/CSD)
 The ability to Present convincingly to individuals and groups the evidence to
support a point of view, position or recommendation (IP/TP)
 The ability to Engage in continuous learning; to reflect on and assess one’s
strengths and developmental needs; to seek feedback from others; and
establish and sustain a professional development network (IP/TP)
Related Content:
 The ability to Understand and apply legal and ethical principles to managerial
and leadership decisions affecting healthcare organizations (IP/TP/CSD)
 The ability to align human resource capacity and practices and processes with
strategic organizational goals (TP)
 The ability to Measure, monitor and improve safety, quality, access and system
care delivery processes in healthcare organizations (IP)
 The ability to assess population and community health needs from a public
service perspective (IP/TP/CSD)
 The ability to synthesize evidence, and apply statistical, financial, economic and
cost effectiveness methods in organizational analysis (IP/TP)
 The ability to Communicate and interact productively in a diverse and changing
industry, workforce and citizenry (IP/TP/CSD)
Assignments and participation in class and case study discussions in this course will
assess progress against the competencies listed above. No student will receive a B or
higher without demonstrating satisfactory progress toward mastery of each
competency.
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TP – Team Paper; IP – Individual Paper; CSC – Case Study Discussion; CP – Class Participation
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LEARNING OBJECTIVES
At the end of Part 1, students will have acquired the knowledge base and skills set to:
 Apply the principles of evidence-based management to decision-making in a
healthcare organization.
 Evaluate the governance, organization and accountability structures of
healthcare organizations.
 Critically evaluate clinical, financial and strategic performance in acute and
chronic care delivery systems.
 Implement performance control and accountability systems.
LEARNING METHODS
Teaching methods include:
 Knowledge transfer though assigned readings, lectures and in-class discussion
 Work/career simulation exercises through case studies (reading, analysis, in-class
discussion and faculty feedback) and student team assignments
 Skill development though reflective learning and completion of a paper
Classroom discussion and debate are essential to this course. Students are expected to
attend all sessions and come prepared to participate in the discussion of topics outlined
for each course session.
REQUIRED TEXTBOOKS AND JOURNAL ARTICLES
Students are expected to read the chapters and articles listed in the syllabus each week.
The primary texts used in the course are:
Required Texts:
 McAlearney AS, Kovner AR eds. Health Services Management: Readings, Cases
and Commentary. 10th ed. Chicago, IL: Health Administration Press, 2013.
(MK10)
 White K. and Griffith J. The Well-Managed Healthcare Organization, 7th ed.
Chicago, IL: Health Administration Press, 2010 (WG7)
Additional Recommended Texts: (available on reserve at Bobst Library)
 Berry LL, Seltman KD. Management Lessons from the Mayo Clinic. New York, NY:
McGraw Hill; 2008.
 Christensen CM Grossman JH, Hwang J. The Innovator’s Prescription: A Disruptive
Solution for Health Care. New York, NY: McGraw-Hill; 2009.
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Kenney C. Transforming Health Care: Virginia Mason Medical Center’s Pursuit of
the Perfect Patient Experience. New York, NY: CRC Press/Taylor and Francis
Group; 2010.
Kovner AR., Fine DJ, D’Aquila R. Evidence-Based Management in Healthcare.
Chicago, IL: Health Administration Press; 2009.
All assigned readings that are not included in the two required textbooks (Kovner;
White) will be posted on NYU Classes.
CLASS TOPICS AND READINGS
Session 1 – January 28, 2015- - Course Expectations and Evidence-Based Management
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Course Expectations/Syllabus
Organizational Control
Evidence-Based management
Discussion Questions:
 What does it mean to manage and lead a health care organization?
 What factors influence managerial use of evidence-based management?
Required Case:
 Kaplan D, Kovner A. Case A: A New Faculty Practice Administrator for the
Department of Surgery. In: MK10: 39-51.
Required Readings:
 Kovner AR, Rundall T. Evidence-Based Management Reconsidered. In: MK10: 935.
 Griffith JR. Finding the Frontier of Hospital Management. In: MK10: 91-108.
 Berwick DM (2010, May). Yale Medical School Graduation Address. Speech given
to the graduating class at Yale Medical School, New Haven, CT. On NYU Classes.
Session 2 – February 4, 2015 - Control: Governance, Information and Incentives
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Governance
Using information to improve performance
Using incentives to improve performance
Discussion question:
 How should a governing board measure organizational and CEO performance?
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Required Case:
 Kovner AR. Short Case 9: Financial reporting to the Board. In: MK10: 148-152.
Required Readings:
 White, Griffith, Strategic Leadership: Governance in WG 103-140. On NYU
Classes.
 Spath PL. Taming the measurement monster. In Frontiers of Health Services
Management. 2007; 23(4): 3-14. On NYU Classes.
 James BC, Savitz LA. How Intermountain trimmed health care costs through
robust quality improvement efforts. Health Affairs. 2011; 30(6): 1185-1191. On
NYU Classes.
 Mauboussin M. The true measure of success. Harvard Business Review. 2012;
90(10): 46-56. On NYU Classes.
 Rosenthal MB, Dudley RA. Pay for Performance: will the latest payment trend
improve care? JAMA. 2007; 297 (7): 740-4. On NYU Classes.
 Inamdar I, Kaplan R. Applying the balanced scorecard in healthcare provider
organizations. J Healthcare Management. 2002; 47(3): 179-195. On NYU Classes.
Session 3 – February 11, 2015 - Organizational Design: Managing Acute Care
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Structuring organizations for effective delivery
Managing Inpatient care
Disruptive innovation in healthcare
Discussion question: What is the relationship between organizational design and
performance in health care delivery settings?
Required Cases:
 Anonymous. Letter to the CEO. In MK10: 383-390.
 McAlearney AS, Schmale R. Improving organizational development in health
services. In MK10: 195-203.
Readings:
 White K. J. Griffith, Foundations of Excellent Care. In WG7: 1-39. On NYU
Classes.
 Christensen CM Grossman JH, Hwang J. The Innovator’s Prescription: A Disruptive
Solution for Health Care. New York, NY: McGraw-Hill; 2009. Chapter 3: Disrupting
the hospital’s business model. 73-110. On NYU Classes.
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Session 4 - February 11, 2015 - Organizational Design: Managing Primary and Chronic
Care
Due this week – Assignment 1: Control Paper
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Primary care delivery
Chronic disease care
Patient-Centered care and medical home
Discussion question: How does managing chronic disease care vary from managing
acute care delivery?
Required Case:
 Muhlestein D, McAlearney AS. System redesign to implement an accountable
care organization. In MK10: 227-229
Readings:
 Kaissi A. Hospital-affiliated and hospital owned retail clinics: strategic
opportunities and operational challenges. In MK10: 173-192.
 Christensen CM Grossman JH, Hwang J. The Innovator’s Prescription: A Disruptive
Solution for Health Care. New York, NY: McGraw-Hill; 2009. Chapter 5: Disruptive
solutions for the care of chronic disease. 149-182. On NYU Classes.
 Crabtree B, Nutting PA, et al. Summary of the national demonstration project
and recommendations for the patient-centered medical home. Annals of Family
Medicine; 8 (suppl 1): S80-S90. On NYU Classes.
 Rundall TG, Shortell SM, et al. As good as it gets? Chronic care management in
nine leading U.S. physician organisations. British Medical Journal. 2002; 325:
958-961. On NYU Classes.
Session 5 – February 18, 2015 - Professional Integration: Managing with Clinicians
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Designing organizations for effective relationships between clinicians and
managers
Supporting front-line workers
Discussion question: What are the productive and unproductive tensions in the
relationships between managers and clinicians?
Required Case:
 Kovner A. Where the rubber hits the road: physician-Phelps Hospital
relationships. In MK10: 270-277.
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Readings:
 Griffith J, White K. The Physician Organization. In GW: 105-128.
 Griffith J, White K. Nursing. In GW: 129-150.
 Tucker A, Edmonson A. Why hospitals don’t learn from failures: organizational
and psychological dynamics that inhibit system change. In: MK10: 245-267.
 Janus K. The effect of professional culture on intrinsic motivation among
physicians in an academic medical center. J Healthcare Management. 2014;
59(4): 287-304. On NYU Classes.
 Lemak CH, Cohen G, Erb N. Engaging primary care physicians in quality
improvement: lessons from a payer-provider partnership. J Healthcare
Management. 2013; 58(6): 429-443. On NYU Classes.
 A New Era of Nursing: Transforming Care at the Bedside. The Robert Wood
Johnson Foundation and the Institute for Healthcare Improvement. 2006. On
NYU Classes.
Session 6 – February 18, 2015 - The Leader’s Role
Guest Speaker:
Jon Sendach, MPA, Deputy Executive Director, at North Shore University Hospital
Discussion question: What is the leader’s role in fostering exceptional organizational
performance?
Required Readings:
 Griffith J, White K. Internal Consulting. In GW: 283-306.
 Curry LA, Spatz E, et al. What distinguishes top-performing hospitals in acute
myocardial infarction mortality rates? Annals of Internal Medicine. 2011; 154(6):
384-390. On NYU Classes.
 Bradley EH, Holmboe ES, Mattera JA, et al. The roles of senior management in
quality and performance improvement efforts: what are the key components? J
Healthcare Mgmt. 2003; 48(1):15-29. On NYU Classes.
Session 7 – February 24, 2015 - Models of Accountable Organizations
Due this week - Assignment 2: Organizational Design Paper
Note: For all students enrolled in Part 2, HPAM-GP 4834 (Part II) please form teams of
3 for Assignment 3 this week.
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Accountability on health care delivery
Models of accountable health care programs
Discussion question: What can managers do to move their healthcare organizations
toward best available results for quality, access and cost/value?
Case Studies:
 C. Kenney, “Management Method,” in Transforming Health Care: Virginia Mason
Medical Center’s Pursuit of the Perfect Patient Experience.” CRC Press, 2011, pp
149-164.
 R. Paulus, K Davis and G Steele, “Continuous Innovation in health Care:
Implications of the Geisinger Experience,” Health Affairs, Sept-Oct 2008, 1246 J. Bush “The Medical Home in the Woods,” in J. Bush, Where Does it Hurt: An
Entrepreneur’s Guide to Fixing Health Care,” Portfolio/Penguin, 2014, pp 122132.
Readings:
 E. Fisher, S. Shortell et al, “A Framework for Evaluating the Formation,
Implementation, and Performance of Accountable Care Organizations,: Health
Affairs, Nov 2012, 2368-2378.
 M Rosenthal, M. Abrams et al, “Recommended Core Measures for Evaluating the
Patient-Centered Medical Home: Cost, Utilization and Clinical Quality, ”The
Commonwealth Fund, Data Brief, May 2012.
COURSE REQUIREMENTS
Written Assignments
Assignment 1: Control Paper (Due Session 4 – February 18)
Please select a unit of a health care delivery organization. If you do not have experience
in a health care delivery organization, select a department or defined area of an
organization related to health care delivery that is familiar or interesting to you, or
choose a health care organization featured in a case study in McAlearney & Kovner’s
Health Services Management. Please compose a memo to the attention of a key
manager in this unit in which you assess the unit’s performance control system. In your
memo, address the following:
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How well the unit is performing, and the rationale for your valuation.
The mechanisms of accountability of the manager for achieving objectives.
What is the information used to measure current performance> What
incentives are used to impact the attainment of objectives?
Evaluate the strengths and weaknesses of the control system
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Make feasible recommendation to improve the control system. Discuss the
opportunities for and constraints to implementation.
3-5 double-spaced pages in 12-point font. Please cite references as appropriate. An
appendix may be included but is not required.
Assignment 2: Organizational Design Paper (Due Session 7 – March 11)
Complete this assignment as a two-person team. You have been hired as consultants
to a manager of a health care organization. This may be an organization familiar to you
ort an organizations featured in a case study in Health Services Management. Discuss
the current organizational structures, work processes and cultural norms that shape the
delivery of health care services and the experience of staff within the organization. To
what extent is the organization designed effectively to achieve high performance on
dimensions of clinical quality, value, patient experience and employee satisfaction?
Please identify strengths and weaknesses and make recommendations to the manager
to improve the organization on these dimensions. Include a discussion of constraints
and opportunities for implementation.
6-8 double-spaced pages in 12-point font. Please cite references as appropriate. An
appendix may be included but is not required.
GRADING
% Grade
Due Date
45% Assignment 1: Control Paper
45% Assignment 2: Organizational Design Paper
10% Class Participation
February 18
March 11
Throughout
Lateness Policy
Please observe written assignment due dates. Assignments not received by class time
on the due date may be penalized up to a full grade (e.g. A to B).
Class Participation
Class participation is an important part of the course. Students will be evaluated on
attendance, engagement in the classroom, and on constructive contributions to class
discussions. Students will receive a mid-year grade on class participation when they
receive feedback on Assignment 1.
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ACADEMIC INTEGRITY
Academic Integrity is vital to the mission of NYU/Wagner, to education at NYU Wagner
and membership in the Wagner community.
It is a core value. It forms the foundation of trust among students, and between
students and teachers.2 Cheating has no place in our community. Academic dishonesty
or other offenses against the community are not individual acts affecting only the
individuals involved. Cheating violates our communal trust in each other; it is an offense
against our community of scholarship. If tolerated, it undermines all we stand for.
Honesty matters at Wagner, just as it does in the broader world of public service.
It is a shared value. Administration, faculty and students each play a vital part in
promoting, securing and nurturing it. I invite you to visit the NYU Wagner website and
review our Academic Code and Academic Oath (www.wagner.nyu.edu/current/policies),
as well as the Wagner Student Association’s Code of Professional Responsibility. If at
any time you have a question about Academic Integrity or suspect a violation of our
code, seek guidance from any member of the faculty or administration.
It is a promoted value. It is incumbent on all members of the community to promote it,
through scholarship, responsible participation in School events, assistance to other
community members who are struggling with it, and by upholding the codes of the
school and the Wagner Student Association.
 Included below is a list of resources for understanding and avoiding plagiarism:
"Plagiarism: What is It and How to Recognize and Avoid It," The Writing Center at
Indiana University, www.indiana.edu/~wts/wts/plagiarism.html
 “Principles Regarding Academic Integrity,�
? Northwestern University,
www.northwestern.edu/uacc/plagiar.html
 “Sources,�
? Dartmouth College, www.Dartmouth.edu/~sources/contents.html,
and www.aug.edu/sociology/plagiarism.html
REFERENCE CITATION


For research resources regarding appropriate citation of the many different sources
you will use in your work, see Writing on the NYU/Wagner webpage, under "Current
Students/Academic Services."
For your information, a quick reference guide to the AMA Manual of Style is posted
on Blackboard.
2
McCabe DL, Trevino LK, Butterfield KD. Cheating in academic institutions: a decade of research. Ethics &
Behavior, 2001: 11(3), 219-232.
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