HPAM-GP 1830.003 Fall 2014 Victory Syllabus
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NEW YORK UNIVERSITY
ROBERT F. WAGNER GRADUATE SCHOOL OF PUBLIC SERVICE
INTRODUCTION TO HEALTH POLICY AND MANAGEMENT
HPAM-GP.1830.003
Fall 2014
Days:
Professor:
Location:
Office:
Office hours:
Mondays 6:45 p.m. – 8:25 p.m. (Dates: 9/08/14 – 12/08/14)
Jacob Victory, Assistant Professor (jov200@nyu.edu)
194 Mercer Street, Room 306
N/A
By appointment and immediately after each class.
COURSE SYLLABUS
This core specialization course in the NYU Wagner MPA: Health Policy and Management program
explores major topics in the study of health and health care delivery. We will discuss determinants of
health, the social distribution of health and disease, and health disparities; the organization and
financing of the U.S. health care system, its historical context, the roles and behaviors of its key
actors, and its comparison to health systems of other nations; the quality, cost and accessibility of
health care services; and health care delivery system improvement and reform. We will examine
these themes using a multidisciplinary approach that employs sociological, political, economic and
ethical perspectives on health and disease, the health care system, and the challenges of meeting the
varied (and often conflicting) needs and motivations of health care system stakeholders. The
objective of this course is to build understanding of fundamental ideas, issues and problems in health
policy and management and thereby to provide a strong foundation for future studies and careers in
the health care field.
COURSE COMPETENCIES
Course focus:
systems can address the needs of vulnerable populations
demographic, cultural, political and regulatory factors involved in and influencing health policy and
management decision-making
Relevant content for the following competencies is also included:
decisions affecting health care organizations
processes in health care organizations
HPAM-GP 1830.003 Fall 2014 Victory Syllabus
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term organizational viability
matters of healthcare with a diverse and changing industry, work force and citizenry
ps the evidence to support a point of
view, position or recommendation
LEARNING OBJECTIVES
At the conclusion of this course, students will be prepared to:
– providers, government and private payers, employers,
regulators, patients – and describe their incentives and behavior
d explain their significance
promote health, prevent disease and improve health services delivery and assess the impact of these
approaches on quality, access, cost and equity goals
BOOKS AND READINGS
Students should arrive to class prepared to participate in the discussion of these themes based on their
critical analysis of assigned readings.
Required textbook:
Health Care Delivery in the United States (10th edition). A. Kovner & J. Knickman, eds. New York,
NY: Springer Press, 2011.
Other required readings:
Assigned weekly readings that are not included in the required textbook will be posted on Sakai.
WRITTEN REQUIREMENTS
In addition to attending and participating in classes, students are required to complete two papers,
one, a memo written by each student, due October 20, 2014, and another, a group research paper, due
December 8, 2014. Instructions for written assignments are included at the end of this syllabus and
also will be distributed and described in class. Grading information is provided at the end of this
syllabus.
HPAM-GP 1830.003 Fall 2014 Victory Syllabus
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COURSE SESSIONS
A. POPULATION HEALTH
September 8, 2014: Week 1. Introduction: Health, Disease and Community
Health Care Delivery in the United States
U.S. Health Care System, pp. 3-8.
Posted on Sakai:
New
England Journal of Medicine 357: 1221-1228.
American Journal of Public Health 92(5): 725-729.
School. The New Yorker, posted May 26.
September 15, 2014: Week 2. Epidemiologic Measures and Determinants of Health
Health Care Delivery in the United States
-102.
Posted on Sakai:
Mechanisms. Annual Review of Public Health 29: 235-252.
rmot, M. 2005. Social Determinants of Health Inequalities. The Lancet 365: 1099-1104.
Health Affairs
24(2): 325-334.
September 22, 2014: Week 3. Public Health Policy and Management
Health Care Delivery in the United States
blic Health: Policy, Practice, and Perceptions,
pp. 103-123.
HPAM-GP 1830.003 Fall 2014 Victory Syllabus
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-149.
Sakai
The Lancet 359(9311): 10551059.
Health Care: New Directions to a Healthier America. Executive Summary and Introduction, pp. 9-25.
B. ORGANIZATION OF THE U.S. HEALTH CARE SYSTEM
September 29, 2014: Week 4. U.S. Health Policy and Reform: 1900 to Present
Health Care Delivery in the United States
-45.
-82.
Posted on Sakai
ans’ Views on Health Policy: A Fifty-Year Historical
Perspective. Health Affairs 20(2): 33-46.
Remedy and Reaction: The Peculiar American Struggle Over Health Care Reform.
New Haven, CT: Yale University Press. Introduction.
Rothman, David, J. 1993. A Century of Failure: Health Care Reform in America. Duke University.
Journal of Health Politics & Law 18(2): 271-286.
October 6, 2014: Week 5. Health Care Financing
d/CHIP and private insurance
Health Care Delivery in the United States
-66.
-276.
376.
HPAM-GP 1830.003 Fall 2014 Victory Syllabus
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Posted on Sakai
Annals of Internal Medicine 142(10): 847-854.
Health Affairs 29(6): 1131-1135.
NO CLASS MONDAY, OCTOBER 13, 2014.
October 20, 2014: Week 6. U.S. Health Care System in International Perspective
Memo due today.
o Comparative health systems
o Models of delivery and payment in other developed nations
Health Care Delivery in the United States
o Frogner, B., Waters, H. and Anderson, G. Chapter 4: Comparative Health System, pp. 67-82.
Posted on Sakai
o Murray, C. and Frenk, J. 2000. A Framework for Assessing the Performance of Health Systems.
Bulletin of the World Health Organizations 78(6): 717-731.
o Davis, K., Schoen, C. and Stremekis, K. 2010. Mirror, Mirror on the Wall: How the Performance
of the U.S. Health Care System Compares Internationally. 2010 Update. Commonwealth Fund,
Pub. No. 1400.
o Weisz, D., Gusmano, M., Rodwin, V., and Neuberg, L. 2008. Population Health and the Health
System: A Comparative Analysis of Avoidable Mortality in Three Nations and Their World
Cities. European Journal of Public Health 18(2): 16-172.
October 27, 2014: Week 7. Providers and Organization of Care
Health Care Delivery in the United States
-204.
-231.
Posted on Sakai
—A Perilous Journey through the Health Care System.
The New England Journal of Medicine 358(10): 1064-1071.
use, D. 2009. Primary Care and Accountable Care: Two Essential Elements of Delivery
System Reform. New England Journal of Medicine 361(24): 2301-2303.
November 3, 2014: Week 8. Medical Professionals and the Health Care Workforce
HPAM-GP 1830.003 Fall 2014 Victory Syllabus
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Health Care Delivery in the United States
rce, pp. 315-329.
Posted on Sakai
Prescription. New England Journal of Medicine 358(16): 1658-1661.
ps, Public Choice, and Health
Care. Journal of Health Politics, Policy and Law 26(5): 1145-1163.
. The Emergence of Clinical Guidelines. The Milbank Quarterly 85(4): 691727.
November 10, 2014: Week 9. Patient Decision-Making and the Provider‒Patient Relationship
-making
-directed care and patient demand for and use of information
Posted on Sakai
Care, and Why Does It Matter? Center for Studying Health System Change, Research Brief No. 8
(October).
itations of Trust in the Provision of Medical Care.
Journal of Health Politics, Policy and Law 23(4): 661-686.
Medical Care Research and Review 66(1 suppl): 53S-74S.
-Directed Health Care: What the Policy
Community Needs. Medicare Care Research and Review 66 (1 suppl): 3S-8S.
C. HEALTH CARE SYSTEM PERFORMANCE, CHALLENGES AND DEBATES
November 17, 2014: Week 10. Meeting Changing Population Needs
-term care
-of-life issues
Posted on Sakai
Chronic Illness: The Chronic Care Model, Part 2. Journal of the American Medical Association 288:
1909-1914.
When It Can’t Save Your Life? The
New Yorker August 2 issue.
-Term Care, and How They Can
Get It. Health Affairs 20(6): 114-127.
HPAM-GP 1830.003 Fall 2014 Victory Syllabus
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-Term Care: Who Gets It, Who Provides It, Who
Pays, and How Much? Health Affairs 29(1): 11-21.
November 24, 2014. Week 11. Improving Quality of Care
Health Care Delivery in the United States
lity Health Care, pp. 233-255.
Kropf, R. Chapter 16: Health Information Technology, pp. 331-349.
Posted on Sakai
Care. New England Journal of Medicine 363: 2124-2134.
December 1, 2014: Week 12. Managing New Medical Technology
Health Care Delivery in the United States
-295.
Posted on Sakai
gical Change in Medicine Worth It? Health Affairs
20(5): 11-29.
Health Affairs 23(1): 208212.
– Are We At a Tipping
Point? New England Journal of Medicine 366(12): 1069-1071.
December 8, 2014: Week 13. Expanding Access and Reducing Disparities in Access and
Treatment
Group research papers due today.
Health Care Delivery in the United States
-178.
HPAM-GP 1830.003 Fall 2014 Victory Syllabus
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Posted on Sakai
Journal of
the American Medical Association 284(16): 2061-2069.
Center for Studying Health System Change, Issue Brief No. 116 (December).
Health Affairs 28(2): w180-w183.
WRITTEN REQUIREMENTS AND GRADING
In addition to attending and participating in class meetings, all students are required to submit the
following written assignments by the following deadlines. Final grades will be calculated
accordingly:
Grades: This class will not be graded on a curve. The grading rubric will be shared prior to each
assignment. This course follows the NYU Wagner School’s general policy guidelines on incomplete
grades, academic honesty and plagiarism. It is the student’s responsibility to become familiar with
these policies. All students of this class are expected to pursue and meet the highest standards of
academic excellence and integrity.
 Incomplete grades: http://www.nyu.edu/wagner/current/pol5.html
 Academic honesty: http://www.nyu.edu/wagner/current/pol3.html
Individual or Team Assignment
Memo: Individual
Research Paper: Teams of Four
Class Participation
% of Final Grade
30%
45%
25%
Due Date
10/20/14
12/8/14
Throughout class
Class Participation: (25% of class grade). This course depends on active and ongoing participation
by all class participants. Participation starts with reading all course materials and listening. Class
participants are expected to read and discuss the weekly readings on a weekly basis. You will not
earn the 25% of your grade for class participation simply by attending classes. While
attendance is a large component, to fully earn the 25% for class participation, students must
come prepared to engage the class. To “engage,” each student must listen to all points of view,
share his/her thoughts on at least one subject or discussion raised within each class, critique thoughts
(in a respectful, reflective and thoughtful manner), ask questions, and/or promote thoughtful dialogue
with class participants. My lectures are frequently very interactive with students in the class and I
have the right to call on any member of the class at any time during class. (If, for some reason, you
have not read the class readings and feel unprepared to respond to being called on in a class, please
let me know. It is understandable that this may be the case on rare occasion. If this, however,
becomes a regular or frequent happening, your participation grade/percentage will be severely
affected.) As other instructors have noted, please note that the quality and quantity of participation
can be, but are not necessarily, correlated.
Lateness Policy – Please submit assignments on time. Assignments must be emailed to me
(jov200@nyu.edu) by 11:59 pm on the date due. Extensions will be granted only in case of
emergency. This is to respect those who abide by class deadlines. Points will be taken off if the
papers are not submitted on the date due. Papers submitted late and without extensions will be
penalized by one-half letter grade for each day late.
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WRITTEN ASSIGNMENTS
General Guidelines for Memos:
Please see the New York University Writing Center Guide to Writing Memos, posted on the course
Sakai site, for memo composition guidelines. Citations are required and a separate references page is
not necessary. If relevant, appropriate exhibits (not included in page length) are acceptable but not
required. All written work should be double-spaced in 12-point Times New Roman font with 1”
margins. Please print the papers on one side of the paper, and not on both sides.
Memo
(Individual)
Due October 20, 2014 (Week 6)
You are the Chief Operating Officer of a large healthcare system, composed of acute, long term care,
and community based organizations in addition to long term care managed care plans. Given your
current studies in health policy and management, the Chief Executive Officer of this large healthcare
system has requested that you prepare a high-level briefing for the system’s Board of Directors in
which you describe: (a) factors that have contributed to dramatic growth in health care spending over
the past 50 years; and (b) how health care payment and delivery models are transforming to promote
greater accountability for cost and quality in the health care system. Please conclude your memo with
your analysis of the most promising approaches for constraining cost growth while maintaining or
improving quality, as well as the limitations or open questions that accompany new reimbursement
and delivery models that are intended to promote “accountable care.”
The memo must be four pages in length. Please include references to course readings as well as
any relevant outside sources that support your analysis. Citations and a references page (not
included in page length) are required.
Research Paper (With at least four student partners)
Due December 8, 2014
12-page research paper
Instructions: In at least a four-student team (some team may vary in the number of student partners
due to class size), please prepare a 12-page research paper on the topics that follow:
Please prepare a 12-page research paper in which you focus on one dimension of performance of the
U.S. health care delivery system. Please examine how performance on this dimension is influenced
by the organization and financing of health care in the U.S. and behavior of key health system
stakeholders, what must be improved or reformed to achieve performance gains in your selected area,
and the implications of your analysis for health policy and management. You may focus on
performance in a broadly-defined area (such as quality of care, cost or access to care) or you may
define your focus more narrowly within one of these categories (e.g., quality of care for chronicallyill elderly patients, cost-effectiveness of new medical technologies, access to specialized care for
low-income populations). In your analysis, please consider all stakeholders relevant to your specified
focus—providers, payers and purchasers, patients, communities, policy-makers, and other groups
that play a role in performance in your focal area—and be sure to examine performance and
implications for reform at both the policy and delivery system levels.
HPAM-GP 1830.003 Fall 2014 Victory Syllabus
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The research paper must be 12 pages in length. Please include references to course readings as
well as any relevant outside sources that support your analysis. Citations and a references page
(not included in page length) are required.
Your paper is due December 8, 2014. It will be responsibility of each team’s identified “lead” to
submit the final paper on behalf of the team. This lead will be identified to the course instructor.