HCMGT 719 Topics in Health Care Management – Health Care Systems examines the evolution, current condition, and future environment of health care services in the U.S. It explores the various user, provider, and resource demand/allocation components of health care as well as the structure and operation of the health care system. You’ll incorporate the role of emerging government and market forces, including managed care and other influential factors, to develop a comprehensive view of the American health care system.
Coursework is designed for engagement, enlightenment, and execution of change. Here are examples of some assignments you may complete as part of HCMGT 719 Topics in Health Care Management – Health Care Systems.
- Discuss the impact of increased use of nurse practitioners related to the Affordable Care Act (ACA).
- Explore what dimensions of health care access become more important as the U.S. moves increasingly toward evidence-based medicine.
- Explain how and why socioeconomic status is one of the most powerful single determinants of health.
Each week of this course focuses on a different theme. Your group discussions and assignments will align with the week’s theme as well as its primary objectives. All weekly course material is proposed and subject to change.
Week 1 – Access to Health Care
During the introduction week, you’ll discuss ACA, and basic trends, research, and policy issues related to monitoring and evaluating health care access. Among many things, you’ll learn to:
- Explain the events leading to the enactment of the ACA.
- Examine the major provisions of the ACA.
- Discuss why the behavioral model is a conceptual framework for analyzing access and equity in health care.
- Explain the epidemiology of health disparities.
- Identify the differences between Medicare and Medicaid.
Week 2 – Disparities in Health Care
In week two, you’ll cover the growing minority populations in the United States, and how this makes addressing health care disparities a paramount policy issue. Among many things, you’ll learn to:
- Determine the role of historical context causing disparities in health care.
- Discuss the efforts to reduce and eliminate disparities.
- Identify social determinants of health at the individual level and community level.
- Explain the contribution of social determinants on population health outcomes and health inequities.
- Analyze the differences among the major public health insurance programs (Medicare, Medicaid, and Children’s Health Insurance Program (CHIP)) in terms of eligibility and benefits.
Week 3 – Evaluating the Financing of Health Care
Throughout week three, you’ll explore how health care costs, levels, and trends are measured. Among many things, you’ll learn to:
- Know the key concepts of private and public insurance.
- Explain the trends in private insurance.
- Distinguish between the terms cost and expenditures.
- Explain the methods of controlling fee-for-service costs: those focusing on price, on quantity, or directly on expenditures.
Week 4 – Measuring Health-Related Quality of Life
During the midpoint week of the course, you’ll gauge ways to measure health-related quality of life and evaluate the quality of care. Among many things, you’ll learn to:
- Understand the pharmaceutical market, with a network of third-party payers and price discrimination between groups of patients.
- Explain how pharmaceutical prices are determined.
- Explain how health-related quality of life (HRQL) is defined and conceptualized.
- Become familiar with different types of HRQL measures.
- Articulate to what extent is quality of care routinely and effectively measured in the U.S.
Week 5 – Health Care Quality
As you progress to week five, you’ll review health care quality through performance report cards and information technology. Among many things, you’ll learn to:
- Explain how the design of public reports on quality affects their use.
- Know about the effects of public reporting on consumer choice of health plans and providers and the effects on quality improvement.
- Determine the area of improvement the health information technology can make in the three critical areas of health care access, cost, and quality.
- Understand that nursing performance measurement has become a major area of quality measurement.
- Gain an understanding of the challenges of developing effective performance measurement systems for nursing care.
Week 6 – Elderly, HIV/Aids, and Children
In week six, you’ll explore issues related to the rapidly growing older population, advancements in treatment for the HIV/AIDS epidemic, and delivering health care to children in the U.S. Among many things, you’ll learn to:
- Understand the basic organization and financing of long-term services and supports (LTSS) that make up the long-term care system.
- Know the basic organization and financing of LTSS nationally.
- Comprehend the changing nature of the HIV/AIDS epidemic.
- Discuss how current policy issues affect the prevention and treatment of HIV/AIDS.
- Describe how health services organization in the U.S. matches the unique health needs of children.
- Explain the problems with financing and organization in the current system.
- Examine emerging and future models of care.
Week 7 – Health Care Delivery Systems
Throughout this week, you’ll discuss homelessness, social change, health care delivery system, and Medicare reform. Among many things, you’ll learn to:
- Identify homeless health status and use of health services.
- Understand the health differences between homeless persons and low-income housed persons.
- Summarize the contemporary efforts to change the U.S. health care delivery system.
- Assess the trade-offs associated with using intrinsic vs. extrinsic motivators for changing provider behavior.
- Explain value-based purchasing.
- Discuss the history of failed attempts to enact national health insurance in the U.S.
- Describe the evolution of Medicare since enactment in 1965.
Week 8 – Ethical Issues in Public Health
During the last week, you’ll explore the expertise, priorities, care, services, and ethics of public health delivery. Among many things, you’ll learn to:
- Understand the role of public health related to the clinical care system from a population-health perspective.
- Recognize how public health agencies have traditionally provided clinical care services and how this role may decrease with health reform.
- Describe how safety-net hospitals and clinics contribute to access, quality of care, and the cost of health care.
- Know the three cardinal principles of public health ethics.
- Discuss ethical issues related to the distribution of and access to health care utilization.