Syllabus

Schedule

Course learning modules are divided into weeks. Each week starts on Wednesday at 12:00 am Eastern Time (ET) and closes on Wednesday at 11:59 pm ET, with the exception of Week 8, which ends on Sunday. All assignments must be submitted by 11:59 pm ET on the due date.

Course Schedule at a Glance

Learning Modules	Topics	Assignments and Due Dates
Week 1 6/27 – 7/4	Introduction & Demand	Introductory Discussion Discussion – Initial post by Sunday 7/1, responses by Wednesday 7/4 Textbook Assignment – Wednesday 7/4
Week 2 7/4 – 7/11	Supply	Discussion – Initial post by Sunday 7/8, responses by Wednesday 7/11 Textbook Assignment – Wednesday 7/11 Budget Topic Proposal – Wednesday 7/11
Week 3 7/11 – 7/18	Market Structure	Discussion – Initial post by Sunday 7/15, responses by Wednesday 7/18 Textbook Assignment – Wednesday 7/18
Week 4 7/18 – 7/25	Overview of Financial Management	Discussion – Initial post by Sunday 7/22, responses by Wednesday 7/25 Executive Summary for Informatics Budget Project – Wednesday 7/25
Week 5 7/25 – 8/1	Operating Revenue	Discussion – Initial post by Sunday 7/29, responses by Wednesday 8/1 Textbook Assignment: Case Study – Wednesday 8/1
Week 6 8/1 – 8/8	Revenue Cycle Management, Materials Management, Financial Analysis	Discussion – Initial post by Sunday 8/5, responses by Wednesday 8/8 Textbook Assignment: Case Study – Wednesday 8/8
Week 7 8/8 – 8/15	Resource Allocation, Budgeting, Cost Accounting	Discussion – Initial post by Sunday 8/12, responses by Wednesday 8/15 Final Project Informatics Budget Proposal – Wednesday 8/15
Week 8 8/15 – 8/19	Future Frontiers & Economic Controversies	Discussion – Initial post by Friday 8/17, responses by Sunday 8/19 Reflection – Sunday 8/19

Detailed Course Schedule

Week 1 — Introduction and Demand

Learning Outcomes:

• Discuss economic assumptions in healthcare and with regards to healthcare behavior
• Apply basic economic demand concepts
• Evaluate the relationship between health, healthcare insurance, and use of healthcare services

Course Materials:

• Sloan & Hsieh (2017) Textbook: Chapters 1 — 4
• Gooch, R. A., & Kahn, J. M. (2014). ICU bed supply, utilization, and health care spending: An example of demand elasticity. JAMA, 311(6), 567-568. doi: 10.1001/jama.2013.283800
• Huang, E. S., & Finegold, K. (2013). Seven million Americans live In areas where demand for primary care may exceed supply by more than 10 percent. Health Affairs, 32(3). https://doi.org/10.1377/hlthaff.2012.0913
• vlogbrothers. (2013, August 20). Why are American health care costs so high? [Video file]. Retrieved from https://youtu.be/qSjGouBmo0M
• vlogbrothers. (2017, March 28). Why Can’t America Have a Grown-Up Healthcare Conversation? [Video file]. Retrieved from https://youtu.be/09RvU9_m30Q

Assignments:

Introductory Discussion: Briefly introduce yourself to your instructor and peers. What interests you about healthcare finance and economics? What are you hoping to learn in this course?

Discussion Question: Economists often assume that people are rational and forward-looking in their decisions. What is meant by the terms “rational” and “forward-looking?” Give concrete examples of a decision in which people are likely to be rational and forward-looking and one in which this assumption seems less tenable. What empirical tests would you use to determine whether people are rational and forward-looking in a particular context or not?

Textbook Assignments: Complete the following from the Exercises section of the chapter:

Chapter 2, Exercise 2.1 (p. 73) “A patient with arthritis of the knee . . .”
Chapter 3, Exercise 3.9 (p. 123) “Bill’s new insurance policy . . .”
Chapter 4, Exercise 4.6 (p. 163) “In each of the following pairs, which situation . . .”
Chapter 4, Exercise 4.7 (p. 163) “Considering each of the following pairs, . . .”

Submit your responses in a WORD document with APA formatting. See the Textbook Assignment Rubric for submission guidelines.

Week 2 — Supply

Learning Outcomes:

• Compare and contrast factors that affect the market for physician services
• Analyze hospital models and hospital behavior
• Explain the business of health insurance including government regulation

Course Materials:

• Sloan & Hsieh (2017) Textbook: Chapters 5, 6, and 10
• Stange, K. (2014). How does provider supply and regulation influence health care markets? Evidence from nurse practitioners and physician assistants. Journal of Economics, 33, 1-27. https://doi.org/10.1016/j.jhealeco.2013.10.009
• Gupta, D., & Potthoff, S. J. (2016). Matching Supply and Demand for Hospital Services. Foundations and Trends in Technology, Information and Operations Management, 8(3-4), 131-274. doi:10.1561/0200000036
• Fraher, E. P., Knapton, A., Sheldon, G. F., Meyer, A., & Ricketts, T. C. (2013). Projecting Surgeon Supply Using a Dynamic Model. Annals of Surgery, 257(5), 867-872. doi:10.1097/SLA.0b013e31826fccfa
• ReasonTV. (2014, July 1). How to Grow the Supply of Healthcare [Video file]. Retrieved from https://youtu.be/Mwm5RY1IbKU

Assignments:

Discussion Question: What is the theoretical relationship between hospital ownership and hospital performance? Do private and not-for-profit hospitals enjoy any advantage that might increase their measured efficiency relative to that of for-profit hospitals? What do the Newhouse and the physicians’ cooperative models imply about the efficiency of private non-for-profit hospitals relative to that of for-profit hospitals?

Textbook Assignments: Complete the following from the Exercises section of the chapter:

Chapter 5, Exercise 5.2 (p. 207) “Suppose a country has a total of three cities . . .”
Chapter 5, Exercise 5.5 (p. 208) “In 1988, Medicare cut the payment . . .”
Chapter 6, Exercise 6.7 (p. 255) “In some settings, physicians are employed on a fixed salary . . .”
Chapter 10, Exercise 10.2 (p. 461) “Suppose country A adopts a public health insurance plan . . .”
Chapter 10, Exercise 10.5 (p. 461) “Compare differences between public health insurance and . . .”

Submit your responses in a WORD document with APA formatting. See the Textbook Assignment Rubric for submission guidelines.

Budget Topic Proposal: Please submit a short paragraph describing the topic for your health informatics budget project. Projects can address a wide range of informatics areas including EHR system updates, clinical quality reporting, revenue cycle management optimization, cost accounting system implementation, or data warehouse implementation. Please do not select a complete EHR implementation for this project. See the Budget Topic Proposal Rubric for submission guidelines.

Week 3 — Market Structure

Learning Outcomes:

• Discuss the economic impact of quality
• Compare and contrast different payment systems
• Debate the rationale for public provisions of health insurance
• Evaluate different approaches to healthcare reform

Course Materials:

• Sloan & Hsieh (2017) Textbook: Chapters 7 (pp. 261-277), 11- 13
• Wheeler, P. (2017). How Allina Health Used Data to Improve Quality and Reduce Cost. Retrieved from https://www.hfma.org/Content.aspx?id=53878
• Cantwell, E. & McDermott, K. (2016). Making Technology Talk: How Interoperability Can Improve Care, Drive Efficiency, and Reduce Waste. Healthcare Financial Management, 70(5), 70-76.
• Sommers, B. D., Maylone, B., Blendon, R.J., Orav, E. J., & Epstein, A. M. (2017). Three-year impacts of the affordable care act: Improved medical care and health among low-income adults. Health Affairs, 36(6), 1119-1128. https://doi.org/10.1377/hlthaff.2017.0293
• Jost Stoltzfus, T. (2018). Active December caps historic year for reform. Health Affairs, 37(2), 181-182. Retrieved from https://doi.org/10.1377/hlthaff.2018.0005
• Warshawsky, M. J., & Leahy, M. (2018). Affordable care act’s cadillac tax could affect one-fourth of workers with employer health coverage by 2025. Health Affairs 37(4), 613-618. Retrieved from https://doi.org/10.1377/hlthaff.2017.0926
• Kaiser Family Foundation Health Reform website: (https://www.kff.org/health-reform/)
• See Blackboard course for links to multiple videos

Assignments:

Discussion Question: Explain the distinction between patient-driven competition and payer-driven competition. Give examples of how these two types of competition would lead to different outcomes in a hospital market.

Textbook Assignments: Complete the following from the Exercises section of the chapter:

Chapter 11, Exercise 11.4 (p. 502) “The following is a summary statistics table for China and India . . .”
Chapter 12, Exercise 12.4 (p. 561) “In the early 1970s, . . .”
Chapter 12, Exercise 12.7 (p. 561) “Use three graphs . . .”
Chapter 13, Exercise 13.4 (p. 627) “According to a study conducted by the World Bank . . .”

Submit your responses in a WORD document with APA formatting. See the Textbook Assignment Rubric for submission guidelines.

Week 4 — Overview of Financial Management

Learning Outcomes:

• Assess the value of healthcare financial management particularly in the changing face of healthcare
• Discuss the roles and responsibilities of key financial managers
• Analyze the rationale for tax-exempt status for healthcare organizations including the importance of community benefits to tax-exempt status

Course Materials:

• Nowicki (2016) textbook: Chapters 1 – 3
• Adler-Milstein, J., Daniel, G., Grossman, C., Mulvaney, C., Nelson, R., Pan, E., . . . Perlin, J. (2014). Return on information: A standard model for assessing institutional return on electronic health records. National Academy of Sciences, Institute of Medicine, Washington, DC, 1-21. Retrieved from https://nam.edu/wp-content/uploads/2015/06/ReturnonInformation1.pdf
• Ham, N. J. (2015). Determining the ROI of clinical care improvement. Healthcare Financial Management, 69(6), 70-74.
• Collum, T. H., Menachemi, N., & Sen, B. (2016). Does electronic health record use improve hospital financial performance? Evidence from panel data. Health Care Management Review, 41(3), 267-274doi: 10.1097/HMR.0000000000000068
• Strata Decision. (2013, November 12). Dan Michelson: The new do or die in healthcare finance: Margin and outcomes management [Video file}. Retrieved from https://youtu.be/aTEwTBfRjKM

Assignments:

Discussion Question: Explain the meaning and rationale of granting corporate status to healthcare organizations and the advantages corporate status provides. What are the steps necessary to qualify for tax-exempt status?

Executive Summary for Informatics Budget Project: This week complete an Executive Project Summary for your informatics budget project. The Executive Project Summary should include the items below submitted in a WORD document and be about 2-3 pages in length. Use APA formatting. See the Executive Summary Rubric for submission guidelines.

• Project type (e.g. what kind of informatics project or system)
• Purpose (1 sentence)
• Overview (1-2 paragraphs that list benefits)
• Need (1-2 paragraph on business drivers, regulatory issues, etc)
• Resources required (should address staffing, equipment, software)
• Project management support needs (i.e. what kind of PM support, expertise required, scope of responsibilities)
• Technical considerations (i.e. who will provide technical support for project – internally or externally)
• Timeline (start date to finish date)
• Estimated cost (TBD – updated based on week seven budget)

Week 5 — Operating Revenue

Learning Outcomes:

• Examine new methods of financing and delivering healthcare
• Identify methods of payment, including bad debt and charity care
• Analyze the current benefits of and financing for Medicare and Medicaid
• Examine the various methods of setting charges as well as methods of reimbursement to providers

Course Materials:

• Nowicki (2016) textbook: Chapters 4, 5, and 7
• Taylor, M. (2016, November 1). Bad debt increasing amid coverage expansions. Retrieved from http://www.hfma.org/Content.aspx?id=50653
• Daly, R. (2016, August 23). Uncompensated care costs fall in medicaid expansion states: Study. Retrieved from http://www.hfma.org/Content.aspx?id=49837
• Howley, M., Chou, E. Y., Hansen, N., & Dalrymple, P. W. (2014). The long-term financial impact of electronic health record implementation. Journal of the American Medical Informatics Association, 22(2), 443-452. https://doi.org/10.1136/amiajnl-2014-002686
• See Blackboard course for links to multiple videos

Assignments:

Discussion Question: Discuss the differences between second-party payment and third-party payment. What led to the creation of the third party payment system? Why do healthcare organizations choose to shift costs to other payers?

Textbook Assignment: Case Study: Read the Case Study, Bobcat Integrated Delivery System, on page 381 in Nowicki. Do problems 5, 6, 8 and 9. Submit your responses in a WORD document using APA formatting. Make sure to provide an introduction and conclusion to your case study. The body of the case will be the responses to each of the questions. See the Case Study Rubric for submission guidelines.

Week 6 — Revenue Cycle Management, Materials Management, Financial Analysis

Learning Outcomes:

• Explain the important elements of a revenue cycle including ratios used to evaluate revenue cycle performance
• Evaluate the importance of materials management as well as methods of valuing inventory and identify costs related to inventory
• Identify the major components of financial statements and explain each step of the financial analysis process

Course Materials:

• Nowicki (2016) textbook: Chapters 9, 10, and 14
• Schuler, M., Berkebile, J., & Vallozzi, A. (2016). Optimizing revenue cycle performance before, during, and after an EHR implementation. Healthcare Financial Management, 70(6), 76-80.
• Beasley, B. W., Mann, H. G., Martin, C. O., & Menninger, B. (2014). Teaming up to take down costs. Healthcare Financial Management, 68(12), 50-55.
• Buchler, R. (2014). Achieving strategic cost reduction in the OR. Healthcare Financial Management, 68(10), 42-44, 46.
• Seth, S. (2017, May 5). Population health management’s revenue cycle impact. Retrieved from http://www.hfma.org/Content.aspx?id=53990
• See Blackboard course for links to multiple videos

Assignments:

Discussion Question: What are the steps to managing accounts receivable? What is the best way to evaluate revenue cycle management performance?

Textbook Assignment: Case Study: This week we will continue with the Case Study on page 381 in Nowicki: Bobcat Integrated Delivery System. Do problems 12, 13, 16 and 18. Submit your responses in a WORD document using APA formatting. Make sure to provide an introduction and conclusion to your case study. The body of the case will be the responses to each of the questions. See the Case Study Rubric for submission guidelines.

Week 7 — Resource Allocation, Budgeting, Cost Accounting

Learning Outcomes:

• Define and understand the importance of budgeting including the various types of budgeting
• Explain each step of the capital budgeting process and the methods used to evaluate the capital budgeting process
• Explain methods of classifying, allocating and assembling costs

Course Materials:

• Nowicki (2016) textbook: Chapters 12, 13, and 6
• Eastaugh, S. R. (2013). The total cost of EHR ownership: Healthcare organizations should consider support costs, upgrade fees, and other long-term costs of EHR systems in determining the total cost of ownership. Healthcare Financial Management, 67(2), 66.
• Wang, T., & Biedermann, S. (2013). Solve the Puzzle of Electronic Health Record Implementation Budgeting. Health Care Manager, 32(1), 43-48. doi:10.1097/HCM.0b013e31827ed984
• Seargeant, D. (2016, October 5). Cost Accounting Provides Keys to Continuous Cost Management. Retrieved from http://www.hfma.org/Content.aspx?id=50349
• Seargeant, D., & Spence, J. (2016, February 15). Taking an Incremental Approach to Cost Accounting. Retrieved from http://www.hfma.org/Content.aspx?id=46596
• Johnston, J. (2017, June 12). Putting Workforce Productivity in Perspective: Are You Taking What Matters into Account? Retrieved from http://www.hfma.org/Content.aspx?id=54528
• Donovan, C. J., Hopkins, M., Kimmel, B. M., Koberna, S., & Montie, C. A. (2014). How Cleveland Clinic Used TDABC to Improve Value. Healthcare Financial Management, 68(6), 84-8.
• Strata Decision. (2016, November 17). The Value of Cost Accounting in Healthcare [Video file]. Retrieved from https://youtu.be/ueuC374ljHM

Assignments:

Discussion Question: Why is it important to be able to classify costs a variety of different ways? What is the point of allocating costs?

Final Project Informatics Budget Proposal: This week you will submit your final informatics budget project. Your final project will include an updated executive summary incorporating any feedback you received in week four with a new section that describes how you will monitor and control your capital budget. This section should be 1-2 paragraphs explaining how often the budget should be reviewed and how you will know the budget is on track. A budget completed in Excel. An example budget template is provided in Blackboard for reference (or feel free to develop your own). Start by identifying key cost areas for the project then research costs and document any assumptions. Make sure to reference the sources you use in your research. See the Final Budget Plan Rubric for submission guidelines.

Week 8 — Future Frontiers & Economic Controversies

Learning Outcomes:

• Explain the relationship between health and economic sectors and personal and population health
• Review and debate economic controversies

Course Materials:

• Sloan and Hsieh (2017) textbook: Chapters 16 and 17
• Healthcare Triage. (2014, October 6). Doctors, quality of care, and pay for performance [Video file]. Retrieved from https://youtu.be/D6u96jL-8l8
• Healthcare Triage. (2017, May 10). Patients don’t shop around, even when they can [Video file]. Retrieved from https://youtu.be/nAjMowOnZZA

Assignments:

Discussion Question: Consider the share of GDP spent on healthcare in every country increases over time. Do you expect this share to continue to rise in the future? Is it possible that a country such as the US will spend more than 30 percent of its GDP on personal health care services in 2030? Explain why this would happen if you think so.

Reflection: Provide a response of about 350-500 words reflecting on what we have covered in this class and your experience. Address the following key areas: What are the top three things you learned in this class and why? Address both healthcare economics and financial management. How can you apply these learnings? How is what you learned in this class relevant to your current and/or future work? Submit your reflection in a WORD document with APA formatting. See the Final Reflection Rubric for submission guidelines.

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Questions? Visit the Student Support Health Informatics page

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