MARY BALDWIN COLLEGE HEALTH CARE ADMINISTRATION PROGRAM HCA 330: MANAGED CARE. Spring 2014-Blackboard Learn Online

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1 MARY BALDWIN COLLEGE HEALTH CARE ADMINISTRATION PROGRAM HCA 330: MANAGED CARE Spring 2014-Blackboard Learn Online Course Instructor: Dr. Peter L. Cruise, Adjunct Associate Professor Contact Information: or (561) This is a Skype number. If I am not able to answer, please leave a VM with your number and the best time to call you back. Office Hours: Online in the Blackboard course Chat Room on Thursday evenings from 8:00-9:00pm ET; other times by appointment. Course Description: This asynchronous online class is designed for the student interested in gaining a better understanding of managed care. This course presents the student with an indepth look at the origins, purposes, functions/operations, trends, and issues related to the funding of health services. Learning Outcomes: Specific objectives include the following: 1) Appreciation of the historical context of managed care in the U.S., where it started and why and how it has developed over time; 2) Detailed analysis of the purposes of managed care in its attempts to control cost and maintain quality for a specified population; 3) Description and analysis of the variety of plans which fall under the managed care umbrella, how these plans have evolved to our understanding of managed care today; 4) A hands-on appreciation of the functional and operational aspects of funding health services including such areas as administration, financial systems, legal aspects, ethical concerns, coding, benefit design, disease management, quality, and outcomes assessments; 5) Analysis of specific trends including health information technology (electronic medical records), Medicare and Medicaid, long term care, legal/regulatory matters, medical homes, global issues, and health care reforms (including Accountable Care Organizations); 6) Analysis of reimbursement theories and practices such as fee-for-service, capitation, per 1

2 diem, pay-for-performance, etc.; and 7) Understanding the health status of a population through descriptive statistics and the use of spatial epidemiology. Provider, manager, and consumer perspectives will be analyzed in each area of the course. A Note about this Asynchronous Learning with Blackboard Courses: Asynchronous learning is a student-centered teaching method that uses online learning resources to facilitate information sharing outside the constraints of time and place among a network of people. (adapted from: Mayadas, F [March 1997], "Asynchronous learning networks: a Sloan Foundation perspective," Journal of Asynchronous Learning Networks). By this definition, HCA 330 is a class that meets continuously for the Spring term However, we are not meeting at a specific time or place within the semester, but we do have assignments and readings due at various points during the semester, as will be explained below. The online learning resources used to support asynchronous learning include , electronic mailing lists, threaded conferencing systems, online discussion boards, wikis, and blogs. Course management systems such as Blackboard, have been developed to support online interaction, allowing users to organize discussions, post and reply to messages, and upload and access multimedia. [Bourne, JR (September 1998), "Net-learning: strategies for on-campus and offcampus network-enabled learning", Journal of Asynchronous Learning Networks 2 (2)]. By this definition, we are using the Blackboard Learn course software adopted by Mary Baldwin College as its online software platform. If you are fairly new to online courses, don't worry. The course software we use-blackboard Learn-makes it pretty easy to get to all the material you will need for this course, so you can focus on Managed Care, and not too much on your computer. During this first week we will get to know each other through online introductions which we will place in the Discussion Forum under Week 1. The Discussion Forum is divided into Weeks This area is where we all interact together--much like in an on ground classroom. It is important that you visit the appropriate Discussion Forum section each week--and participate in our class activities there each week. The Discussion Forum weeks follow the date schedule of this class, as is noted below. Technical Issues: There are times when Blackboard may be unavailable. These times are usually announced on mymbc. If Blackboard is generally unavailable at a particular time frame, I will make allowances for assignment submissions. Please read the MBC Blackboard FAQs tab on the left course 2

3 screen menu at the start of the course to help answer any general technical questions you might have. As we are an asynchronous online course, you can access the course from anywhere with an internet connection and your MBC password. Computers are available on campus in several locations and in public libraries around the United States. You will always have access to the course as long as Blackboard at MBC is working. Therefore, please do not use the lack of a working computer as a reason for not completing an assignment. A Note About Course Weeks Each course Week begins on Monday at 12:01 am ET and ends seven days later on Sunday 11:59pm ET. It is important that you participate in each Discussion Forum topic during the week it is assigned and "open." After the assigned week is over, that Discussion Forum section "closes" and you can no longer participate or get Discussion grade points in that week. Also, case study short papers are due for a particular week must be submitted via Blackboard no later than the end of the course week they are due. More on Discussion Forum Participation: Discussion Forum Questions provide a forum for you to ask questions and answer important questions about the course material. The discussion forum questions also allow you to receive feedback from the instructor and other students in the class. The instructor will interact with students within the discussion board each week. A discussion question grade will be posted to the Blackboard gradebook for each week. Weekly Assignments: Each course week will have readings (both text and online-as noted), case study papers and written tests all due by specific dates. Click on the Assignments link on the left course menu for these readings and assignments, listed as Weeks Each course week (except for exam weeks) will also have a Discussion Forum topic. Click on the Discussions tab on the left screen menu to access these weekly items. Use of Rubrics for Grading: Many online college courses use rubrics in the grading process. Rubrics are guides that help to score and grade the performance of students. Rubrics can be used by both instructors and students when creating, scoring, grading, or providing feedback on course tasks and assignments. These performance guides can help to provide a common understanding between students and instructors regarding the learning and performance expectations. Rubrics can also be used to evaluate student work collected for purposes of assessment, program evaluation, and improvement of student learning (for more on rubrics, see 3

4 So both the instructor and students have a common understanding of expectations for work submitted in this course, I have developed a set of rubrics that I will use to grade your online discussions and your written case study work. The rubrics translate into point totals which ultimately translate to the final letter grade for the course. The MBC course grade scale is listed below in the Grade Scale section. Please find your Discussion Forum and Case Study Paper Rubrics in the Rubrics section below. Contacting the Instructor You can contact me at any time via (pcruise@mbc.edu) or via Skype at I check and Skype several times each day. You can post a question for me in the Discussion Board also. I always respond within 48 hours or less. You can seek me out in real time through the course Blackboard Chat Room during my online office hours. I will return your graded work to you within 72 hours of its due date, and probably sooner. I always reference Grading Rubrics for this course when I return your work. Required text: Peter R. Kongstvedt. Managed Care What It Is and How It Works, 3rd ed., Sudbury, MA: Jones and Bartlett, 2009, ISBN Additional reading materials: Additional reading assignments are posted online on Blackboard in the weeks in which they are assigned. Be sure to add these to your assigned textbook readings each week. LATE POLICY Late work will not be accepted unless there are clear and compelling extenuating circumstances. If you have extenuating circumstances that prevent you from completing course assignments/exams you must contact your instructor immediately prior to the assignment/exam/quiz due-date unless prevented from doing so by emergency circumstances. Examples of extenuating circumstances are serious personal and/or family illness/hospitalization, death in the family, weather-related evacuation/emergencies, work emergencies, and issues related to active military assignment. Personal computer/software/internet connectivity issues and course blocks are not considered extenuating circumstances. Granting of late-work submission due to extenuating circumstances is at the discretion of the instructor and will require documentation for verification of extenuating circumstances. If late work submission is granted, the instructor will establish new due-dates and requirements without loss of course points. Ultimately, if the late submission date is not met, students may receive a zero for that assignment. NETIQUETTE Interactions in an online classroom are in written form. Your comfort level with expressing ideas and feelings in writing will add to your success in an online course. The ability to write is 4

5 necessary, but you also need to understand what is considered appropriate when communicating online. The word "netiquette" is short for "Internet etiquette." Rules of netiquette have grown organically with the growth of the Internet to help users act responsibly when they access or transmit information online. As a Mary Baldwin University student, you should be aware of the common rules of netiquette for the Web and employ a communication style that follows these guidelines. Wait to respond to a message that upsets you and be careful of what you say and how you say it. Be considerate. Rude or threatening language, inflammatory assertions (often referred to as "flaming"), personal attacks, and other inappropriate communication will not be tolerated. Never post a message that is in all capital letters -- it comes across to the reader as SHOUTING! Use boldface and italics sparingly, as they can denote sarcasm. Keep messages short and to the point. Always practice good grammar, punctuation, and composition. This shows that you ve taken the time to craft your response and that you respect your classmates' work. Keep in mind that threaded discussions are meant to be constructive exchanges. Be respectful and treat everyone as you would want to be treated yourself. Use spell check! Grade Scale: There are a maximum of 1000 points available. Divide your final point total by 10 to determine your letter grade on the scale below. A- = A = B- = B = B+ = C- = C = C+ = D- = D = D+ = 67 69, F = 59 or below Academic Honesty: All students are expected to adhere to MBC policy requiring honesty in their work. Course Schedule 5

6 *ASSESSMENTS KEY: K= Kongstvedt text; R=Blackboard reading(s)-found online in the specific course week. Week # and Topic Learning Activities Assessments* Week 1 Overview of Insurance and Managed Care Principles and History Introduce Yourself Participate in Discussion Week 2 HMOs and Integrated Delivery Systems Case Study Analysis as used in this course Week 3 Week 4 Risk, Capitation, and other Financial Issues PPOs and CDHPs and other non-hmo models K: Chapter 1 Discussion board K: Chapter 2 R=See Blackboard readings Discussion board K= Chapter 3 Case Paper # 1 Discussion board R= See Blackboard readings Test # 1 Week 5 Quality & Accountability in MC K= Chapter 4 Discussion board Week 6 Week 7 Medicare & Medicaid Managed Care Medicaid and Health Reform for Uninsured Week 8 Managed Care in a Global Context Regulation and Accreditation in MC Feb 28-Mar 9 K=Chapter 6 Case Paper # 2 Discussion board K=Chapter 5 R=See Blackboard readings Discussion board K=Chapter 7 Test # 2 SPRING BREAK NO CLASS Week 9 Ethical Issues in Managed Care & Health Insurance R=See Blackboard readings Discussion board Week 10 Pharmaceuticals and MC: PBMs & Medicare Part D R=See Blackboard readings Case Paper # 3 Discussion board 6

7 Week 11 Managed Behavioral/Mental Health Services R=See Blackboard readings Discussion board Week 12 Health Information Technology in MC: EMR s, Long term care and MC, medical homes Week 13 Developing Trends in MC R=See Blackboard readings Test # 3 R=See Blackboard readings Discussion Board Week 14 MBC Final Exam Week Final Examination Blackboard Gradebook: Every gradable course activity that appears in the course gradebook is listed in the table below. Remember: Chicago/Turabian style is the required format to follow in doing endnotes, bibliography, etc., for all written HCA assignments. Please refer to the two following websites related to The Bedford Handbook, 6 th ed. for free sample papers in the Chicago style: and All HCA classes with written papers must use the in-text raised number endnote style, with the Endnote page after the conclusion and before the Bibliography/Reference List. The written assignment, outline and projects listed below are described in more detail in the Blackboard course pages. Gradebook Week # Total Discussion Tests MC Case Analysis Short Papers Final Examination Total

8 RUBRICS Discussion Forum Participation Rubric Students are expected to post: A Minimum of three posts per weekly discussion thread. o one post in response to the instructor s question by EOD Wednesday o two posts in response to two classmates by EOD Sunday, end of Week Grade Evaluation Criteria Percentage A/A- B+/B/B- C+/C/C- D+/D/D- F Participates with the required number of relevant postings of required length Initial response posted by Wednesday; comments posted by Sunday. Consistently responds to postings Consistently uses Standard American English with rare misspellings Frequently attempts to motivate the group discussion Presents creative approaches to topic Accurately cites information. Participates with the required number of relevant postings of required length Initial response posted by Wednesday; comments posted by Sunday. Postings reflect the reading and some outside source material but may not be accurately cited. Consistently uses Standard American English with rare misspellings Comments are logical and reflect critical thinking. Participates with the required number of relevant postings of required length Initial response posted by Wednesday; comments posted by Sunday. Participates, but does not post anything that encourages others to respond to the posting. Minimal grammatical or spelling errors are noted in posts Opinions and ideas are stated clearly Participates with the required number of relevant postings Initial response not posted by Wednesday; comments posted by Sunday. Significant errors in spelling and/or grammar Occasionally posts off topic Posts do not meet length requirements Does not meet the required number of posts on time Poor spelling and grammar appear in most posts Posts topics which do not relate to the discussion content % 80-89% 70-79% <60%

9 Case Study Short Paper Rubric Grade Evaluation Criteria Percentage A/A- B+/B/B- C+/C/C- D+/D/D- F Focuses clearly on the assignment. Well organized. Shows original and critical thought. Answers all questions with clarity, thought and substance, using references and examples as appropriate. The writing style is appropriate to the assignment, interesting to read, accurate (no far-fetched, unsupported comments), precise (say what you mean), and concise (not wordy). Contains very few if any spelling, grammatical, or other errors. Shows some focus on the assignment with only minimal evidence of going off topic. Most sections are well organized and clear. Answers most questions with clarity, thought and substance, using some references and examples as appropriate. The writing style is generally appropriate to the assignment, interesting to read, accurate (no far-fetched, unsupported comments), precise (say what you mean), and concise (not wordy). Contains few spelling, grammatical, or other errors. Focus of the assignment is unclear or veers off of the assigned topic in places. While the organization is okay in some places, the overall organization of the assignment is not effective. Shows little original thought. Answers some questions incompletely, and references and examples are not used when needed. The writing style is appropriate in places, but elsewhere language is vague and imprecise. Numerous spelling, grammatical, or other errors. Assignment is very unfocused. The organization has multiple problems. Shows very little original thought. Answers several questions incompletely, and references and examples are not adequate to support the points being made. Writing style interferes with the development and clarity of the main points. Numerous spelling, grammatical, or other errors. Assignment meets none or very few of the assignment's guidelines. The components outlined for a 'D' paper are not met. It may be plagiarized % 80-89% 70-79% 60-69% <60% 9

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