Fall 2013 - 63820 - PA393L - Advanced Policy Economics

Health Care Finance
Much of the content for this course will be driven by the U.S. Supreme Court's decision on the Affordable Care Act.  In addition to issues regarding state implementation of new mandates and responsibilities, the capacity of the federal government to fund the expansions and the ability of the authorities to encourage and support higher quality but less costly care there will be the challenges of imposing this system on a health care delivery system that has been nurtured by a much more fractionated insurance system. The challenge will be  to develop denominator based planning, and to apply managed care to new populations (Medicare and Medicaid) and new services (mental health and developmental disabilities). This is all taking place in the shadow of a divided government where Medicare and Medicaid have taken on great symbolic significance. Other factors such as an aging population and rapid technological change in medical care and in information processing capacity are driving further changes. This course will try to provide some contemporary skills as well as provide background which will enhance the student's capacity to function in the health care arena. Because so much of the material is evolving we may have guest lecturers for portions of several of the classes. The requirements will include one 5-6 page, single-spaced briefing paper and a research paper (about 20 pages). There will be an open book exam. Some topics worthy of analysis might be a comparison of several states with regard to hospital and health plan concentration, quality assurance, undermanaged care and antitrust protections, a look at changes in contracting, credentialling, alternative strategies for raising capital, or the economics or financing of a particular disease or condition.Papers on implementation challenges faced by the Affordable Care Act in a number of arenas will be also encouraged. Alternatively you might do a project for a health provider or agency or  work on one of several projects, with which I may be able to put you in touch. As long as a paper or project can be broadly conceptualized as health care finance it qualifies. Grades will be based on class participation (30%), final paper (30%), briefing paper (20%), and exam (20%).