COURSE INFORMATION

Course Number: MGT 698/HPM 698

Course Title: Healthcare Policy, Finance, and Economics
Term and Year: Spring 2017
Class Meeting Time, Day: M/W 2:40pm-4:00pm
Course Support: Laura Goldfarb

CONTACT INFORMATION

Professor(s) TA(s)
Name: Howard P. Forman Name: Emily Trask-Young
Office Location: Evans 2200 E-mail Address: emily.trask-young@yale.edu
Telephone Number: 203-376-9793
E-mail Address: howard.forman@yale.edu Name: Avi Tutman
Office Hours: by appointment E-mail Address: albert.tutman@yale.edu
Review Sessions:
Final Project Review Session: TBD
Exam Review Session: April 17 (in class)

TEXTBOOKS AND RECOMMENDED/REQUIRED READINGS

Textbook(s): None required

Required Readings: Listed and on Canvas
Recommended Readings: Listed and on Canvas

SOFTWARE USED

None

COURSE DESCRIPTION AND OBJECTIVES

Course Description: Survey course that looks at demand-side and supply-side factors that influence the
delivery of healthcare and health in the US. The course, inherently, challenges the student to consider
the appropriate role of government in the US healthcare delivery system.
Course Outline: see below
Course Objectives:
To provide students with a functional understanding of the financing of healthcare delivery in
America
To understand the basic economic principles, and their effects, with regard to healthcare delivery
To identify the opportunities for private and public sector involvement in improving healthcare
To enable understanding and discussion of health and healthcare reform and its effects on the various
industries in the healthcare sector
 To develop skills in industry and company analysis, as a primer for financial valuation of example
companies
Prerequisites: There are no prerequisites for SOM or YSPH-HCM students. Other students must receive
direct permission from the course director.

COURSE REQUIREMENTS AND SPECIFIC GRADING POLICY

Course Requirements
Short Paper Monday, February 27, 2017 15%
Final Exam Wednesday, April 19, 2017 25%
Final Project (group) Due at the time of final presentation 45%
Attendance and Participation Ongoing 15%

Grades

Students are graded according to the policies of their enrolled school.

Once grades are officially recorded, they may not be changed except in cases in which a mathematical
error has been made in computing the grade or a clerical error has been made in recording it. Students
seeking correction to a grading error must contact the instructor within two weeks (ten working days)
from the receipt of the grade.

DESCRIPTIONS OF REQUIREMENTS/ASSIGNMENTS/PROJECTS
Participation: The course is taught in a small lecture format and thus interchange and discussion are
expected. Each student should bring their name-card to every class to facilitate discussion. Each lecture will
have both assigned and optional reading, primarily from recent literature in the field. Please look to the
Canvas website for the most up-to-date information on reading assignments.

Project Team: Each student will be assigned to a team of 6 members according to the criteria below.
Assignments will be made to maximize the diversity of the teams experience and satisfy submitted industry
preferences as best possible.
Team requirements:
Minimums: 2 SOM students; 3 YSPH students; 1 student with clinical healthcare experience; one
student with finance background/talent.
Maximums: 2 physician and/or medical students; 1 undergraduate student; 3 SOM students;
6 students total

Once assigned (teams will be formed during the third week of class), teams will choose a company in their
assigned industry for their final project. Professor Forman needs to approve the company before the group
proceeds.

Individual Competitive Strategy Paper: Each team member will evaluate the assigned industry from the
perspective of one of Michael Porters five forces. For those unfamiliar with the Porter Forces, the reference
text is available at most bookstores and on-line retailers. The reference textbook is not required but reading
it will facilitate work on this portion of the project. There are also many websites with fairly good coverage of

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this theme. For groups with six members, Government & Regulation can be considered the sixth force in the
industry.

The paper should be roughly 1000 words. The paper need not be heavily referenced, but references should
be made when appropriate. Prior to handing in the paper, the group must meet and make certain that there
is no inappropriate duplication of material. While each paper is an individual assignment, the cohesiveness of
the sum must be apparent and will become more relevant during completion of the final project. Each paper,
however, will be graded on an individual basis. This paper will be due on Monday, February 27nd.

Final Project: Each group will submit a final presentation on their chosen company within their assigned
industry. The company must be approved by Professor Forman. The project will consist of:

A final presentation given to the class, as outlined below

A one-page executive summary of the groups findings and proposals
An annotated version of the groups presentation slides, submitted in hard-copy using PowerPoint
Notes. This may include a small number of appendices for financial models, background
information, etc. (This does not have to be your script; But that might be easiest: points will be
deducted if there is no annotation.)
References, as appropriate, submitted at the time of the slide deck

Your project should address the following topics:

A summary of the competitive analysis presented in the short individual papers
A strategic analysis of the company including an analysis of management, mission, vision,
marketing strategies, and operational considerations
A financial analysis of the company including a discussion of current and projected earnings, cash
flow, and financing needs
A series of recommendations regarding the prudence of investing in this entity, as well as
recommendations to management regarding the necessary next steps to be successful.

The written portion of the final project will be due at the time of the groups presentation. Groups will also
be asked to submit records of group meetings with attendance over the course of the project. At the time
of the final presentation, groups will submit a statement of contribution and evaluation, which will detail
each students contributions to the whole and attest to each individuals ownership of the full product.

Final Presentation: The final project will be presented during the last two sessions of the class, with all
members of the team participating. The talk should be treated as a professional business presentation, and
professional attire is appropriate. Groups will have 20 minutes to present, with 5 minutes for discussion and
questions. Timing is important, and the cohesiveness of the presentation is considered highly in grading.

Note: Professor Forman reserves the right to extend class on May 1nd, May 3th, and May 8th for an extra
30 minutes as needed. Please hold those times on your calendar.

Final Exam: This will be a test of the course material with free-text answers. Only material discussed in the
lectures will be on the exam and it will cover material through the class on Wednesday, April 12th. There will
be a review session on Monday, April 17th, and the final exam will be held on Wednesday, April 19 , 2017.
th

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YALE SOM HONOR CODE

Guiding Principles
Honesty is fundamental to the profession and practice of management. It is therefore the bedrock
premise of management education at Yale. To the community of students, faculty, and staff of the Yale
School of Management, honesty and integrity build the trust essential to a free and lively exchange of
ideas.
The Yale SOM Honor Code is intended to foster the Schools exceptional learning environment and to
support conduct that will distinguish the faculty, staff, and students in their lives as managers, at
school, at school-related functions, and in the larger management community. The Honor Code will
be referred to as the Code hereafter.
The Honor Committee has jurisdiction over all Code violations including matters of academic
dishonesty and egregious violations of the social and professional norms of behavior.
Academic Integrity
The Yale SOM community, including faculty, staff, and students, supports the highest standards of
academic integrity. All academic work affords an unparalleled opportunity to put forward new and
innovative ideas; at SOM, we aspire to always acknowledge the ideas upon which new solutions are
based.
When working on any assignment with a team, students must clarify the expectations for each
member of the team.
Faculty will provide clear guidelines for students on the parameters of any group work, as well as
guidelines for proper citation.
A student will contact the professor for clarification if there is a question about the way in which the
group work is to be completed.
Students are encouraged to consult print resources as well as online resources, available on the SOM
portal, concerning proper citation.
Community Standards
A hallmark of the Yale SOM community is its inclusive nature, which respects the diverse backgrounds
and views of its members. SOM faculty, students, and alumni aspire to standards of conduct while at
Yale, and as they function in the larger management community, that will further distinguish SOM as a
center of integrity and fair dealing.
Students must uphold, among themselves, the highest standards of professional behavior.
Students must strictly adhere to ethical guidelines during the job searchwith interviewers,
prospective employers, and their student colleagues.
Students must remember that they represent the School as they take part in activities in the
University, New Haven, and the larger management community.
Standards of individual responsibility in the job search, and in the use of School and University
information technology resources, are detailed under Policies and Guidelines of the Career
Development Office and Policies on the Use of Information Technology Facilities in this chapter.

YALE ACADEMIC INTEGRITY:

Academic integrity is a core institutional value at Yale. It means, among other things, truth in presentation,
diligence and precision in citing works and ideas we have used, and acknowledging our collaborations with
others. In view of our commitment to maintaining the highest standards of academic integrity, the Graduate
School Code of Conduct specifically prohibits the following forms of behavior: cheating on examinations,

Page 4
problem sets and all other forms of assessment; falsification and/or fabrication of data; plagiarism, that is,
the failure in a dissertation, essay or other written exercise to acknowledge ideas, research, or language
taken from others; and multiple submission of the same work without obtaining explicit written permission
from both instructors before the material is submitted. Students found guilty of violations of academic
integrity are subject to one or more of the following penalties: written reprimand, probation, suspension
(noted on a students transcript) or dismissal (noted on a students transcript).

GENERAL STATEMENTS

Attendance
Requiredparticipation cannot occur in ones absence!
Laptop/Device Policy
Laptop usage is permitted in lieu of printing the notes. However, it is STRONGLY preferred that you limit non-
class related usage. Participation and respect for the lecturer will be expected.

DETAILED OUTLINE OF CLASS SESSIONS

Session Topics Readings Assignments Due

Session 1 Introduction - Overview of the
1/23 Course, Administrative Details, and None
Discussion of Course Requirements
Session 2 300 word statement of
Health Industries Overview,
1/25 Please see detailed interest due for
National Health Expenditures
outline below students not pre-
registered
Session 3 National Health Expenditures Please see detailed
1/30 (cont.) outline below
Session 4 Guest Lecturer: Thomas Balcezak,
2/1 MD, Vice President of Performance Please see detailed
Management, Associate Chief of outline below
Staff, Yale-New Haven Hospital
Session 5 Please see detailed
Healthcare Microeconomics Project Overview
2/6 outline below
Session 6 Healthcare Microeconomics (cont.) Please see detailed
Formation Survey
2/8 Pharma Overview outline below
Session 7 Pharma Overview (cont.) Please see detailed
2/13 FDA Regulation outline below
Session 8 FDA Regulation (cont.), Generic Please see detailed
2/15 Drug Industry and Supply Chain outline below
Session 9 Health Disparities
Please see detailed
2/20 Guest Lecturer: Marcella Smith,
outline below
MD, MHS, Yale School of Medicine
Session 10 FDA Policy Please see detailed
2/22 Guest Lecturer: Joseph Ross, MD, outline below

Page 5
 Session Topics Readings Assignments Due
MHS, Yale School of Medicine

Session 11 Please see detailed

Economics of Health Insurance Short Paper
2/27 outline below
Session 12 Economics of Health Insurance Please see detailed
Company Choice
3/1 (cont.) outline below
Session 13 Please see detailed
Medicare Part A
3/6 outline below
Please see detailed
*Class does not meet*
3/8 outline below
Yale SOM Spring Recess
Session 14 Please see detailed
Medicare Parts B and D
3/27 outline below
Session 15 Medicaid, SCHIP, and the Please see detailed
3/29 Uninsured outline below
Session 16 Medicare/Medicaid/SCHIP/Uninsur Please see detailed
4/3 ed Catch up and Wrap up outline below
Session 17 Please see detailed
Hospitals and Facilities
4/5 outline below
Session 18 Physician and Nursing Labor Please see detailed
4/10 Market outline below
Session 19 Physician Payment Schemes and Please see detailed
4/12 Incentives outline below
Session 20 Please see detailed
Final Exam Review Session (TAs) Bring Questions
4/17 outline below
Session 21 In-Class Final Exam Please see detailed
4/19 (Will cover material in classes 1-20) outline below
Session 22 Please see detailed
Hold For: Catch-up Lecture
4/24 outline below
Session 23 Capstone Class Session - Health Please see detailed
4/26 Reform: The PPACA and Beyond outline below
Session 24 ***Group Presentations*** Final presentation and
Please see detailed
5/1 Class may be extended by 30 deliverable (for those
outline below
minutes (2:40 PM - 4:30 PM) presenting)
Session 25 ***Group Presentations*** Final presentation and
Please see detailed
5/3 Class may be extended by 30 deliverable (for those
outline below
minutes (2:40 PM - 4:30 PM) presenting)
Session 26 ***Group Presentations*** Final presentation and
Please see detailed
5/8 Class may be extended by 30 deliverable (for those
outline below
minutes (2:40 PM - 4:30 PM) presenting)

The instructor reserves the right to modify and/or change the course syllabus as needed during the course.

Page 6
Session 1: January 23, 2017
*NONE*

Session 2: January 25, 2017

National Health Expenditures:
Required:
Sussman. Anna Louie. 5 Things to Know about Health Care Spending in the U.S. WSJ. Aug 25, 2016.
D. Squires and C. Anderson, U.S. Health Care from a Global Perspective: Spending, Use of Services, Prices,
and Health in 13 Countries, The Commonwealth Fund, October 2015.
Blumenthal D, Abrams MK. Tailoring Complex Care Management for High-Need, High-Cost Patients.
JAMA. 2016;316(16):1657-1658. doi:10.1001/jama.2016.12388
Optional:
Folland, Goodman and Stano: Chapters 1 & 4
Lucy Larner. "National Health Spending Growth Accelerates in 2014"; Health Affairs Blog. 2015 Dec 2.
David Blumenthal, M.D., M.P.P., Kristof Stremikis, M.P.P., M.P.H., and David Cutler, Ph.D. Health Care
Spending A Giant Slain or Sleeping? N Engl J Med 2013; 369:2551-2557December 26, 2013DOI:
10.1056/NEJMhpr1310415

Session 3: January 30, 2017

National Health Expenditures (Cont.)
Required:
Anne B. Martin, Micah Hartman, Benjamin Washington, Aaron Catlin and the National Health
Expenditure Accounts Team. National Health Spending: Faster Growth In 2015 As Coverage Expands
and Utilization Increases. Health Affairs 36, no 1 (2017): 166-176. doi: 10.1377/hlthaff.2016.1330
originally published online December 2, 2016.
Drew Altman, Dana Goldman. "Medicare Spending Cuts and Hospital Productivity Gains". The Wall
Street Journal. 2015 Feb 25.
Nikhil Sahni, Anuraag Chigurupati, Bob Kocher MD, David M Cutler. "How the US Can Reduce Waste in
Healthcare Spending by $1 Trillion". Harvard Business Review.
Optional:
Rovner, Julie. Will the U.S. create a single-payer health system? PBS NEWSHOUR. July 13, 2016.
http://www.pbs.org/newshour/rundown/will-u-s-create-single-payer-health-system/
Drew Altman. "How Health-Care Bills Hinder Millions of Americans". The Wall Street Journal. 2016 Jan
06.
Ken Thorpe, Sanjula Jain, and Peter Joski. Prevalence and Spending Associated with Patients Who
Have a Behavioral Disorder And Other Conditions. Health Affairs 36 No. 1 (2017): 124-132.

Session 4: February 1, 2017

*NONE*

Session 5: February 6, 2017

Healthcare Microeconomics:
Required:
Bruce C. Vladeck. Paradigm Lost: Provider Concentration And The Failure Of Market Theory. Health
Aff June 2014 33:1083-1087.

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 William M. Sage. Getting The Product Right: How Competition Policy Can Improve Health Care
Markets. Health Aff June 2014 33:1076-1082.
Optional:
Folland, Goodman and Stano: Chapters 5 & 18
Akerlof GA. The Market for Lemons: Qualitative Uncertainty and the Market Mechanism. Quarterly
Journal of Economics. 82 (1970): 488 500.
Tim Xu, Albert Wu, and Martin Malary. The Potential Hazards of Hospital Consolidation Implications for
Quality, Access, and Price. Octoer 6, 2015. JAMA 314(13): 1337-1338.
Session 6: February 8, 2017
Healthcare Microeconomics (cont.)
Required:
Martin Gaynor. Competition Policy In Health Care Markets: Navigating The Enforcement And Policy
Maze. Health Aff June 2014 33:1088-1093
Drew Altman. "Health-Care Deductibles Climbing Out of Reach". The Wall Street Journal. 2015 Mar
11.
Optional:
Folland, Goodman and Stano: Chapters 8 & 9
Volpp K, Das A. Comparative Effectiveness: Thinking beyond Medication A versus Medication B. N
Engl J Med. 2009; 361(4):3313.

Pharmaceutical Industry Overview:

Required:
Fiona Scott Morton, Margaret Kyle, Handbook of Health Economics, Chapter 12: Markets for
Pharmaceutical Products.
Chin, William W. A Delicate Balance- Pharmaceutical Innovation and Access. New England Journal of
Medicine. Nov 5, 2015; 373(19): 1788-1801.
Optional:
Folland, Goodman and Stano: Chapter 17
Walker, Joseph. "Costly Vertex Drug Is Denied, and Medicaid Patients Sue." The Wall Street Journal.
Dow Jones & Company, 16 July 2014.

Session 7: February 13, 2017

Pharmaceutical Industry Overview (cont.):
Required:
Dennis, Brady. Rattled by drug price increases, hospitals struggle with cost, care. Chicago Tribune.
March 14, 2016.
Pollack, Andrew. Drug Goes from 13.50 a Tablet to $750, Overnight. The New York Times. Sept 20,
2015. http://www.nytimes.com/2015/09/21/business/a-huge-overnight-increase-in-a-drugs-price-
raises-protests.html?_r=1
Drugs in America: Seizure-Inducing. The Economist. Sep 3, 2016.
http://www.economist.com/news/business/21706347-row-over-mylans-epipen-allergy-medicine-
raises-fresh-questions-about-how-drugs-are?zid=318&ah=ac379c09c1c3fb67e0e8fd1964d5247f
Optional:
Rob Lott. New Players Join The Drug Development Game. Health Aff October 2014 33:1711-1713.
Vardi, Nathan. The 29 Year Old Behind the Giant Biotech IPO That Rose By 90% Speaks. Forbes. Jun
11, 2015. http://www.forbes.com/sites/nathanvardi/2015/06/11/the-29-year-oldbehind-the-giant-
biotech-ipo-that-rose-by-75-speaks/

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FDA Regulation:
Required:
Sharfstein, JM. The FDA - A Misunderstood Agency. JAMA. 2011; 306(11): 1250-51.
Edney, Anna. Shkrelis Strategy to Jack Up Drug Prices May Be Curbed by FDA. Bloomberg. March
14, 2016. http://www.bloomberg.com/news/articles/2016-03-14/shkreli-s-strategy-to-jack-up-drug-
prices-may-be-curbed-by-fda
Caponnetto, Pasquale, Daniela Saitta, David Sweanor, and Riccardo Polosa. What to consider when
regulating electronic cigarettes: Pros, cons, and unintended consequences. International Journal of
Drug Policy. June 2015; 26(6): 554-559.
Optional:
Grabowski HG, Kyle M. Evolving Brand-Name And Generic Drug Competition May Warrant A Revision
Of The Hatch-Waxman Act, Health Affairs. 2011 2157-2166.
Nathalie Tadena. "Doctors Proposed Ban of Drug Ads Goes After Top Magazine Ad Category". The
Wall Street Journal. 2015 Nov 18.

Session 8: February 15, 2017

FDA Regulation (cont.)
Required:
Falit, Benjamin P., Surya C. Singh, and Troyen A. Brennan. Biosimilar Competition in the United States:
Statutory Incentives, Payers, and Benefit Managers. Health Affairs. 2015: 34(2): 294-301.
Robert Kocher, and Bryan Roberts. The Calculus of Cures. N Engl J Med 2014; 370:1473-1475April 17,
2014

Optional
Kevin Outterson. Clinical Trial Transparency Antidote to Weaker Off-Label-Promotion Rules? N Engl
J Med 2014; 371:1-3July 3, 2014.

Generic Drug Industry and Supply Chain:

Required:
Russel, John. Generic drugs: a bargain or a sticker shock? Chicago Tribune. Jan 5, 2016.
http://www.chicagotribune.com/business/ct-generic-drug-prices-pass-inflation-0106-biz-20160105-
story.html
McClusky, Priyanka Dayal. As competition wanes, prices for generics skyrocket. Boston Globe. Nov
6, 2015. https://www.bostonglobe.com/business/2015/11/06/generic-drug-price-increases-alarm-
insurers-providers-and-consumers/H3iA9CSxAUylnCdGjLNKVN/story.html
Silverman, Ed. FDA proposes biosimilar labeling that favors generic drug makers. April 4, 2016.
https://www.statnews.com/pharmalot/2016/04/04/fda-biologics-generics/

Optional:

Glen Schumock. National trends in prescription drug expenditures and projections for 2015. Am J
Health-Syst PharmVol 71, 2014.
Bach PB. New Math on Drug Cost-Effectiveness. N Engl J Med 2015; 373:1797-1799
Health Policy Brief. Biosimilars. Health Affairs. Oct 10, 2013
Nicole Fisher. "The Sunshine Act is Finally Final." Forbes.com. 2/11/2013.

Session 9: February 20, 2017

*Guest Lecturer, Additional Readings TBD*

Page 9
Health Disparities:
Required:
Harris, Drew. When Adequate Food Is What the Doctor Prescribes. WSJ. Oct 21, 2016.
http://blogs.wsj.com/experts/2016/10/21/when-adequate-food-is-what-the-doctor-prescribes/
Optional:
Neugebauer, Richard. Randomized Clinical Trials to Evaluate Mental Health Interventions in
Resource-Poor Societies. JAMA: 316 (24). Dec 27, 2016.
http://jamanetwork.com/journals/jama/fullarticle/2594699?resultClick=1

Session 10: February 22, 2017

*Guest Lecturer, Readings TBD*

Session 11: February 27, 2017

Economics of Health Insurance
Required:
Brandeisky, Kara. The Hidden Risk of High-Deductible Health Plans. Time. Nov 03, 2015.
http://time.com/money/4091524/health-insurance-high-deductible-plans-risk/
Peter Orzsag. "Save Medicare, Starting with Your Hips". Bloomberg View. 2015 Jul 09.
Optional:
Buchmueller T, Carey C, Levy HG. Will Employers Drop Health Insurance Coverage Because of the
Affordable Care Act? Health Affairs, 32, no.9 (2013): 1522-1530.
Health Policy Brief. Excise Tax on 'Cadillac' Plans. Health Affairs. Sep 12, 2013.

Session 12: March 1, 2017

Economies of Health Insurance (cont.):
Required:
Anna Wilde Mathews. "Health-Care Providers, Insurers Supersize". The Wall Street Journal. 2015 Sep
21.
S. L. Hayes, S. R. Collins, D. C. Radley, D. McCarthy, and S. Beutel, A Long Way in a Short Time: States
Progress on Health Care Coverage and Access, 20132015, The Commonwealth Fund, December 2016
Quoctrung Bui, Margot Sanger-Katz. "We Mapped the Uninsured. You'll Notice a Pattern.". The New
York Times. 2015 Oct 30.
Optional:
Folland, Goodman and Stano: Chapters 10 & 11
Thomasson, M. Health Insurance in the United States. Economic History Association. February
2011.
Anna Wilde Mathews. "Health Insurers Struggle to Profit From ACA Plans". The Wall Street Journal.
2015 Nov 01. http://www.wsj.com/articles/health-laws-strains-show-1446423498
Sabrina Corlette, Christine Monahan, Katie Keith, and Kevin Lucia. Selling Health Insurance Across State
Lines: An Assessment of State Laws and Implications for Improving Choice and Affordability of Coverage.
The Center on Health Insurance Reforms. Georgetown University Health Policy Institute. October 2012.

Session 13: March 6, 2017

Medicare Part A
Required
Christopher Weaver, Anna Wilde Mathews, Tom McGinty. "Medicare Rules Reshape Hospital
Admissions". The Wall Street Journal. 2015 Dec 01.

Page 10
 Ian Morrison. "Health Care Costs and the Choices in the Last Years of Life". Hospitals & Health
Networks. 2015 Mar 03.
Elizabeth Weeks Leonard. "CMS Proposed Changes To The Two-Midnight Rule: Partial Restoration Of
Medical Judgment". Health Affairs Blog. 2015 Sep 01.
Optional
Folland, Goodman and Stano: Chapters 21
Baicker K, Chernew ME. The economics of financing Medicare. N Engl J Med. 2011 Jul 28;365(4): e7.
Christopher Hogan, Direct Research LLC. "Spending in the Last Year of Life and the Impact of Hospice
on Medicare Outlays". MedPac. 2015 Jun.
Session 14: March 27, 2017
Medicare Part B and D:
Required:
Julie M. Donohue. The Impact and Evolution of Medicare Part D. N Engl J Med 2014; 371:693-
695August 21, 2014
Hackman, Michelle. U.S. Spending More on Specialty Drugs Under Medicare. WSJ. Jan 5, 2017.
Optional:
Okma KG, Marmor TR, Oberlander J. Managed competition for Medicare? Sobering lessons from The
Netherlands. N Engl J Med. 2011 Jul 28;365(4):287-9.
Wilensky GR. Improving value in Medicare with an SGR fix. N Engl J Med. 2014 Jan 2;370(1):1-3.

Session 15: March 29, 2017

Medicaid, SCHIP, and the Uninsured:
Required:
"Where the States Stand on Medicaid Expansion". The Advisory Board Company. 2016 Jan 13.
Sparer, Michael. Maintaining Insurance Access Under Trump- A Strategy. New England Journal Of
Medicine: 375(26). Dec 29, 2016. http://www.nejm.org/doi/full/10.1056/NEJMp1611202
"Special Feature: Should States Expand Medicaid Under the ACA?". Rand Health. 2013 Jun.
Optional:
Krueger AB, Kuziemko I. The demand for health insurance among uninsured Americans: Results of a
survey experiment and implications for policy. J Health Econ. 2013 Sep;32(5):780-93.
Brendan Saloner, Lindsay Sabik, and Benjamin D. Sommers. Pinching the Poor? Medicaid Cost Sharing
under the ACA. N Engl J Med 2014; 370:1177-1180March 27, 2014.
John Ayanian, Gabriel M. Ehrlich, Donald R. Grimes, and Helen Levy. Economic Effects of Medicaid
Expansion in Michigan. The New England Journal of Medicine. Ja 4, 2017.
http://www.nejm.org/doi/full/10.1056/NEJMp1613981?query=featured_home

Session 16: April 3, 2017

Medicare/Medicaid/SCHIP/Uninsured Catch Up
Required:
"Medicare and Medicaid at 50: Perspecitives of Beneficiaries, HealthCare Professionals and
Institutions, and Policy Makers". JAMA. 2015;314(4):384-395. doi:10.1001/jama.2015.7811.
Irene Papanicolas, Jose F. Figueroa, E. John Orav, and AshishK. Jha. Patient Hospital Experience
Improved Modestly, But No Evidence Medicare Incentives Promoted Meaningful Gains. Health
Affairs: 36(1), 133-140.
Winakur J. What are we going to do with Dad? Health Affairs. 2005;24(4):1064-1072.
Optional:
Enthoven AC. Reforming Medicare by reforming incentives. N Engl J Med. 2011 May 26;364(21): e44.

Page 11
 Aaron HJ. How not to reform Medicare. N Engl J Med. 2011 Apr 28;364(17):1588-9.
Holahan J, Yemane A. Enrollment is driving Medicaid costs--but two targets can yield savings. Health
Affairs. 2009 SepOct;28(5):1453-65.
Health Policy Brief. Medicare Hospital Readmissions Reduction Program. Health Affairs. Nov 12, 2013.

Session 17: April 5, 2017

Hospitals and Facilities:
Required:
Ken Thorpe, Sanjula Jain, Peter Joski. Prevalence and Spending Associated With Patients Who Have a
Behavioral Health Disorder and Other Conditions. Health Affairs: 36(1), 124-132.
Nichols and OMalley. Hospital Payment Systems: Will Payers Like The Future Better Than The Past?
Health Affairs. 2006; 25(1): 8193.
Bernheim SM, Ross JS. Hospital Discharge and the Transition Home for Poor Patients: "I Knew I
Couldn't Do What They Were Asking Me". J Gen Intern Med. 2014 Feb;29(2):269-70.
Christine K. Cassel, M.D., et al. Getting More Performance from Performance Measurement. Dec. 4,
2014. n engl j med371;23.
Optional:
Folland, Goodman and Stano: Chapter 14
Pear, Robert. "U.S. Sues Michigan Blue Cross Over Pricing." The New York Times. The New York Times,
18 Oct. 2010.
Gabor, Andrew. "Running a Hospital Like a Factory, In A Good Way," New York Times, February 22,
2004.
Atul Gawande, The Checklist Manifesto: How to Get Things Right

Session 18: April 10, 2017

Physician and Labor Market:
Required:
Asch DA, Nicholson S, Vujicic M. Are We in a Medical Education Bubble Market? N Engl J Med. 2013
Oct 30.
Gawande, Atul. Piecework. The New Yorker, April 4, 2005.
Mary D. Naylor, and Ellen T. Kurtzman. The Role of Nurse Practitioners in Reinventing Primary Care.
Health Affairs 29(5), 893-899. May 2010. http://content.healthaffairs.org/content/29/5/893.full
Optional:
Folland, Goodman and Stano: Chapter 15
Iglehart JK. A New Day for Workforce Redesign. Health Affairs, 32, no.11 (2013):1870
Beck M, Innovation Is Sweeping Through U.S. Medical Schools, WSJ

Session 19: April 12, 2017

Physician Payment Schemes and Incentives:
Required:
Cunningham R. The Payment Reform Paradox. Health Aff May 2014 vol. 33 no.5 735-738.
Mechanic RE. Opportunities and Challenges for Episode-Based Payment. N Engl J Med. 2011; 365(29):
777-779.
Brook RH. Physician Compensation, Cost, and Quality. JAMA. 2011; 304(7): 795-6.
Optional:
Folland, Goodman and Stano: Chapter 16

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 Berenson RA, Kaye DR. Grading a physician's value--the misapplication of performance measurement.
N Engl J Med. 2013 Nov 28;369(22):2079-81
Check out Medicare payments to specific providers through this interactive tool:
http://graphics.wsj.com/medicare-billing/

Session 20: April 17, 2017

*None*

Session 21: April 19, 2017

*None*

Session 22: April 24, 2017

*None*

Session 23: April 26, 2017

Healthcare Reform:
Required:
Blumenthal, David., Melinda Abrams, Rachel Nuzum. The Affordable Care Act at 5 Years. New England
Journal of Medicine. June 2015: 372(25): 2451-2458.Altman, Drew. The Affordable Care Act After Six
Years. The Wall Street Journal. March 23, 2016. http://blogs.wsj.com/washwire/2016/03/23/the-
affordable-care-act-after-six-years/
Obama, Barack H. Repealing the ACA without a Replacement- The Risks to American Healthcare. Jan 06,
2016. http://www.nejm.org/doi/full/10.1056/NEJMp1616577?query=featured_home
Sanger-Katz, Margot. The Biggest Changes Obamacare Made, and Those That May Disappear. The
New York Times. Jan 12, 2017. https://www.nytimes.com/2017/01/13/upshot/the-biggest-changes-
obamacare-made-and-those-that-may-disappear.html
Optional:

Tricia Brooks. Open Enrollment Take Two. Health Aff June 2014 33:927-930;
What Can Massachusetts Teach Us About National Health Insurance Reform? Journal of Policy
Analysis and Management, 30(1): 177-195 (2011). Jon Gruber and Doug Holtz-Eakin.
S.T. Edwards and B.E. Landon. Medicare's Chronic Care Management Payment Payment Reform for
Primary Care. N Engl J Med 2014; 371:2049-2051.

Session 24: May 1, 2017

*Presentations*

Session 25: May 3 2017

*Presentations*

Session 26: May 5, 2017

*Presentations*

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