REUBIN O'D. ASKEW SCHOOL OF PUBLIC ADMINISTRATION AND POLICY

COLLEGE OF SOCIAL SCIENCE

FLORIDA STATE UNIVERSITY

Health Care Finance     Dr. Thomas (Tim) Lynch
PAD 5935-70 (3 hours)     Director, Center for Economic Forecasting and Analysis
Fall, 1997     lynch@cefa.fsu.edu
Gus Turnbull Conference Center     2035 E. Paul Dirac Dr., Suite 137, Morgan Bldg.
7:00 pm to 9:45 pm     Innovation Park, Tallahassee, FL. 32310
      phone (w)644-7357 (h)422-2487

Course Syllabus in Adobe PDF format

Overview

Primary Operative Condition - We are all going to learn a lot and ave fun doing it !!!

This course has 2 principal goals:

This course will provide students with both a macro overview of the principal financial mechanisms in place across the U.S. health care industry and specific insights into the critical issues the industry currently faces. Additionally the course will emphasize the development of practical financial analysis skills that will provide students with a foundation for immediate application within the health care industry and a better understanding of course materials as presented. Training in use of these tools will include use of several of the most important financial tools and methodologies employed across the health care industry such as benefit/cost and cost effectiveness analysis, ratio analysis and others.

Course Requirements

This class is intended as an interactive dialogue and not a monotone 3 hour diatribe where the professor summarizes all materials students are assigned to review and are intelligent enough to understand. The students are full partners in this class and are expected to participate fully in dialogue, policy analysis, raise key issues and questions, share personal experiences, and challenge assumptions. Students are expected to add creatively to assigned materials and share their insights and generally enable a rich two-way flow of ideas during class. The class will require all students to attend and participate in all class sessions, complete all readings and homework assignments and complete course exams. Students will also participate in a team case study evaluation of a current health care finance issue. Students will critique and analyze a current health care finance issue using the tools acquired in class and from their own experiences. They will then develop and present their financial analysis and final recommended solutions with copies for all members of class to share and evaluate, based on the materials covered in class. Class teams (composed of four or five members ) and issues will either be voluntarily developed by class members or will be assigned.

Course Grading

The course final grade will be based on three factors: 1. Participation in class 20%
2. Midterm and Final Exams 40%
3. Team health care finance research project 40%

Text and Readings

Health Care Finance: Economic Incentives and Productivity Enhancement, Eastaugh, S.R. (1992) New York: Auburn House (ISBN 0-86569-049-9)

Financial Analysis and Decision Making for Healthcare Organizations - A Guide for the Healthcare Professional , Gapenski, Louis C.,(1996), Healthcare Financial Management Association, Irwin Professional Publishing, McGraw Hill Companies

FHA Eye on the Market - Healthcare in the Sunshine State, 1996, Florida Hospital Association (FHA), Post Office Box 531107 (Target) (Chapters are not numbered in this report but are numbered in the readings in order for convenience)

Facts and Trends - The Nursing Facility Sourcebook- 1996, AHCA, American Health Care Association (AHCA)- (Target)

Nursing Home Reporting System, 1994 Annual Report, Agency for Health Care Administration, Tallahassee, Florida, December 1994, (Target)

Florida Medicaid - Summary of Services Fiscal Year - Fiscal Year 1996-97, Striving for Excellence in Health Care, Agency for Health Care Administration, October 1996 (Target)

Goldfield, N., Boland, P., (1996) Physician Profiling and Risk Adjustment, Chapter 11, Public Disclosure: A State Agency Response, Lynch, T.A., et al. (Target)

Lynch, T. Measuring and Assessing Quality Health Care Service Delivery in Florida, Florida Data Review, July-September, 1994, Agency for Health Care Administration, State of Florida

Estimating Tobacco-Related Health-Care and Mortality Costs in Florida, Journal of the Florida Medical Association, February 1996, Volume 83. No.2

Other Class materials as provided by the instructor or guest lecturers

August 27 Orientation to the Course and Eastaugh, Managerial Concerns for Payers and Providers-Hospitals Financial Issues Chapters 1 Payment Incentives, Provider Behavior and the Need for Better Cost Management and FHA, Chapter 1 Assumptions p 1-28 and Chapter 15 Common Health Care Terms, pp 243-256
August 27 Chapter 2 Hospital Accounting, Purchasing and Product Specialization - Florida's Hospital Financial Reporting Systemand Chapter 6 Hospitals pp. 67-94, and introduction to Financial ratios analysis. Gapenski, pp.17-27.
September 10 Conclusion of Hospital Finance issues. Cleverley's Ratios and Florida Hospital Financial Profiling. Presentation by Mr. Roger Bell, Hospital Budget Review Section, Agency for Health Care Administration.Options beginning of Eastaugh
September 17 Chapter 3- HMOs, PPOs and Competition Health Plans. Begin, FHA Chapter 3 pp.34-49, Florida's HMO data bases and trends
September 24 Completion of Eastaugh, Chapter 3- HMOs, PPOs and Competition Health Plans. Speaker Florida HMO Financial Trends-Speaker, Ms. Joyce Bohl- Department of Insurance- Life and Health Accuracy- Bureau of Life and Health Forms and Rates - Division of Insurer Services and/or AHCA Medicaid and Non-Medicaid HMOs)
October 1 Chapter 4 Long Term Care: Issues and Options Issues. AHCA Nursing Home Financial Data Bases and Nursing Home Reporting System, 1994 Annual Report pp.1-24, Mr. James Tillery, Florida nursing home and long term care financing issues
October 8 Midterm exam
October 15 Conclusions of Chapter 4 and Long Term Care: Issues and Options Issues. Guest speakers Mr. James Tillery, Florida nursing home and long term care financing issues. , Mr. John Owens, Medicaid nursing home rate setting, and Chapter 5, Diversification for the Single Hospital and Chapter 6, Marketing, Pricing and Specialization
October 22 Public Finance of Health Care, Medicaid and Medicare in Florida. FHA Ch 4. Medicare pp.49-56, Ch.5. Medicaid pp. 57-66, Florida Medicaid Summary of Services 1996-97, pp. 1-10, Medicaid Program Speaker (TBA)
October 29 The Finances of the Doctor, Eastaugh Chapter 7- Paying the Doctor, Chapter 8. Graduate Medical Education, and the Teaching Hospital, FHA, Chapter 7 - The Physician
November 5 Benefit/cost and cost effectiveness analysis in health care financial analysis, Gapenski, Chapter 4 Discounted Cash Flow (DCF) Analysis, pp109-141 (don't panic - we will cover basic math concepts in this section and you too will get it as all of my previous students have!!)
November 12 Conclusion of Benefit/Cost Analysis and cost effectiveness analysis in health care financial analysis and Eastaugh, Chapter 9, Hospital diversification for the Single Hospital
November 19 Chapter 11, Quality Measurement, Value Shopping and the Deeming Method, Eastaugh, Chapter 12, Tax-Exempt and For Profit Multihospital Systems, Lynch, T. Measuring and Assessing Quality Health Care Service Delivery in Florida, Florida Data Review
November 26 Class Team Presentations
December 3 Class Team Presentations
December 10 Final Exam