This course traces the evolution of the U.S. health care delivery system over the last century with a focus on the structure and function of the contemporary managed care system. The course examines a wide range of factors (sociocultural, political, economic, legal and technical) which have impacted the evolution of the current system. Economic factors related to the delivery of health care services are extensively covered. Comparative health care systems are examined. The impact of the changing demographics of the U.S. population on the design and delivery of health care is reviewed.

This course is designed for health care managers who do not have a background in financial management. As an introduction to the tools and processes that empower managers entrusted with budgetary oversight, the course provides fundamental skills for effective financial management in the rapidly changing health care environment. Students become prepared to make their organizations more effective in the four managerial functions of planning, organizing, leading and controlling by balancing inflows (revenues) and outflows (expenses), successfully monitoring and controlling costs and staffing, and identifying areas to be targeted for improvement. Strategies to acquire and allocate funds and to plan, analyze, and control financial operations are introduced.

This course analyzes various methods of health care financing, including Medicare/Medicaid, private insurance (including HMOs), and self-funding. It then discusses the various methodologies for reimbursement under these programs, including fee-for-service, capitation, and DRGs, and their impact on the health care organizations providing the services. Students will analyze how budgets, expenses, and financial statements, etc., are linked to the reimbursement process, and they will examine the role of the non-financial manager in health and human services in these processes.

This course provides students with legal and ethical frameworks for working through increasingly complex issues that affect health and human services delivery from the standpoint of the individual, the public, and the system of providers. Through an overview of current law, regulation, standards of ethics, and moral theory, students will evaluate pervasive issues and dilemmas present in their field of study. This course incorporates case studies with philosophical and theoretical analysis to equip students with nuanced perspectives regarding the ethical, legal, and health policy challenges facing society.