Week of June 6 – 10, 2016

HEALTH POLICY RESEARCH REPORTS AND KEY TAKEAWAYS

Health Care IT, Leadership and Management 
Located in the east San Francisco Bay area, Contra Costa County has a population of approximately 1 million.  But the same data shows that while the median household income is $78,187, the per capita income is $38,106.  How one health system addressed 2,000 patients’ social needs in 2 years.

How can health care organizations sustain improvements in safety, effectiveness, and efficiency of patient care? According to the new IHI White Paper, Sustaining Improvement, the key is to focus on the daily work of frontline managers, supported by a high-performance management system that prescribes standard tasks and responsibilities for managers at all levels of the organization.  Sustaining Improvement,

The goal of this article is to provide an overview of the use of health IT in behavioral health and to describe some unique challenges experienced in that domain.  Behavioral Health Information Technology: From Chaos to Clarity (abstract),

We are in the Age of Authenticity, where “be yourself” is the defining advice in life, love and career.  But for most people, “be yourself” is actually terrible advice.  Unless You’re Oprah, ‘Be Yourself’ Is Terrible Advice,

Effective CEOs must be more than just friendly, according to this HBR article; they must be highly decisive, as CEOs with that trait are 12 times more likely to get strong performance scores from their respective boards.  HBR, The Dangers of Hiring a Nice CEO,

ACA Implementation
In this column for WSJ Think Tank, Drew Altman discusses Republican and Democratic health reform objectives, and why GOP proposals and the Affordable Care Act are better understood as policies with very different goals, trade-offs and consequences.  The Fundamentally Different Goals of the Affordable Care Act and Republican ‘Replacement’ Plans,

In a new Commonwealth Fund issue brief, Sherry Glied of NYU and Adam Striar of Manatt Health Solutions report that the Cadillac tax will likely be more progressive than prior analyses have suggested, while reducing total health spending only modestly.  Looking Under the Hood of the Cadillac Tax,

CMS released a final rule Monday that aims to strengthen incentives for ACOs in the Medicare Shared Savings Program.  Acting Administrator Andy Slavitt said they will “encourage more physicians to improve patient care by joining ACOs, while also refining how the program measures success, so that current participants are better rewarded for quality.”  CMS issues final rule for Medicare Shared Savings Program ACOs: 5 takeaways,

Sixty-one percent of people who have used health insurance obtained through the Affordable Care Act (ACA) are getting care they previously could not access or afford, according to new Commonwealth Fund survey findings.  Americans’ Experiences with ACA Marketplace and Medicaid Coverage: Access to Care and Satisfaction,

Residents of Medicaid expansion states are more likely to have insurance and thus more likely to have a usual source of care; they are less likely to have unmet health care needs or problems paying medical bills. But there are further benefits of Medicaid expansion.  Beyond the Reduction in Uncompensated Care: Medicaid Expansion Is Having a Positive Impact on Safety Net Hospitals and Clinics,

Short term insurance policies, which do not qualify as coverage under the Affordable Care Act and put consumers at risk of a tax penalty, can siphon healthy people away from the online marketplaces because they are generally less expensive.  HHS Announces Plans To Curtail Consumers’ Use Of Short-Term Insurance Policies,

Many states are using Section 1115 waivers to expand eligibility for Medicaid.  Wisconsin’s 2014 BadgerCare demonstration is testing the effect of reducing, rather than expanding, eligibility.  Wisconsin’s waiver, approved by CMS, lowers Medicaid income cutoffs and moves some beneficiaries into the marketplace. Wisconsin’s 1115 Medicaid Demonstration: What Will Policymakers Learn?

ELSEWHERE IN THE NEWS

A new study out in Scientific Reports finds that more and more young people have early stage ear damage. Hearing tests run on 170 students between ages 11 and 17 found that nearly 25 percent have persistent tinnitus, or a buzzing or ringing in the ears.  Scientific Reports,  

Crispr describes a series of DNA sequences discovered in microbes, part of a system to defend against attacking viruses. Microbes make thousands of forms of Crispr, most of which are just starting to be investigated by scientists. If they can be harnessed, some may bring changes to medicine that we can barely imagine.  NY Times,

In the United States, the transition from volume to value dominates discussions of health care reform. While shared decision making might help patients determine whether to get care, transparency in procedure- and hospital-specific value measures would help them determine where to get care.  Milbank Quarterly,

There is another story about prescription drugs that should get attention. It doesn’t involve a sleazy entrepreneur or a breakthrough drug that costs more than a luxury car. It is not even a new story.  Milbank Quarterly,

Despite opposition from the pharmaceutical industry, Vermont late last week became the first state in the country to require drug makers to justify price hikes for medicines.  STAT,

Drug monitoring databases show promise in curbing certain opioid prescriptions. States that launched a monitoring program saw a 30 percent drop in the rate of Schedule II opioid prescriptions in the next decade, according to a new analysis of 24 states published in Health Affairs.  Health Affairs (abstract),

Some type 2 diabetic patients are being overtreated, and that might actually be increasing their risk of dangerously low blood sugar, finds new research in JAMA Internal Medicine.

In “How Doctors Die,” a powerful essay that went viral in 2011, a physician described how his colleagues meet the end: They go gently. A new study reveals a sobering truth: Doctors die just like the rest of us.  Journal of the American Geriatrics Society,

In an effort to get or keep a good performance rating from the federal government, transplant centers have been labeling some patients “too sick to transplant” and dropping from the waitlist some who may been viable candidates, the researchers found.  Journal of the American College of Surgeons (abstract),

Latinos who’ve recently arrived in the U.S. often have poor access to health care, mental health treatment in particular. UNC Charlotte is among several universities trying to change that.  Kaiser,

The FDA said Monday that over-the-counter antacid products, commonly taken for heartburn and upset stomach, that contain aspirin can cause “serious bleeding.” The Charlotte Observer,

Vice President Biden on Monday announced the launch of a first-of-its kind, open-access cancer database to allow researchers to better understand the disease and develop more effective treatments. The Genomic Data Commons, a part of the National Cancer Institute, contains the raw genomic and clinical data for 12,000 patients.  The Washington Post,

Citing misrepresentations and broken promises, the New York State attorney general’s office is seeking to prevent the purchase of two nursing centers by a company that was involved in transactions that put a Manhattan nursing home in the hands of luxury condominium developers.  NY Times,  

One of the most successful research enterprises funded by the NIH, the Clinical Research Center (CRC) program, is dying, its highly productive life cut short with virtually no discussion in the scientific community.  Journal of Clinical Investigation, 

Many more babies die in the United States than you might think. In 2014, more than 23,000 infants died in their first year of life, or about six for every 1,000 born. According to the Centers for Disease Control and Prevention, 25 other industrialized nations do better than the United States at keeping babies alive.  NY Times,

Researchers found no improvement in 30-day mortality rates for several conditions after the data began appearing on CMS’s Hospital Compare website, according to a study published in the Annals in Internal Medicine (abstract).

A new guide is offering primary care practices practical guidance and a flexible framework to increase their ability to serve patients with depression, anxiety, and other common mental health issues.  United Hospital Fund,  

In this nationally representative survey of adults in the United States, the age-adjusted prevalence of obesity in 2013-2014 was 35.0% among men and 40.4% among women.  JAMA,  

This NAM workshop explored the intersection of health literacy and precision medicine through a number of topics, but its impetus was the Precision Medicine Initiative (PMI). The PMI is a multiyear effort launched in 2016, led by the White House to advance the practice of precision medicine.  Read the workshop brief,

The U.S. Food and Drug Administration finalized its efforts to streamline the process used by physicians to request expanded access, often called “compassionate use,” to investigational drugs and biologics for their patients.  FDA,

Early evidence suggests that the Affordable Care Act is working in one important respect, according to researchers at the Federal Reserve Bank of New York. Analysts found a big difference between indebtedness trends in states that embraced the Medicaid expansion versus the ones that did not. Bloomberg,  

British scientists announced that they developed a blood test that can accurately predict whether you’ll respond to the conventional, commonly prescribed antidepressants on the market.  International Journal of Neuropsychopharmacology

Microsoft scientists have demonstrated that by analyzing large samples of search engine queries they may in some cases be able to identify internet users who are suffering from pancreatic cancer, even before they have received a diagnosis of the disease.  NY Times,  

Stephen Klasko, MD, president and CEO of Thomas Jefferson University and Jefferson Health, wrote a new book, We Can Fix Healthcare Now.   Here are the 12 Disruptors outlined in the book.  Becker’s,

High-cost, high-need Medicare and Medicaid beneficiaries face a host of challenges when interacting with the healthcare system, but certain policy changes could improve care for these patients, according to a new fact sheet from the National Coalition on Health Care (NCHC).   

There are more than 500 quality measures related to behavioral health, but only 5 percent are used in quality-reporting programs. This study provides an overview of current measures of behavioral health, identifies priorities for measure development, and outlines the most significant challenges.  Commonwealth Fund and Health Affairs,

The idea is to create implants the size of a grain of rice, or even smaller, that can be bolted directly onto nerves to treat diseases, augmenting or replacing drugs.  the project is a long-odds bet that Glaxo is virtually alone in making among its Big Pharma peers. It has started a $50 million venture fund for bioelectronics.  Bloomberg,  

Rates of syphilis have trended steadily upward since 2000, and the CDC’s syphilis elimination efforts officially ended as of December 2013.  JAMA,

The battle to contain and ultimately defeat the Ebola epidemic of 2014–2015 has been vividly described. Yet more than 11,000 people died, and local economies were brought to a halt. The battle was won, but at immense cost,  NEJM Perspective,

The U.S. Food and Drug Administration said on Thursday it, along with international authorities, has formally sought to suspend 4,402 websites that illegally sell potentially dangerous, counterfeit or unapproved prescription drugs to U.S. consumers.  Reuters,

Much uncertainty remains about how best to collect and utilize patient data and perspective in ways that satisfy the needs of all the parties involved. But many influential entities have made patient engagement part of their culture in an effort to fundamentally improve the R&D process. Science Translational Medicine,

Week of June 13-17, 2016

HEALTH POLICY RESEARCH REPORTS AND KEY TAKEAWAYS

Health Care Leadership, Management and HIT
Although Ernest Shackleton’s Endurance Antarctic expedition of 1914 to 1916 is a famous epic of survival, the medical achievements of the two expedition doctors have received little formal examination.  Of Penguins, Pinnipeds, and Poisons: Anesthesia on Elephant Island, 

If the past five years of health IT can be characterized by government intervention, the next five will be characterized by innovation from the private sector. This is the prediction of John Halamka, MD, CIO of Beth Israel Deaconess Medical Center, The Five Year Plan, 

In April 2015, the IOM convened a workshop to identify how modeling could inform population health decision making based on lessons learned from models that have been, or have not been, used successfully, opportunities and barriers to incorporating models into decision making, and data needs and opportunities to leverage existing data and to collect new data for modeling. How Modeling Can Inform Strategies to Improve Population Health: Workshop Summary,  

Workers should complete the tasks that require deep focus during the hours when physical and cognitive capabilities reach their peak, Ron Friedman writes in the Harvard Business Review.  When to Schedule Your Most Important Work,  

What many leaders may not recognize is that we often need to give something up — a belief, attitude or behavior — in order to achieve a new level of performance. How is this done effectively?  To Win the Civil War, Lincoln Had to Change His Leadership,
 
Healthcare leaders today are expected to have the skills to create both short- and long-term strategies that anticipate and respond to the rapidly changing health care environment.  Leadership: Translating Challenge to Success, NEJM Catalyst June 2, 2016 Conference Speaker presentations,  

A study in the Journal of Medical Internet Research sought to understand millennial physicians’ perceptions about social media and professionalism, as well as determine the effects social media policy training may have on the new generation of healthcare professionals.   Millennial physicians have ‘casual approach’ to social media, 

ACA Implementation
In this second edition of our quarterly survey of the NEJM Catalyst Insights Council for the New Marketplace initiative, we posed questions designed to gauge the pace of adoption of value-based payment models, and to unpack the motivation underlying the recent consolidation wave among health care providers.  Read the survey results,

California Governor Jerry Brown signed a bill into law allowing unauthorized immigrants to buy health insurance on a state exchange created under the U.S. Affordable Care Act.  California Governor Signs Bill Letting Undocumented Immigrants Buy Insurance, 

Maryland’s health cooperative filed a lawsuit Monday seeking to block the federal government from requiring it to pay more than $22 million in fees for a program designed to cover insurance company shortfalls.  Maryland health co-op sues over ‘flawed’ Obamacare requirement,  

A Kaiser Family Foundation analysis of ACA proposed marketplace rates finds benchmark silver plan premiums are projected to increase 10 percent in 2017 on average across 14 major metropolitan areas.  Early Analysis of 14 Major Cities Finds Benchmark Silver Plan Premiums in ACA Marketplaces Estimated to Rise 10 Percent on Average in 2017,  

A new report examines what quality measures to consider when setting up value-based payment arrangements that focus on improving children’s health.  The report looks at recent examples from other states, and presents four central lessons for New York as it sets up quality measures for value-based payment for children.  You Get What You Pay for: Measuring Quality in Value-Based Payment for Children’s Health Care,

ELSEWHERE IN THE NEWS

A federal judge has paved the way for Advocate Health Care and NorthShore University HealthSystem to merge and create the dominant hospital network in Illinois, a huge blow to federal antitrust regulators.  Crain’s Chicago, 

In the wake of the mass shooting in an Orlando LGBT nightclub Sunday, White House officials waived patient privacy protections to make it easier on hospitals to communicate with families of victims without getting the patient’s consent first. HHS, 

As health care consolidation accelerates nationwide, a new study shows that hospital prices in two of California’s largest health systems were 25 percent higher than at other hospitals around the state.  Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems,Inquiry,
  
Scattered E.R.s around the country have been working to reduce opioids as a first-line treatment, but St. Joe’s, as it is known locally, has taken the efforts to a new level.  NY Times,

In U.S. drinking water, many chemicals are regulated — but many aren’t.  Washington Post, 

New York Mayor Bill de Blasio and the City Council agreed on an $82.1 billion budget for fiscal year 2017, and the biggest new spending item is a $700 million funding boost for the city’s public hospital system.  Bloomberg,  

The Puerto Rican fiscal crisis has resulted in limited access to basic health services, an overwhelming tax burden, and widespread migration from the Island. An often unnamed contributor to the crisis is federal policy that limits Medicaid funding for the U.S. territories. Health Affairs Blog, 

The US Department of Health and Human Services and the Cuban government on Monday signed a memorandum of understanding to encourage cooperation between the two countries on health matters.  STAT,  

Location was everything when it came to treating the victims from the Pulse nightclub mass shooting.  This tragedy happened within two blocks of one of the country’s top Level 1 trauma centers, Orlando Regional Medical Center.  Orlando Sentinel,

UNOS announces technology changes to increase organ donations in U.S.  Richmond Times Dispatch, 

New York is poised to expand access to breast cancer screening under an agreement reached by top state lawmakers and Democratic Gov. Andrew Cuomo.  Under the deal, the state would order hospitals to expand hours when mammograms are offered and require insurance companies to eliminate deductibles and co-pays for the screening and some other diagnostic tests.  Washington Post,

The vast majority of hospitals need to redefine themselves from organizations that deliver care to organizations that orchestrate care.  The folks at New York-based Mount Sinai seem to get it. Last year, readers of The New York Times were treated to a Mount Sinai marketing campaign headline that read, “If our beds are filled, it means we’ve failed.”  Becker’s, 

Some studies indicate larger integrated health care systems are more likely to use evidence-based care and manage chronic conditions.  But integrated delivery systems in and of themselves may not improve outcomes.  NY Times, The Upshot,  

A new toolkit to improve the quality of care offers practical approaches and tools for home care professionals and hospital acute care providers to systematically assess the risks for and reduce the incidence of central line–associated bloodstream infections in patients receiving home health care services.  United Hospital Fund, 

Dialysis is a big, profitable, and growing business in the United States. Outcomes trail those of other countries, however.  NEJM Catalyst, 

It should come as no surprise that per-capita spending on prescription drugs grew to $9,523 in 2014 and is projected to grow by 6.3% annually through 2024, far outpacing inflation and total health expenditures nationally.  One widely discussed idea is whether to tie the price of drugs to their actual value to patients. NEJM Catalyst, 

The 1999 publication of To Err Is Human from the IOM focused attention on the need to improve the safety of medical care and spurred a variety of public and private responses. Despite this attention, progress in reducing patient harms in hospitals has been slow.  It is now clear, however, that over the past few years hospitals have made substantial progress in reducing harms.  JAMA,

In its June report to Congress, the Medicare Payment Advisory Commission warned that rising drug costs and other factors have helped drive Medicare Part D spending up nearly 60 percent from 2007 to 2014.  Kaiser,  

Many people admitted to a hospital do not go home directly after discharge; they are referred to an inpatient setting for rehabilitation (rehab services). This can be a confusing transition, and it’s one that is now addressed in a revised Next Step in Care guide for family caregivers: Short-term Rehab Services in an Inpatient Setting. United Hospital Fund,  

The 4-year, multipayer Comprehensive Primary Care Initiative was started in October 2012 to determine whether several forms of support would improve the quality and reduce the costs of care at 497 primary care practices in 7 regions across the US.  These practices have not yet shown savings in expenditures for Medicare Parts A and B after accounting for care-management fees, nor have they shown an appreciable improvement in the quality of care or patient experience.  NEJM,

The National Academies of Sciences, Engineering, and Medicine convened a committee to recommend ways to ensure that lessons learned from the military’s experiences in Afghanistan and Iraq are sustained and built on for future combat operations–and that they are translated into the civilian system.  Read the report brief,  

The Supreme Court on Thursday issued a unanimous ruling that could affect fraud charges brought against health care providers under the False Claims Act (FCA).  Boston Globe,

The following was delivered as the commencement address at the California Institute of Technology, on Friday, June 10th by Atul Gawande.  The New Yorker,

Faculty and Staff

The faculty of the Health Care Delivery Leadership program includes some of the best in the industry as well as health care thought leaders. Learn more about our faculty below.

Alan J. Moskowitz, MD
Faculty Director, MS in Health Care Delivery Leadership Program
Professor and Vice Chair, Dept. of Population Health Science and Policy

Robert Albright, PhD
Professor of Practice, Lally School of Management, Rensselaer Polytechnic Institute

Lawrence D. Brown, PhD
Adjunct Professor, Dept. of Population Health Science and Policy
Professor of Population Health Science and Policy and Management, Columbia University Mailman School of Public Health

Bruce Darrow, MD, PhD
Vice President of Information Technology and Chief Medical Information Officer, Mount Sinai Health System; Associate Professor of Medicine, Cardiology

Ashley Fox, PhD
Assistant Professor, Dept. of Population Health Science and Policy

Arthur A. Gianelli, MBA, MPH
President, Mount Sinai St. Luke’s

Elizabeth Howell, MD, MPP
Associate Professor, Dept. of Population Health Science and Policy
Associate Professor, Dept. of Obstetrics, Gynecology and Reproductive Science
Associate Professor, Dept. of Psychiatry

Harold S. Kaplan, MD
Senior Faculty, Dept. of Population Health Science and Policy

Madhu Mazumdar, PhD
Senior Faculty, Dept. of Population Health Science and Policy

Brian J. Nickerson, PhD
Senior Faculty, Dept. of Population Health Science and Policy

Norma Padron, PhD
Research Scientist, Center for Health Innovation, the New York Academy of Medicine

José A. Pagán, PhD
Director, Center for Health Innovation, the New York Academy of Medicine

Michael Pugh
Senior Faculty, Institute for Healthcare Improvement

Alexander Preker, MD, PhD
President and CEO, Health Investment & Financing Corporation
Visiting Professor of Economics
Former Chief Economist for Health and Head of Health Systems Development, World Bank

Additional Course Presenters

Our course presenters include colleagues from throughout Mount Sinai and other health care experts from various disciplines.

Kenneth L. Davis, MD
President and Chief Executive Officer, Mount Sinai Health System
Professor of Psychiatry
Professor of Pharmacology and Systems Therapeutics

Dennis S. Charney, MD
Anne and Joel Ehrenkranz Dean, the Icahn School of Medicine at Mount Sinai
President for Academic Affairs, Mount Sinai Health System

Annetine Gelijns, PhD, LLM
Edmond A. Guggenheim Professor of Population Health Science and Policy and Chair, Dept. of Population Health Science and Policy

Richard Amiraian, MD
CEO, Primary Care Institute, Mount Sinai Health System

Jeffrey Farber, MD, MBA
CEO, Mount Sinai Care LLC, Icahn School of Medicine at Mount Sinai

David Reich, MD
President, the Mount Sinai Hospital

Michael Schaffer
Senior Associate Dean for Clinical Affairs
Executive Director and Chief Operating Officer, Mount Sinai Doctors Faculty Practice
Senior Vice President, Ambulatory Care for the Mount Sinai Health System

Strategic Communications in Health Care Delivery

John Ambrose
Director, Genetics and Genomic Sciences

Brad Beckstrom
Director of Community Affairs, the Mount Sinai Hospital

Ron Cappello
Founder & CEO, Infinia Group & Rocketure

Marcia Horowitz
Senior Executive Vice President at Rubenstein Associates

Dorie Klissas
VP, Marketing & Communications, Associate Dean, Mount Sinai Health System

Bob Loughhead
Principal, Implementation at Infinia Group

Emma Palmer
Vice President of Government Affairs and Public Policy, Mount Sinai Health System

Deborah Raskin
Executive Vice President, Rubenstein Communications

Karsten Risch, MD, PhD, MPH
Chief Medical Officer, Havas Health

Francoise Simon, PhD,  MBA
President of SDC Consulting and Professor of Marketing at Columbia University

Robin Verges
Senior Vice President at Rubenstein Associates

Leading and Managing Health Care Delivery Organizations

Frank Irr
Senior Partner, AIM Consulting Associates

Leveraging Data for Evidence-Based Decision-Making in Health

Natalia Egorova, PhD, MPH
Assistant Professor, Mount Sinai Medical Center

Steve Ellis
Senior Director, Informatics & IT, Institute for Personalized Medicine, Mount Sinai School of Medicine

Bart Ferket, MD, PhD
Assistant Professor, Mount Sinai Medical Center

Umut Ozbek, PhD
Assistant Professor, Mount Sinai Medical Center

Rehana Rasul
Biostatistician, Mount Sinai Medical Center

Doran Ricks
Director, Decision Support, Mount Sinai Health System

Health Information Systems and Technology

Kaylan Baban, MD, MPH
Chief Resident Physician and Course Director, Icahn School of Medicine at Mount Sinai

Adel Bassily-Marcus, MD
Associate Professor, Icahn School of Medicine at Mount Sinai

Kevin Baumlin, MD
Associate Medical Information Officer, Vice Chair and Associate Professor, Icahn School of Medicine at Mount Sinai

Laurie Anne Buckenberger
AVP Corporate IT, Mount Sinai Health System

Heather Chamides
Director HIPAA Compliance, Icahn School of Medicine at Mount Sinai

Kevin Chason, MD
Director, Emergency Management and Pre-Hospital Care, Mount Sinai Medical Center

Kumar Chatani, MBA
Executive Vice President and Chief Information Officer, Mount Sinai Health System

Kenny Chu, JD
Sr. Director, IT Security, the Mount Sinai Medical Center

Mary Joy Dia, PhD
Director, Clinical Applications, Information Technology, Mount Sinai Health System

Paul Francaviglia
Associate Director, IT, Mount Sinai Health System

Robbie Freeman, MSN, RN, NE-BC
Assistant Director, Nursing Quality Initiatives, Mount Sinai Beth Israel

Nick Genes, MD, PhD
Emergency Medicine Informatics Research, Mount Sinai Health System

Matthew Grob, CPHIMS, FHIMSS
Senior Director, Enterprise IT Planning, Mount Sinai Health System

Joseph Kannry, MD
Lead Technical Informaticist, EMR Clinical Transformation Project, Mount Sinai Health System

Avniel Shetreat-Klein, MD, PhD
Associate Chief Medical Information Officer, Mount Sinai Health System

Jason Martin
Senior Director of Operational and Integration Applications, Mount Sinai Health System

Kash Patel
Senior Director, Innovations & Analytics, Mount Sinai Health System

David Reich, MD
President, the Mount Sinai Hospital

Jason Shapiro, MD
Associate Professor, Emergency Medicine, the Mount Sinai Medical Center

Pattie Spuma
Nurse Manager, Mount Sinai Beth Israel

Barbara Straub,RN
Nurse Informaticist, New York Eye and Ear Infirmary of Mount Sinai

Sudipto Srivastava, MBA
Senior Director – eHealth, the Mount Sinai Health System

Fred Thum, MD, FACEP
Assistant Professor and Informatics Fellow, Icahn School of Medicine at Mount Sinai

Gateway (Introductory) Seminar Participants

Peter Orszag, PhD
Vice Chairman; Chairman—Public Sector; and Chairman, Financial Strategies and Solutions, Citigroup; and member, Boards of Trustees, Mount Sinai Health System

Christopher F. Koller
President, Milbank Memorial Fund and former Health Insurance Commissioner of Rhode Island

Jo Ivey Boufford, MD
President, the New York Academy of Medicine

Arthur Klein, MD
President, the Mount Sinai Health Network

Arthur A. Gianelli, MBA, MPH
President, Mount Sinai St. Luke’s

Kathleen Shure, MPA
Senior Vice President of Managed Care and Insurance Expansion for the Greater New York Hospital Association (GNYHA)

Murray N. Ross, PhD
Vice President, Kaiser Foundation Health Plan, Inc. and Director, Kaiser Permanente Institute for Health Policy

John McDonough, DrPH, MPA
Professor of Public Health Practice, Department of Health Policy & Management, Harvard School of Public Health (HSPH) and Director of the HSPH Center for Executive and Continuing Professional Education

Michael S. Sparer, PhD, JD
Chair, Health Policy & Management and Professor of Health Policy and Management, Columbia University Mailman School of Public Health

Pierre-Gerlier Forest, PhD
Director of the Institute for Health and Social Policy, Johns Hopkins Bloomberg School of Public Health

Miriam J. Laugesen, PhD
Assistant Professor of Health Policy and Management,  Faculty Lead, Mailman Health Policy Certificate Programs of Health Policy and Management,  Columbia University Mailman School of Public Health

Staff

Brian J. Nickerson, PhD
Administrative Director, MS in Health Care Delivery Leadership Program
Professor, Dept. of Population Health Science and Policy

Herb Lopez
Administrative Coordinator
Dept. of Population Health Science and Policy

Mariana Bernstein
Senior Instructional Technologist

Molly Zitouni
Business Coordinator
Dept. of Population Health Science and Policy

Advisory Council

Jeremy Boal, MD
Chief Medical Officer, Mount Sinai Health System

Frank Cino, MPH, CPA
Senior Vice President, Finance, Icahn School of Medicine at Mount Sinai

Beth Essig, JD
General Counsel, Mount Sinai Health System

Eric Genden, MD
Professor & Chair, Otolaryngology; Professor, Neurosurgery

Paul Lawrence
Associate Dean of Academic Technology/Vice President, Academic Informatics & Technology

David Reich, MD
President, The Mount Sinai Hospital

Michael Schaffer
Senior Associate Dean for Clinical Affairs
Executive Director and Chief Operating Officer, Mount Sinai Doctors Faculty Practice
Senior Vice President, Ambulatory Care for the Mount Sinai Health System

Maria L. Vezina
Vice-President, Chief Nursing Officer, Mount Sinai St. Luke’s

Ex Officio

Annetine Gelijns, PhD, Chair, Department of Population Health Science and Policy

Alan Moskowitz, MD, Vice Chair, Department of Population Health Science and Policy

Brian J. Nickerson, PhD, Administrative Director

Herb Lopez, Administrative Coordinator

Course Schedule

The Master of Science in Health Care Delivery Leadership program at the Icahn School of Medicine at Mount Sinai offers many thought-provoking and skill building courses. Please see below for the 2015-2016 course schedule. Learn more about specific courses.

Course Schedule Cohort 2016

Here is the course schedule for those who will graduate in 2016.

Fall 2015

Course Number Course Title Start-End Date
HCD 0810 Leveraging Data for Evidence-Based Decision-Making in Health Care Section II 7/5/2015 – 7/25/2015
HCD 0602 Seminar 2 – Improved Health Care Delivery Effectiveness and Quality: Systems, Approaches, Tools* 7/27/2015 – 7/31/2015
HCD 0820 Health Information Systems and Technology 8/2/2015 – 9/26/2015
HCD 0830 Finance Essentials for Health Care Delivery Leadership 9/27/2015 – 11/14/2015
HCD 0840 Operations Management in Health Care Delivery Section I 11/15/2015 – 12/12/2015

*One week on-site residency session

Spring 2016

Course Number Course Title Start-End Date
HCD 0841 Operations Management in Health Care Delivery Section II 1/3/2016 – 1/23/2016
HCD 0850 Improving Population and Public Health Delivery 1/24/2016 – 3/12/2016
HCD 0860 Clinical Microsystems Innovations 3/13/2016 – 4/30/2016
HCD 0901 Capstone 5/01/2016 – 5/14/2016

Course Schedule for 2017 Cohort (Dates Subject to Change)

Here is the course schedule for those who will graduate in 2017.

Fall 2015

Course Number Course Title Start-End Date
HCD 0601 Gateway Seminar—Critical Themes for Health Care Delivery in the 21st Century* 8/24/15 – 8/28/15
HCD 0720 The Affordable Care Act 8/31/15 – 9/12/15
HCD 0721 Navigating Health Care Reform Policy and Politics 9/13/15 – 10/31/15
HCD 0730 Health Care Delivery Economics 11/1/15 – 12/19/15

*One week on-site residency session

Spring 2016

Course Number Course Title Start-End Date
HCD 0740 Strategy Creation for Health Care Delivery Organizations 1/3/16 – 2/20/16
HCD 0750 Strategic Communications for Health Care Delivery Organizations 3/8/16 – 4/16/16
HCD 0760 Leading and Managing Health Care Delivery Organizations 4/17/16 – 5/28/16
HCD 0770 Leveraging Data for Evidence-Based Decision-Making in Health Care Section I 6/5/16 – 7/1/16

Fall 2016

Course Number Course Title Start-End Date
HCD 0810 Leveraging Data for Evidence-Based Decision-Making in Health Care Section II 7/5/16 – 7/23/16
HCD 0602 Seminar 2 – Improved Health Care Delivery Effectiveness and Quality: Systems, Approaches, Tools* 7/25/16 – 7/30/16
HCD 0820 Health Information Systems and Technology 8/07/16 – 9/24/16
HCD 0830 Finance Essentials for Health Care Delivery Leadership 9/25/16 – 11/12/16
HCD 0840 Operations Management in Health Care Delivery Section I 11/13/16 – 12/17/16

Spring 2017

Course Number Course Title Start-End Date
HCD 0841 Operations Management in Health Care Delivery Section II 1/2/17 – 1/14/17
HCD 0850 Improving Population and Public Health Delivery  1/15/17 – 3/4/17
HCD 0860 Clinical Microsystems Innovations 3/5/17 – 4/22/17
HCD 0901 Capstone 4/23/17 – 5/6/17

 

 

Courses

As part of the Master of Science in Health Care Delivery Leadership program at the Icahn School of Medicine at Mount Sinai, we offer a number of classes designed to improve your critical thinking and health leadership skills.

Gateway Seminar: Critical Themes for Health Care Delivery in the 21st Century (one week on-site seminar session): HCD0601

This intensive gateway seminar introduces you to key program themes and course materials. It helps frame initial themes of the program content that will follow in the online portion of the experience. The seminar will allow for ample networking and collaborative opportunities among course colleagues, faculty, and prominent guest speakers. Key themes to be explored are: leading in a disrupted health care delivery sector, understanding broad system influencers, quality improvement and evidence-based decisions in health care delivery, reform basis of the Affordable Care Act, and managing critical urban health issues. There will also be a highly interactive session on personal leadership development.

The Affordable Care Act: HCD0720

This course begins with a review of the critical public policy issues facing the US health care system, followed by an examination of the formulation and implementation of the Patient Protection and Affordable Care Act of 2010 (ACA). The study of ACA formulation and implementation will address the intent and design of the law and then what the law demands in practice from the government.

Topics to be explored within ACA formulation and implementation are:

  • The individual mandate
  • Medicaid expansion
  • Subsidized exchanges
  • Insurance regulations
  • Cost containment

Navigating Health Care Reform Policy and Politics: HCD0721

For current and aspiring health care managers, this course seeks to illuminate central components of health care policy, a critically important area.  The course also  examines the political forces that have created the different types of public intervention that constitute current US health care policy. It explores how the government (especially the federal government) has influenced the voluntary and private institutions in the health care system, and how public policy intervention has built up steadily since World War II. You will gain a better understanding of the policy constraints and opportunities you confront in your work. You will gain a greater ability to position yourself and your organization to influence political dynamics and policy outcomes.

Health Care Delivery Economics: HCD0730

This course provides an overview of the economics of health care delivery for industry leaders. It begins with an in-depth analysis of the structure and dynamics of the US health care system and trends in health care expenditures. We address economic perspectives and theory related to the production of health care and the supply and demand of health care services, the health insurance market, the structure of health care systems and industries through the continuum of care (medical practices, hospitals, and post-acute care providers), and health care system reform.

Strategy Creation for Health Care Delivery Organizations: HCD0740

Designed for experienced managers in a health care or related organizations, this course is an opportunity to learn how to transform organizational knowledge into a strategic management system. We will examine the uses of external environmental analysis, organizational assessment, practical research, data collection and leadership principles as the basis for the creation of strategic management and leadership tools. We will focus on the analytical dimensions of strategic thinking and planning to ensure you are exposed to the technical and conceptual elements of strategy.

Strategic Communications for Health Care Delivery Organizations: HCD0750

Communications and marketing strategy must keep pace with rapid changes in the new health care landscape. Health care leaders and managers must understand the fundamentals of communications, marketing, and digital strategy to ensure effective delivery of health care services. The new competitive landscape requires focused attention on brand, perception of quality, and the ways to advance core functions in order for businesses to remain viable. Similarly, the use of digital and social media in personal, professional, and institutional marketing and branding are key drivers of leadership success. This course will explore these new realities and focus on critical topics.

Leading and Managing Health Care Delivery Organizations: HCD0760

This course is designed to increase the critical leadership competencies that are essential for the leaders of the most complex health care organizations. In order for  organizations to flourish in the current environment, leaders must be aware of their own idiosyncrasies, as well as their strengths, weaknesses, values, and ways they resolve conflicts.  They also must excel at building and leading teams, interdependent functions, and large scale systems. Successful leaders of tomorrow must be experts in change management, labor-management relations, and strategic organizational leadership. The course will enhance what you have learned from experience through frameworks and models that will prepare you to understand the relationship between senior leadership and the health care organization’s attainment of competitive advantage.

Using Data for Evidence-Based Decision Making in Health Care: HCD0770 & HCD0810

This course is designed to provide an understanding of the analytical methods health care managers and executives need to critically interpret the findings of comparative effectiveness studies and to use hospital-derived data for assessing and improving quality of care and process performance. The course structure contains four overarching topics:

  • Biostatistical and epidemiological methods for comparative effectiveness research
  • Statistical process control
  • The scope and limits of evidence-based medicine
  • Hospital-based and public sources of health care data

Through selected readings, case studies, problem-solving assignments, on-line self-study components, and lecture presentations and discussions, you will develop a conceptual understanding of the principles and analytical tools necessary to become a critical reader of health services research literature. This will enable you to identify and adopt best practices for your institution. Moreover, it will give you the analytical skills needed for guiding quality improvement projects effectively.

Seminar 2 – Improved Health Care Delivery Effectiveness and Quality: Systems, Approaches, Tools (one week on-site residency session): HCD0602

This intensive seminar focuses on the central elements that ensure quality throughout health care delivery systems and organizations. These elements include:

  • An examination of patient safety management
  • Quality improvement concepts and innovations
  • The clinical microsystems approach to value and quality improvement

The seminar will  allow course colleagues, faculty, and prominent guest speakers to network and collaborate. There will also be another interactive session on personal leadership development.

Health Information Systems and Technology: HCD0820

The health care field is one of the most information-intensive sectors in the US economy and avoidance of the rapid advances in information technology is no longer an option. Consequently, the study of health care information technology and systems has become central to health care delivery effectiveness. This course covers the modern application of information technology that is critical to supporting the vision and operational knowledge of health care leaders. Health care decision makers must meet head-on the dynamic challenges of health care delivery, quality, cost, access, and regulatory control. In addition, this course integrates the Healthcare Information System as integral to the Quality Assurance Tracking Programs. This includes measurement of systems inputs, processes, and outputs with special emphasis on systems outcomes research and organizational accountability to its various stakeholders, notably government regulators.

Finance Essentials for Health Care Delivery Leadership: HCD0830

This course provides an intensive examination of financial decision-making concepts and tools critical to ensuring accountable, effective, and efficient health care delivery. Topics will intersect the domains of resource allocation, managerial accounting, and corporate finance that are most relevant to health care delivery. No previous advanced knowledge of finance is required for the course. Course topics and materials are delivered from the standpoint of equipping you with critical frameworks to support leadership-level decisions involving finance or issues with critical financial dimensions.

Operations Management in Health Care Delivery: HCD0840

This course provides a solid foundation in the role of production and operations management in the health care industry. You will review the integration of human, economic and technological factors in accomplishing the operations management mission and executing the related strategies. Among the many important topics are: evidence-based medicine, balanced scorecard, statistics, forecasting, simulation, capacity planning, scheduling, location analysis for clinics, process strategy involving patient flow, supply chain management, project management, and quality control management. We will also examine the role of ethics within the framework of the operations management’s sub-functions.

Improving Population and Public Health Delivery: HCD0850

This course will enable you to probe the Public Health and Community/Population-Based Approach and address the core principles and functions of public health, including how this approach differs from acute care medicine, and how public functions are institutionalized in the US health care system. The course will focus upon arguments and evidence that the health status of populations is shaped not by medical care and health care policy but rather by basic social conditions that often correlate closely with class, race, and ethnicity. Interrelated topics include: status and stress; social isolation and community engagement; complex socio-clinical conditions (mental illness, HIV, substance abuse, homelessness); promotion of healthy behaviors; and the role of the ACA in advancing public health.

Clinical Microsystems Innovations: HCD0860

This course immerses you in best-in-class microsystems methods that organize front-line health care delivery to maximize quality, value, and flexibility for innovation. The Microsystem approaches provide defined processes and techniques which serve as an effective vehicle for implementing  organizational change at the point of care. The course will focus on planning processes, tools and techniques that can be applied immediately in clinical settings. Several Mount Sinai and other hospital-based clinical microsystem innovations will be examined as detailed case studies.

Capstone: HCD0901

You will have the opportunity to work on a project that directly addresses a strategic problem in your institution, or carefully examine one of a host institution. This action learning project will enable the application and integration of course material into a coherent response and potential solution(s) to an actual health care delivery issue. These projects will form a repository of knowledge that program cohort peers can use to learn from and share.

Frequently Asked Questions

What are you looking for in a student?

We require forward-thinking health care professionals who are seeking knowledge and skills to  provide strategic leadership and effective management within a rapidly changing health care sector.

How flexible is the program schedule?

The unique educational approach and online learning management system offers you flexibility in completing engaging course work at convenient times. We  also provide multiple opportunities for collaborative learning and networking with other program participants, faculty, and health care leaders.

The program involves, on average, 16 hours per week of time dedicated to fulfilling the requirements of the learning experience. Courses are sequenced in consecutive seven-week blocks with some brief breaks. There are two onsite residency seminar sessions: one at the beginning of the program and one that bridges into the second year.

When will the program start and how long will it take?

The program begins in late August with a required one-week on-site residency session at our main campus in New York. With the exception of a second on-site residency session the following summer and a three-week intensive online course on the Affordable Care Act, all other courses are seven weeks in length and delivered sequentially online. It will take students 21 months to complete all the requirements of the program.

Why should I consider Icahn School of Medicine at Mount Sinai as the educational institution to earn my degree?

This program is part of the Mount Sinai Health System, the most comprehensive system of unrivaled knowledge, resources, and leadership expertise in the New York metropolitan region. Mount Sinai has a trusted reputation for actually developing and implementing innovative practices in health care delivery which provides a unique basis for teaching and learning.

Can more than one person from an organization join the program?

Organizations benefit from sponsoring participants in the program by building deeper internal expertise to navigate the complexities of today’s health care landscape, reducing money spent on external consultants, and leveraging new opportunities.

Does Mount Sinai encourage enrollment in the program by individuals historically underrepresented in health care leadership?

The mission of our highly regarded Center for Multicultural and Community Affairs (CMCA) is to address health equity by focusing efforts on workforce diversity and facilitating policies and research to improve outcomes for minority and underserved communities. CMCA works with leadership through several formal executive level committees and councils to coordinate outreach, recruitment and retention activities. These efforts have helped sustain outstanding diversity of women and racial and ethnic minorities in the medical and graduate schools. For more information, visit their website.

Is financial aid available for the program?

Yes. Accepted applicants who are U.S. citizens or eligible residents and are interested in pursuing federal loans must submit the Free Application for Federal Student Aid (FAFSA). Students will be considered for the Federal Stafford Loan program. In addition, all students can consider a monthly payment plan option through our provider, Tuition Management Systems (TMS). Participants often receive tuition subsidization or time off from their employers to complete program work or the applied improvement project (capstone project).  The Program Director can provide additional information to support such requests.

Computer and Technical Requirements

Requirements

Students in the MS Program in Health Care Delivery Leadership are required to have a computer that meets the following specifications:

PC

Here are the requirements for PC computers:

  • Processor: Minimum Intel® Pentium® 4 ( we recommend later versions) 1.4GHz or faster for Microsoft® Windows® XP or Windows 7; 2GHz Pentium 4 (or equivalent) or faster processor for Windows Vista®
  • Operating System: Windows XP, Vista, or Windows 7 or 8 (or latest version)
  • Memory: 1GB RAM or higher recommended
  • Browser: Internet Explorer, Firefox or Chrome (latest editions)
  • Plug-ins: Adobe Flash Player 10.1 (or latest version)  and Adobe Reader (or latest version)

Mac

Here are the requirements for Mac computers:

  • Processor: 1.83GHz Intel Core™ Duo or faster processor
  • Operating System: Mac OS X, 10.5, 10.6, or 10.7.2 (Intel, or latest version)
  • Memory: 1GB recommended or higher
  • Browser: Firefox, Safari 4 or 5, or Chrome
  • Plug-ins: Adobe Flash Player 10.1 and Adobe Reader (latest versions)

Java Requirements

Here are the Java requirements:

  • PC: Windows XP, Vista, 7,8: 1.6, 1.7 (Java SE 6 & Java SE 7), Java Access Bridge 2.0.1
  • Mac: OS X: Apple Java 1.5.0_16 +(J2SE5-32 bit), Apple Java 1.6.0_07 +(J2SE6-64 bit), Oracle Java 1.7
  • Linux: 1.6, 1.7 (Java SE 6 & Java SE 7), 64 bit JVM’s with 64 bit Operating Systems Webcam and microphone
  • Webcam and microphone: If your PC doesn’t have a built-in webcam or microphone, we recommend you acquire Logitech HD Webcam C270 (PC Only) or USB Headset with Microphone (We recommend the Plantronics Audio 655)

Program Competencies and Expectations

Domain A: Personal Leadership Development

The program will enable you to:

  • Learn to build and manage team decision making
  • Update and improve project leadership skills
  • Lead change management processes
  • Manage conflict
  • Develop cultural competence to serve heterogeneous populations
  • Recognize and analyze the ethical dimensions that arise in the course of health care delivery

Domain B: Technical and Substantive Knowledge

The program will provide opportunities for you to learn how to:

  • Use financial information in strategic decision making
  • Navigate medical reimbursement and payment systems
  • Use economic analyses to understand major market influences and to find organizational cost effectiveness and efficiencies
  • Identify successful models of cost containment that enhance quality service delivery
  • Apply operations management tools/practices toward performance improvement and optimization
  • Apply basic tenets of human resource management to health care delivery problems
  • Appraise the use of evidence-based and leveraged translational science for decision making in health care delivery
  • Articulate the role of information systems and technologies in improving patient-centered health care delivery
  • Understand the content and likely implications of the Affordable Care Act and the nature of the regulatory system
  • Identify potential methods for managing patient growth under ACA
  • Analyze social and behavioral determinants of health
  • Craft potential solutions to the major challenges of public health interventions
  • Apply principles of safety and risk management towards improving health care delivery effectiveness
  • Understand the strengths and limitations of innovations in clinical microsystems

Domain C: Conceptual Reasoning

You will further develop your ability to:

  • Understand rationales, theories and political models of health care policy making
  • Learn strategy creation and implementation methods
  • Learn and apply processes for creating and employing innovation
  • Improve problem-solving skills
  • Enhance knowledge of strategic communication strategies and principles
  • Learn legal perspectives and context about health care delivery issues

Competencies and Requirements

The Master’s Degree in Health Care Delivery Leadership provides the opportunity for you to further develop and refine the following professional attributes that are critical to success in the health care delivery industry:

  • Lead in evaluating models and crafting strategies that guide health care organizations toward successful adoption of, and adaptation to, changes in policy and management.
  • Be critical consumers of the major literature about health care delivery and reform, with the ability to judge the quality of prominent proposals for innovation in health care systems, and a capacity to discern challenges in the translation of theories into practice.
  • Know how to locate, interpret, and apply reliable evidence from multiple sources, both qualitative and quantitative, to organizational problem solving.
  • Analyze the political, financial, competitive, and global aspects of health care organizations and assess the influence of external developments on the organizations in which they have, or aspire to have, leadership roles.
  • Bridge, both conceptually and institutionally, the worlds of clinical-care medicine and population-based health improvements.

Program Details

Our program allows you to learn about leadership development, improve your technical knowledge, and participate in a unique, online learning experience.

 

Program Costs

The Icahn School of Medicine at Mount Sinai offers a leadership scholarship of up to $1,500 each to all enrollees currently residing within the United States. Any applicant from the US will be automatically considered; no separate application is required.

Program costs are divided into four installments of 25 percent each and are billed and payable at four specified points over the 21-month program. For more information about payment options, please contact Dale Fuller in the Financial Aid Office at  212-241-5245.

Tuition for the 21-month program beginning Fall 2015:

  • $73,500 plus a program fee of $500

Tuition and program fees do not include:

  • Books and subscription materials
  • Travel costs
  • Room and board for in-person seminar sessions at the School’s New York City campus

Total Program Costs:

  • $100 application fee
  • $500 program fee
  • $73,500 tuition
  • $1,500 estimated for texts, books, subscriptions, supplies
  • $1,400 estimated for lodging and meals for each of two on-campus seminar residency sessions. These are not applicable to local participants who commute during the seminars.

Estimated total program costs after leadership scholarship is applied: $76,900, not including travel costs.