Canyon College Syllabus
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Course Number and Title: NR422 – Nursing and Managed Care
School of Learning: Nursing
Instructor: Dr. Deryl Gulliford
Contact: deryl@pldi.net
Credits: 4 Semester Credits
Prerequisites: None
Required Text Online Bookstore
Managed Care: A Nursing Perspective – 1st Edition
by Anita Finkelman, Published October, 2000. Prentice Hall.
ISBN: 080538152X
Course Description
This course focuses on the impact of managed care on health care delivery, and specifically on the nursing field. It’s goal is to help students better understand what managed care is, how managed care works, and to guide the student in acquiring knowledge of reimbursement, quality, legal and ethical issues involved with managed care programs. A diversity of managed care models are presented, including HMO’s, PPO’s, IPA’s and many others.
Course Objectives
After completing the course, students will have developed the knowledge, skills, and abilities to:
- Understand and describe the modern health care environment as related to managed care.
- Discuss principles of health care reimbursement.
- Define and discuss managed care.
- Understand and present key concepts of performance and cost under managed care.
- Discuss the role of case management in a managed care environment.
- Define and discuss clinical pathways, explaining their significance in managed care programs.
- Discuss consumer interactions in managed care.
- Describe the role of managed care in Medicare and Medicaid.
- Describe the role of nursing in a managed care environment.
- Discuss managed care impacts on patient care.
- Understand the role of advanced practice in managed care.
- Discuss the future of managed care in nursing.
Course Outline
This course is divided into four units, covering text chapters as follows:
Unit 1 – Chapters 1-2
Unit 2 – Chapters 3-6
Unit 3 – Chapters 7-10
Unit 4 – Chapters 11-14
Grading
Each Unit Exam is worth 20% of the course grade, and the Scholarly Paper is worth 20% of the course grade.
A 90 - 100%
B 80 - 89%
C 70 - 79%
D 60 - 69%
F 0 - 59%
Additional Information
Communication with Instructor
Students are expected to communicate with the professor weekly during the course term. A brief email update is sufficient, although the professor will be please to discuss any matter by phone during the work day or during the evening hours at home.
Evaluation
There is a written essay examination for each Unit, and a Scholarly Paper (approximately 10 pages in length) is required for completion of the course. The Scholarly Paper topic and outline must be approved prior to writing. There is no final examination for this course.
About the Professor
Dr. Gulliford is CEO of the Northwest Oklahoma Healthcare Consortium, based in Enid, OK. He has twenty years of experience in senior healthcare management. His clinical background includes work in respiratory care, critical care medicine, non-invasive and invasive cardiology, and cardiovascular perfusion. Dr. Gulliford is State Director for the American Academy of Medical Administrators in Oklahoma. His peers in hospital administration voted him William Newcomer Healthcare Executive of the Year for the United States in 2005.
Dr. Gulliford’s philosophy:
………..therefore however you want people to treat you, so treat them.
Version #2 – 18 Feb 2010