Health Policy and Administration Fall 2012 Newsletter

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NEWS for Alumni of the Department of Health Policy and Administration COLLEGE OF HEALTH AND HUMAN DEVELOPMENT FALL 2012

From the Department Head How much has changed since we sent our last print newsletter in the fall of 2011. As I sit to write today, the one word that keeps coming to my mind is integrity. It’s something that resonates with me from my own days as an undergraduate student. My university, the College of William and Mary, had a student honor code. In most classes, professors handed out exams and walked out of the room. Students were expected to act with integrity, including reporting whether their peers honored that academic code. I appreciated the idea that we were a community of scholars with high expectations for ethical behavior. That’s one reason I was drawn to study health care, where we find high expectations for professional behavior combined with a vibrant and tempting economic market. I loved the dynamic between my field of economics and the ethical issues raised in health care. All around us, we see areas where integrity is compromised—from academic medical centers that fail to identify, prevent, or manage financial conflicts of interest among physicians to the many instances of fraud in almost every area of health care. While leading the undergraduate program in HPA, I wrote a statement on academic integrity, which many faculty members now include in their syllabi. The statement stresses the ideas that ethical integrity is critically important in health care, where compromises can have life or death implications, and that ethical behavior is a habit developed over time. Thus, academic integrity is just one part of developing a habit of

integrity. In my opinion, students who lie, cheat, or plagiarize are likely to become health professionals who cut corners, shade the numbers, or cook the books. Recent research on behavior, such as that found in Dan Ariely’s book “The (Honest) Truth About Dishonesty,” is offering new insights into how and why we deceive ourselves and others. As our health system pushes more opportunities for risk and reward onto providers, a better understanding of how these impact ethical behaviors is critical. I’d be interested in hearing your thoughts on two questions: 1) What do you see as the most important ethical challenges facing health care leaders and organizations today? 2) What does HPA need to do to better prepare our students to handle these challenges? Our Penn State community has had a stunning lesson in integrity during the past year. I don’t think any of us have fully comprehended its meaning. During the course of the events, someone spoke with me about “The Grand Experiment.” I do not know that I have the facts or the ability to fully assess that history. As a scholar, however, my thought was that you learn in science that almost every experiment fails. Great researchers, like great leaders, learn the lessons from each failure and do it better the next time.

Regards,

Dennis Shea Professor and Head

www.hhd.psu.edu/hpa


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Message from APG President Randy Coulthard Greetings HPA alumni and friends! How have you been? Can you believe the fall 2012 semester has already begun? My initial response to that question is “no,” but then I look out my window and am quickly reminded when I see that the leaves on the trees have already begun changing into their beautiful colors. It truly seems like time goes by faster each year. As the saying goes, “time flies when you’re having fun!” While reflecting back on this past year and the HPA Affiliate Program Group (APG), several exciting accomplishments come to mind that I believe are worth noting. Let me share some of them with you. In the fall of last year, we held our fifth annual Professionals in the Classroom (PiC) event. This event was a huge success and provided twenty-four alumni with the opportunity to visit more than 750 students in fourteen undergraduate and three graduate classrooms. In the spring, our Mentoring Program Weekend had the largest participation to date, including a total of thirty-four alumni and student partnerships. The HPA APG also has been successful in hosting several social-professional events in various locations, including Philadelphia, Pittsburgh, and Washington D.C. To add to that, our Penn State HPA Alumni LinkedIn group has grown to over 800 members. So many accomplishments in what seems to be such a short time!

The HPA APG is now looking forward to this upcoming 2012-13 fiscal year and all the possible opportunities that it may bring. This year our major focus will be on further developing and increasing participation in some of our already successful programs and events. Professionals in the Classroom (PiC); the M.H.A. Professional Development Day; the Undergraduate Mentoring Program Weekend; the kick-off of our first M.H.A. Mentoring Program; and our social media sites, such as LinkedIn and Facebook, are just a few items of focus. In addition, we will continue to partner with the department and student representatives to remain engaged both on and off campus with various student and alumni professional networking events. We are all a part of the HPA program and APG organization. I welcome you and am always open to any suggestions and feedback that you may have. If you are interested in serving on an APG committee, participating in any of our initiatives and events, or would like to be a part of the APG board, please let me know. The APG also can serve as a great avenue for you to become reconnected with former classmates, colleagues, and old friends. I do encourage you all to join the “Penn State HPA Alumni” group on LinkedIn or “Penn State University Health Policy and Administration” on Facebook if you have not done so already. You also can connect with us through our APG website alumni.hhd.psu.edu/hpa or contact me directly at randy.coulthard2@cigna.com. I am both proud and honored to serve as your APG president and look forward to this upcoming year! WE ARE...

Survival of safety-net hospitals at risk Many public safety-net hospitals are likely to face increasing financial and competitive pressures stemming in part from the recent Supreme Court decision on the Affordable Care Act, according to Jonathan Clark, assistant professor. Safety-net hospitals provide a disproportionate share of charity and under-reimbursed care to uninsured and low-income populations. They often tailor their services to meet the special needs of these populations, and they frequently provide needed, but unprofitable, services, such as regional trauma and inpatient mental health services. Clark and his colleagues analyzed the financial performance and governance of 150 safety-net hospitals between 2003 and 2007. The team categorized the hospitals into governance types—directly con-

trolled public, delegated public authority, private non-profit, and private for-profit. The team then analyzed the relationship between governance type and profitability. The results are published in a recent issue of Health Affairs. “We found, counter-intuitively, that public hospitals directly controlled by governments, especially those in highly competitive markets, were more profitable than other safety-net hospitals,” Clark said. “The economic downturn, slow recovery, and politics of deficit reduction have eroded the ability of governments—especially local governments—to support the safety net. Couple that with the expected changes in safety-net funding [from the Affordable Care Act] and safety net hospitals, especially those that rely on direct public subsidies, face a new market dynamic. The question is whether and how they can adapt to this new reality. Our findings suggest that because many of these public hospitals lack the governance and management practices that have enabled private safety-net hospitals to thrive in the absence of subsidies, they will need to transform their organizations in order to sustain themselves financially.”


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HPA/APG group taps new officers, members Newly elected HPA APG officers and board members include:

At-Large Board — Debra Price

(Also serving as a member of the Social/Professional Committee) Debra is currently the regional manager for ProHealth Physicians, the largest primary care group practice in New England. She is a 1974 HPA and 1995 MPA graduate from Penn State. She resides in the Southbury, Conn., area.

Treasurer — Shane Flickinger

(Also serving as a member of the Communications Committee) Shane is a 2010 dual MHA/HPA (Schreyer Honors College) graduate who serves as the process improvement coordinator at Riddle Memorial Hospital, part of the Main Line Health system. Shane also serves as a student mentor in the APG Mentoring Program. He resides in the Philadelphia area.

Mentoring Committee Member — Heather Haefner Heather is a 2001 HPA graduate and is currently the administrative director for the Heart and Vascular Institute at Susquehanna Health System in Williamsport, Pa. Prior to this position, she was administrative director for cancer services at Susquehanna Health, a multi-section administrator for Temple University’s School of Medicine, and a senior consultant with McBee Associates. Heather has just completed two consecutive terms, a six-year commitment, on the College of Health and Human Development Alumni Board, where she served as the co-chair of the board’s Careers Committee.

Awards Committee Chair — Stephanie Donolli Stephanie is a 2007 HPA graduate and received her MPH degree in 2009 from Indiana University, Bloomington. She is currently the director of public policy at ALTHA, a non-profit organization in Washington, D.C. Stephanie also serves as a student mentor in the APG Mentoring Program.

Communications Committee Chair — Marcy Dzwill Currently a corporate project manager, Marcy is responsible for process transformation and large-scale facilities projects at Virtua Health in southern New Jersey. Prior to that, she served as the lead for critical systems projects as a Six Sigma Master Black Belt and as a human resources manager at Virtua Health. She is a 1985 graduate and is pursuing a master’s degree in industrial/organizational psychology. Marcy also serves as a student mentor in the APG Mentoring Program.

Undergraduate Student Representative — Kat Christian Born and raised in Berks County, Pa., Kat transferred to Penn State in the fall of 2011 after initially beginning her undergraduate studies in nursing at Mount St. Mary’s University and studying in Europe. She recently completed an internship at JFK Health System in Edison, N.J., in the Program Management and Process Improvement Office and plans to graduate in May of 2013.

M.H.A. Student Representative — Vanessa Gruver Vanessa, originally from York, Pa., graduated from the HPA program in December 2010. She worked at NHS Human Services as a utilization coordinator in the behavioral health and rehabilitation services department after graduation and prior to entering the M.H.A. program. She also held her graduate administrative residency position at FreemanWhite Inc., a health care design and consulting firm, and expects to graduate in May 2013.

Ph.D. Student Representative — Jim Pitcavage Jim is a second-year Ph.D. student in HPA and resides in Danville, Pa. He is a project manager for the Geisinger Center for Health Research, working on projects in health economics and outcomes research. For more details on the HPA APG, please visit alumni.hhd.psu.edu/hpa.

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Wagman elected to Penn State Alumni Council HPA alumnus, Steve Wagman, is among the newly elected Penn State Alumni Council members who began serving a three-year term effective July 1. Wagman is a 1982 graduate of the Health Planning and Administration program (the current Health Policy and Administration program) and has been proudly serving the Penn State community at the University, alumni, and student levels since graduation. Wagman, who is vice president for Siemens Medical Solutions USA, Inc. in Malvern, Pa., also serves as a Siemens relationship executive to Penn State. “My activities and involvement at Penn State have allowed me to gain a deeper insight and appreciation for the world-class University that we have become, supported by the largest dues-paying alumni association in the world,” said Wagman. “I have a passion to further establish the bond between the alumni and the current students at Penn State.” While serving as the president of the HPA Affiliate Program Group (APG), Wagman led the establishment of the HPA Program Endowment, which yields revenue annually to help support studentrelated activities within the department that are not otherwise covered by the department budget. “This is an example of how the alumni can work to support the overall student experience at Penn State in perpetuity,” he said. Wagman sees serving on the Alumni Council as an extension of his current service to alumni, the University, and students. This service includes serving as a life member and sustaining life member of the Penn State Alumni Association; a member of the Golden Lion Society; a member of the Corporate Campaign Committee - For the Future Campaign; an ad-

Steve Wagman, center, talks with students. visory board member of the Center for Integrated Healthcare Delivery Systems (CIHDS) - College of Engineering; an executive board member of the Health and Human Development Alumni Society; a board member, a past communications committee chair, and an awards committee chair of the Health Policy and Administration APG; the board president (2009-11) of the Health Policy and Administration APG; a student mentor for the College of Health and Human Development / Health Policy and Administration; a guest speaker for the HPA Professionals in the Classroom program; a mock interview professional for the M.H.A. Program; an alumni admissions volunteer; and a member of the Nittany Lion Club. Wagman adds that one of the most gratifying experiences over the past months was hearing from many Penn State alumni who reached out to him. “We have a unique ‘family’ within the Penn State alumni,” he said, “and I am honored to serve on the Alumni Council.”

HPA student one of 10 national scholarship winners HPA doctoral student, Beatrice Abiero, is one of ten U.S. students to earn a 2012 David Winston Scholarship, a one-time financial award for graduate health policy students. “I applied for the scholarship because in my career, I am eager to continue to serve as an advocate for changing health policy through health services research,” said Abiero. “I was surprised when I learned that I was one of the Beatrice Abiero ten scholarship recipients because I knew it was a nationally competitive award and that several other students would be applying as well.” Abiero sees winning the scholarship as an inspiration to be more like David Winston and to commit to a career in health policy.

“I am very honored and thankful to be a recipient of this award,” she said. Abiero said she will use the scholarship to pay for textbooks and course supplies, as well as to pay down some of her student loans. Additionally, she is looking forward to attending a symposium in Washington, D.C., to network with other graduate health policy students, and to gain a unique and in-depth view of health policy in the nation’s capital. Rhonda BeLue, associate professor, who wrote a letter of recommendation on Abiero’s behalf, sees Abiero as a worthy recipient of the Winston scholarship. “Beatrice has worked very hard and is most deserving of the 2012 David Winston Scholarship,” said BeLue. “She is passionate about improving health services and policies for vulnerable populations. I look forward to seeing her contributions to the field of health services and policy research in the future.”


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Alumnus among the first graduates of the M.H.A. program By Kianna Walker, senior in HPA Edward G. Longazel, MHA, CHC, CHRC, is one of 12 alumni from the Master of Health and Administration (M.H.A.) class of 1987 at Penn State. He and his classmates represent the beginnings of the M.H.A. program, which is celebrating its 25th anniversary this year. Longazel’s career path has evolved through different aspects since his days studying in Penn State’s M.H.A program. His accomplishments and employment throughout his professional career include positions at the Drexel University College of Medicine, the U.S. Army Medical Service Corps, and the University of Pennsylvania Health System. He currently serves as chief compliance and privacy officer at the Drexel University College of Medicine. Longazel believes his Penn State education set in motion his rewarding professional life. “The M.H.A. program provided the foundation for understanding the complexity of an integrated approach to the management of health care delivery,” he said, adding that his peers provided a wide range of talents to his class, which consisted of 10-12 students. Longazel believes that pursuing a master’s degree was critical for his success in the military and for his professional career. Longazel served with the Armed Services while in graduate school; he was active in an Army Reserve medical unit in Altoona, Pa. In 1977, he joined the Association of Military Surgeons of the United States, a professional association serving military and public health administration officers in the United States. While attending graduate school, Longazel had the opportunity to teach as a teaching assistant. He also taught undergraduate health

administration courses at the Drexel-Goodwin College and graduate courses at St. Joseph’s University. After earning his M.H.A. degree, Longazel’s biggest professional challenge was his deployment to Saudi Arabia for Desert Storm in 19901991 as an Army Medical Service Corps Officer. His 400-bed Army Reserve hospital from Ashley, Pa., served as the prisoner-of-war hospital for injured enemy soldiers. In his role, Longazel worked as a purchasing officer reacting to daily requests for hospital supplies. Additionally, Longazel was responsible for presenting specifications for required items to help local factories’ productions. He says this challenge was significant; however, the personal and professional rewards were unequalled. Over the past 25 years, Longazel believes that health care administration has changed due to the power of information technology and the complexity of regulations, both of which have increased exponentially. Specialization within health care administration became a requirement as funding streams and coverage evolved, as well as locations of delivery, integration of delivery systems, and the Internet. Longazel says he enjoys working in the health care field and sees important benefits for those who pursue a health care career. “The rewards go beyond the compensation, and, despite the internal and external policies and regulations that professionals in health care administration face, they know that the delivery of excellent care is the service they provide. It feels good to know you’re leading others to do the right thing for patients.”

M.H.A. students land jobs, serve residencies This year’s graduates of the Master of Health Administration (M.H.A.) program have secured positions in various roles throughout the health care field. Included in these new positions are administrative fellowships at Penn State/Hershey Medical Center, Lehigh Valley Health System, and ARAMARK. Other administrative placements of 2012 M.H.A. graduates include Jersey Shore Hospital (director of human resources), Tele-Tracking, Inc. (client manager), Riverside Health System (revenue cycle analyst), Med-Star Health (quality improvement database analyst), Children’s Hospital of Philadelphia (administrative manager of outreach services), and Geisinger Health System (operations and research manager). In addition, second-year M.H.A. students are beginning their 2012-13 academic year after serving in various summer residency programs at the following sites: John’s Hopkins Children’s Center

FoxRun Long-Term Care

Hershey Health System

Hershey Medical Center

Highmark Blue Cross/Blue Shield

Riverside Health System

Mount Nittany Medical Center Physicians Group

United Health

Guthrie Clinic

Geisinger Health System

Geisinger Health System

Ephrata Community Hospital

MedStar

Freeman White, Inc. University of South Alabama Medical Center

Cleveland Clinic

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Penn State assistant professor provides insights into breast cancer screening disparities By Justin Winstanley, senior in HPA Patricia Miranda, assistant professor of health policy and administration, strives to shed light on health disparities, especially among minority women. Beginning in 2010, she focused her research efforts on a growing trend among Mexican-origin women that showed these women were less likely to engage in breast cancer screenings. She found that only 59 percent of Mexican-origin women over age 40 were likely to seek a mammogram over the past two years as compared to the 70 percent and 72 percent of African American and white populations, respectively. She also found that Mexican-origin women “have a significant number of additional barriers” that can be associated with their increased odds of not being screened for breast cancer. Among the goals of Healthy People 2010, which was published in 2000, was to increase the number of U.S. women who received breast cancer screenings from 40 percent to 70 percent by 2010. Although by 2008, the initiative had succeeded in raising the number of women

overall who received breast cancer screenings to 68 percent, the effort focused on the entire female population and did not have the same impact to increase the number of Mexican-origin women who receive mammograms. Miranda explained that the lower mammogram percentage among Mexican-origin women is a concern because the greatest costs occur after later detection of breast cancer. She stresses that such costs could be significantly lower if the proper screenings and education targeted this population. “It’s important to dig deeper for the full story,” she said. “The next step is to better understand why the differences exist.” Miranda speculated that the lower breast cancer screenings among Mexican-origin women are due to the lower socioeconomic statuses of the women. She explains that this population is generally among the lowest educated, leading to a reduced understanding of health issues. In addition, Mexican women tend to work in low-income, part-time jobs, which do not provide health insurance. An added concern, she said, is that the female Mexican population is growing steadily, and this problem will only become larger. Miranda believes that national efforts to help increase access to breast cancer screenings can help to improve the disparity that exists between Mexican-origin women and many other women in the United States.

HPA professor serves the community Growing up in a depressed region in rural Pennsylvania, Diane Spokus saw firsthand how people struggle to access health care. “Having grown up in the Appalachian coal region where coal mining was the main industry, I can identify very well with lack of access to health care,” she says. “When I was growing up, we did not have health care, so there were no preventive services available. In addition, in the a rural area where I lived, many families had to drive great distances for specialty care. The socioeconomic status determined who had the access to medical and dental services.” Today, Spokus is an instructor and currently serves on the Lewistown Healthcare Foundation Board of Directors and the Pennsylvania Rural Health Association (PRHA) Board of Directors. She has served on the

Lewistown board for three years as the vice chair of trustees and the vice chair of the executive committee. “I have been able to build a network of health care professionals through my service on the Lewistown Hospital Board the past three years, the Southcentral Workforce Investment Board (SCWIB) Allied Healthcare Steering Committee the past nine years, and the (PRHA) Board of Directors the past two years,” Spokus said, adding that these roles benefit her work with the summer HPA administrative internship program in securing internship sites. “In addition, working on these committees has kept me abreast of current issues facing hospital administration, physician practices, and specialty groups.” The PRHA is dedicated to enhancing the health and well being of Pennsylvania’s rural citizens and communities. By combining the efforts of individuals, organizations, professionals, and community leaders, PRHA provides a collective voice on rural health issues and serves as a conduit of rural health information and resources benefiting all citizens of Pennsylvania.


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Jung earns faculty endowment Kyoungrae Jung, assistant professor, recently was selected to receive funding from the College of Health and Human Development’s Fran and Holly Soistman Faculty Development Endowment for 2012-13. The award recognizes a faculty member who is actively engaged in teaching or in conducting innovative research related to the design, development, delivery, administration, and/or evaluation of health care services. Jung’s research focuses on consumer information, provider behavior, and incentive schemes in health insurance. She has been the principal investigator of a project sponsored by the National Institute of Aging, which investigates selection incentives by Medicare home health agencies under a nationwide public reporting program. She currently is examining price responsiveness in the use of brand-name drugs among Medicare beneficiaries. Additionally, she has been a consultant to the Research Data Assistance Center regarding the use of Medicare claims data for health policy research.

Moran promoted to associate professor John Moran now serves as an associate professor with tenure in the Department of Health Policy and Administration following his recent promotion. Moran joined the department in January 2006, after serving as an assistant professor in the Department of Economics at Syracuse University. He earned a Ph.D. degree in economics from Penn State in 1997. His teaching and research interests include the economic impact of cancer, vulnerable populations, health insurance, and causal inference.

HPA undergrad earns Academic All-Big Ten honors Jane Swenson, an HPA senior, is among 108 Nittany Lion spring student-athletes to receive Academic All-Big Ten honors, which means she maintained a 3.00 GPA or higher while competing. Overall, Penn State’s spring honorees rank third among the twelve Big Ten institutions. Swenson, a thrower with the women’s track and field team, competes in all throwing events, including the shot put, the hammer, the discus, and the weight throw. Her 2012 accomplishments include: Indoor 2012 season highlights – Swenson won the shot put (14.84 m) competition and placed third in the weight (16.34 m) competition at the Penn State Relays. She won the shot put (14.50 m) competition and placed third in the weight (17.34 m) competition at the Nittany Lion Challenge meet. She placed third in the shot put (14.62 m) competition and sixth in the weight (16.93 m) competition at the Penn State National. At the Sykes Sabock, she placed fifth in the shot put (14.74 m) competition and fourth in the weight (17.43 m) competition. Swanson ended the indoor season ranked 20th in the shot put and 19th in the weight throw. Swenson was red-shirted during the 2012 outdoor season. “Being a student athlete is a great way to experience college,” said Swenson. “This honor required a lot of hard work and dedication, which makes it that much better to have earned it! I have learned so much in my years at Penn State, and I value the time and effort involved in academic studies and success, as well as athletic competition. It has been challenging to find a balance between the two and I am thankful that all the work has paid off.” Penn State’s student-athletes continue to graduate well above their peers nationwide, earning record-setting academic performances, according to statistical information released by the National Collegiate Athletic Association (NCAA). The NCAA’s annual study of institutions nationwide revealed that Penn State’s student-athletes at the University Park campus earned a Graduation Success Rate (GSR) of 88 percent compared to the 80 percent average for all Division I institutions for students entering from 2001-02 through 2004-05.

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HPA grad student presents at public health conference in Chicago By Tyler Joseph, senior in HPA

Apeksha Iyer, a 2012 graduate with a master’s degree in HPA, is learning through her research efforts that public health initiatives are crucial to saving the lives of many minority women who have cervical cancer.

Through her research, Iyer learned that more than 60 percent of women who had been diagnosed with cervical cancer had never been screened. The majority of these women were of a race other than White. Her research also taught her that socioeconomic status possibly plays a part in this problem. These factors include education, income, and access to health care.

Iyer first began researching this issue out of curiosity. She became more interested in the topic when she took the advice of her adviser, Patricia Miranda, assistant professor of health policy and administration, to incorporate what she already knew about cervical cancer into a much larger discussion and present it as a talk in February at the 4th Annual University of Illinois Chicago School of Public Health 2012 Minority Health in the Midwest Conference. The title of her talk was “Socioeconomic status does not explain ethnic/racial differences in cervical cancer screenings among U.S. women.”

In her research, Iyer used two models. Using a logistic regression model, her first model analyzed ethnic/racial differences in Pap test use within the past three years. Her second model analyzed socioeconomic status and ethnic/racial differences in Pap test use over the past three years.

Reflecting on her presentation in front of a crowd of thirty people, she said, “It was a rewarding experience to let the world know that minorities who do not have health care suffer from serious problems that could be fixed with a change in the health care system.” Iyer explained that cervical cancer is preventable. She stressed that mixed evidence does not clearly illustrate the amount of attention women of different races receive for cervical cancer. She believes that women are treated differently when undergoing cervical screenings. “Researchers have speculated that culture has something to do with it,” she said. “Because of culture and sexuality, some women do not go to see a gynecologist. Maybe it has something to do with fear because they only go when something is wrong.”

“My results indicate that White women received fewer screenings compared to Hispanic and Black women,” she said. “White women also received more screenings than Asian women.” Furthermore, Black women and Hispanic women who were privately or publicly insured were more likely to be screened than those who did not have insurance. She also found that for each year of age, the odds of women being screen decreased by 2 percent. From these findings, Iyer concluded that socioeconomic status does not explain ethnic/racial inequalities in Pap test use. Iyer values the help from her professors and classmates in preparing her for her trip to Chicago. “Presenting my abstract in front of my classmates and professors was more intimidating than presenting at the conference,” she said, noting that she is grateful for the tremendous amount of feedback from her classmates and professors, which helped her to present her ideas more effectively during the conference. Iyer began working this past summer for the National REACH coalition in Washington D.C. as a program coordinator, implementing prevention programs in vulnerable communities across the United States.

Research Finding: 89 million people uninsured during 2004 to 2007 Eighty-nine million Americans were without health insurance for at least one month during the period from 2004 to 2007, and 23 million lost coverage more than once during that time, according to a study by Pamela Farley Short, professor of health policy and administration. To do their analysis, the researchers used data from the U.S. Census Bureau’s Survey of Income and Program Participation, which collects information from the same individuals every four months over a fouryear period. The team examined changes in insurance coverage among people ages 4 to 64 from 2004 to 2007, which is the most recent period for which four-year data are available. The researchers found that, of the 89 million people who were uninsured during the period from 2004 to 2007, 12 million were continu-

ally uninsured; 11 million gained coverage at some point; 11.5 lost coverage; 14 million experienced a single gap in coverage; and 6 million had a temporary spell of coverage, but were otherwise uninsured. In addition, 23 million people lost health insurance more than once during the four-year period. “We all have a stake in this problem of providing everyone with continuing access to affordable insurance,” Short said. “Promoting stability and minimizing uninsured gaps should be high priorities as federal and state officials proceed with the implementation of national health care reforms.” The results of the analysis appeared online in the July 24 issue of the journal Medical Care Research and Review.


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ACHE Chicago Trip 2012 The following commentary is from Penn State HPA senior Alyssa Reed, who joined her fellow Future Healthcare Executive Club members this past spring to attend the annual ACHE Congress on Healthcare Leadership conference in Chicago: Excitement filled the eighty-degree March air as sixteen Penn State students stepped off of a plane in Chicago. These sixteen students, including myself, are all part of the Future Healthcare Executives (FHE) club of Penn State, and were eager to begin the five-day excursion of seminars and networking events to brighten our future health care careers. This year, FHE members worked hard at various Bryce Jordan Center events to raise money to travel to Chicago for the annual Congress on Healthcare Leadership. President Kristin Chiesi, as well as Vice President Benjamin Pease, did a wonderful job in leading the group throughout the year. Thousands of CEOs and executives filled the Hyatt Regency of Chicago from Monday, March 19, until Thursday, March 22. Graduate and undergraduate students from all of over the country attended the congress to gain insight on health care issues, as well as to network with an overwhelmingly large number of health care executives. One of the members traveling with the FHE was junior Gideon Casper. He was elected to serve as vice president of FHE for the 2013 academic

year. He is excited to take over Benjamin Pease’s spot, and hopes to continue the excellence that this club has enjoyed thus far. Casper said that the best parts of the Chicago trip were the various seminars and workshops he attended. “The How to Succeed as an Early Careerist seminar gave me a lot of insight and good advice on what to do after graduation,” he said. “I heard top executives speak about what worked best for them as they were beginning their careers in health care.”. Aside from benefiting from the various speakers at the congress, Casper pointed to another benefit of the trip. “Dr. Shea took all sixteen of us out to dinner in Chicago. I thought this was really cool because not many other students can say that they bonded with the head of the HPA department like we did.” Elections were held recently to choose the upcoming executive board for the FHE club. Members from the 201112 year elected Kelly Wehner as president, Casper as vice president, Adam Kramer as treasurer, and Alyssa Reed (myself) as secretary. These four individuals are confident that they will be able to recruit new members for the 2012-13 year, raise sufficient funds through fundraising events at the Bryce Jordan Center, and enjoy the next Congress on Healthcare Conference in Chicago. We are all extremely excited not only for the next ACHE trip but also for our upcoming careers in health care.

HPA faculty members/students showcase expertise at AcademyHealth Several doctoral students in the Department of Health Policy and Administration joined HPA faculty members in presenting their research findings during the 2012 AcademyHealth meetings. The following list highlights HPA presenters and the titles of their work that they showcased at the AcademyHealth forums: Veronica Fuentes, Ph.D. student: Adherence to Recommended Medication among Patients with Chronic Illnesses and the Use of Electronic Health Records in Physician Practice. Dooyoung Lim, Ph.D. student: National Trends in the Use of Antidepressant Medication and Psychotherapy Treatments for Depression Patients among Medicare Beneficiaries. Chris Louis, Ph.D. student: Disparities in Time-to-Diagnosis and Time-to-Treatment of Breast Cancer in Four Appalachian States. Deirdre McCaughey, assistant professor of health policy and administration: 1) Social Media and Patient Experience HCAHPS: A New Value Equation in the Era of Health Reform and 2) Using an Educational Intervention to Enhance Quality of Life for Breast Cancer Survivors with Lymphedema

Yunfeng Shi, research assistant and professor in HPA: The Experience of Care Coordination Among Chronically Ill Patients at Small- and Medium-Sized Physician Practices – Is Health Information Technology a Factor? Jennifer O’Hora, Ph.D. student: The Likely Effects of Healthcare Readmissions Policies: What Policy Makers and Practitioners Need to Know Geoffrey Silvera, Ph.D. student: Exploring the Use of Group Technology to Reduce Door-to-Physician Time in the Emergency Department. Nengliang Yao, Ph.D. student: Treatment Choice in Older Patients with Early-Stage Breast Cancer.

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HPANews

Alumni spotlight: Shannon Cosgrove By Christopher Stevenson, ’12 HPA In a health care system riddled with rising costs and growing disparities, Shannon Cosgrove, ’04 HPA, ’06g MHA is utilizing her Penn State education to make a difference. Currently serving as the health equity project manager for the YMCA of the USA in Washington D.C., Cosgrove’s career revolves around analyzing race- and ethnicity-related disparities regarding chronic disease and coordinating projects that aim to bridge these gaps and alleviate such disparities. Cosgrove began her Penn State career as a math major and enjoyed the problem-solving aspect, but the career options didn’t quite sparked her passion, “so I explored and found one of our most complicated problems: health care.” After officially enrolling in the Health Policy and Administration program, Cosgrove joined the HPA Club and became an active member of the HPA program. Once immersed in the program, she quickly realized where to focus her problem-solving abilities.

“The first day on the job, I went to Mississippi for the Place Matters conference, where I was exposed to the world of health inequities,” she said. “In the Mississippi Delta, people have to drive 40 miles to get to the nearest doctor’s office; there are no local grocery stores; and some communities have infant mortality rates three times higher than neighboring communities. It isn’t fair or right.” In Baltimore, where her job was based, Cosgrove worked with community health care workers to implement policy changes and provide more opportunities to counteract unhealthy lifestyle choices. She focused on the relationship between quality education, availability of healthy food, opportunities to exercise, and safe/affordable housing to ensure quality health and minimize disparities, which are similar initiatives she has brought to her position at the YMCA of the USA. In this role, where she acts as an innovator to help eliminate disparities, she helped to create the Health Equity Initiative, which funds and supports projects in more than thirty low-income communities of color to increase quality of health and decrease health-related disparities.

“I found out that there is a whole level to the health crisis that not everyone thinks about: Why is everybody sick? Why are we spending so much on health care and getting the same results?”

“One of the biggest long-term solutions that we are currently working on is creating a model that communities can adopt and utilize to improve conditions of their own environment,” she said. “The model will allow them to see where their community lies on the spectrum of social justice, and provide them with the tools to jump in and take action as an independent entity. Within the next five years, I find myself staying in the health equity field, and I hope that this model helps bridge that gap across the country. Until then, we will continue to provide technical assistance and strategic planning for communities in need. In 20 or 30 years I hope to no longer have a job because inequities will no longer exist.”

Later, Cosgrove focused her career on race/ethnicity-based public health while working in the Prevention Service Program at the Centers for Disease Control. In this role, she served as a health disparities coordinator.

Editor’s note: Shannon Cosgrove participates in the HPA Mentoring Program. Her protégé, Christopher Stephenson, interviewed Cosgrove and wrote this article about her work in the health care field.

“The more I learned about our health crises, the more I realized that the solution cannot solely rely upon health care,” she said. After taking her first public health class with Marianne Hillemeier, associate professor of health policy and administration, Cosgrove became certain that public health was among her career aspirations.


Eugene Woods elected to American Hospital Association’s Board of Trustees The American Hospital Association (AHA) has elected Eugene Woods ‘87 HPA ‘91 MBA as one of seven new members of its Board of Trustees. The new members will begin their service on January 1, 2013. The Board of Trustees is the policy-making body of the AHA and has ultimate authority for the governance and management of its direction and finances. Eugene Woods is the executive vice president and chief operating officer of CHRISTUS Health in Irving, Texas, a position he has held since June 2011. He is responsible for overseeing acute, post-acute, and international operations for all of CHRISTUS Health’s regions in the United States and Mexico. CHRISTUS Health is a health system of more than 50 hospitals and longterm care facilities, with 175 clinics and outpatient centers and 30,000 associates. Previously, Woods served as CEO of the seven-hospital Saint Joseph Health System, one of the largest regional systems within Catholic Health Initiatives (CHI). He also was promoted to senior vice president for CHI in 2008 and served as a member of the National Operations Leadership Group. Prior to joining CHI, he was the chief operating officer at the Washington Hospital Center, a 926-bed teaching hospital located in the nation’s capital and one of the busiest hospitals in the mid-Atlantic region. In 2001, he was named by Modern Healthcare as an “Up & Comer,” and, in 2006 and 2008, Modern Healthcare named him as one of the top 25 minority executives in the country.

Research Finding: Patients are safer when nurses fess up When nurses feel safe admitting to their supervisors that they’ve made a mistake regarding a patient, they are more likely to report the error, which ultimately leads to a stronger commitment to safe practices and a reduction in the error rate, according to an international team of researchers. In addition, when nurse leaders’ safety actions mirror their spoken words -- when they practice what they preach -- unit nurses do not feel caught between adhering to safety protocols and speaking up about mistakes against protocols. “Avoidable medical errors in U.S. hospitals kill at least 44,000 patients a year,” said Deirdre McCaughey, assistant professor of health policy and administration at Penn State. “Feeling comfortable reporting errors also leads to a stronger commitment to safe practices, which ultimately reduces error rate. McCaughey and her colleagues surveyed 54 nursing teams in four hospitals in Belgium to determine if the leadership actions of head nurses were aligned with the verbal expectations they had given to staff nurses, as well as to examine the effect of that congruence on nurse/employee commitment to following safe work protocols and willingness to report a patient treatment error. Six months later, the team then examined the relationship between fostering safety and reporting patient errors to determine if they were related to a reduction in errors regarding patients. The researchers found that when nurse managers’ spoken expectations regarding safety aligned with their commitment to safety, their teams had a stronger commitment to acting safely while carrying out work duties, as well as a greater rate of reporting errors. In addition, this greater emphasis on safety resulted in a reduction in patient treatment errors. The results appeared online on September 24 in the Journal of Applied Psychology.

Alumni generosity leads to first HPA graduate scholarship Penn State alumni Ken and Jennifer Newell have committed to endowing the first graduate scholarship in health policy and administration, which will provide the department with added flexibility to recruit students and offer competitive financial aid packages. Ken, ’76 HPA, and Jennifer, who received her associate degree in retailing from Penn State in 1977, live in Richmond, Virginia. Ken currently serves as president and CEO of Manorhouse Management, L.C., which acquires, owns, and manages assisted living retirement communities. Ken is also a past member of the

Health and Human Development Alumni Society Board and is a lifetime member of the Penn State Alumni Association. The scholarship endowment, according to Dennis Shea, professor and head of the Department of Health Policy and Administration “is a great opportunity for us to identify outstanding candidates for our graduate programs and encourage them to choose Penn State. Competition for the best students is fierce, and Ken’s and Jennifer’s gift will ensure that HPA is always making competitive scholarship offers to potential students.”

Supporting the Department Gifts to the department help students pursue a high-quality education or help faculty members conduct cuttingedge research. For more information regarding philanthropic opportunities within the Department of Health Policy and Administration, please contact: Kathleen Rider Director of Development 814-863-4157 kmr80@psu.edu


Department of Health Policy and Administration The Pennsylvania State University 604 Ford Building University Park, PA 16802

NONPROFIT ORG U.S. POSTAGE PAID STATE COLLEGE, PA PERMIT NO. 1

Calendar of Events December 22

Fall 2012 Commencement Health and Human Development undergraduate commencement ceremony 12:30 p.m., Bryce Jordan Center, University Park, PA

— 2013 — February 15-17 The Penn State IFC/Panhellenic Dance Marathon (THON) benefitting the Penn State Hershey Four Diamonds Fund
Bryce Jordan Center, University Park, PA The American College of Healthcare Executives (ACHE) 2012 Congress on Healthcare Leadership, Hyatt Regency, Chicago, IL (TBA) Early 2013 The 15th Annual Stanley P. Mayers Endowed Lecture and Reception Event date to be announced in early 2013 February 22-24

HPA Mentoring Weekend

March 4-8

Spring Break

April 19-21

Blue-White Weekend

May 5

Spring 2013 Commencement Health and Human Development undergraduate commencement ceremony 3:00 p.m., Bryce Jordan Center, University Park, PA

Stay Connected Through Facebook and LinkedIn Find fellow alumni online by searching for the following groups:

“Penn State University Health Policy and Administration” “Penn State MHAs” “Penn State College of Health and Human Development”

“Penn State HPA Alumni” “Penn State University MHA”

This publication is available in alternative media on request. Penn State is committed to affirmative action, equal opportunity, and the diversity of its workforce. (HPA13026) U.Ed. HHD 13026


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