Friday, March 31, 2017


This week our students have enjoyed the annual tradition of traveling to Chicago to attend the American College of Healthcare Executives' (ACHE) Congress on Healthcare Leadership as well as the Trinity University Health Care Administration Department Alumni Association's Dean Duce Award Dinner, which this year recognized distinguished alumnus Bruce Lawrence ('82), President and CEO of INTEGRIS Health.  This cherished ritual offers first-year students a critical experience during the program, through which they are afforded opportunities to bond with classmates, to engage in and learn from ACHE's professional community of healthcare executives, to connect with and celebrate Trinity HCAD alumni, to prepare for Preceptor's Conference with mock interviews, and to experience the city of Chicago.  Current student Camille Fagan put together this great account of her time in Chicago:

Earlier this week, all 23 first year on-campus program students attended the American College of Healthcare Executives 2017 Congress on Healthcare Leadership. The entire Trinity HCAD faculty joined them in Chicago for the conference. With more than 150 education and networking sessions to choose from, students were busy meeting with healthcare professionals and students from other graduate programs. Students also enjoyed meeting past Trinity HCAD graduates during alumni happy hour and dinner events. Connections created at these events will hopefully turn into potential residency opportunities come Preceptor’s Conference in May.


We are particularly proud of our professor Dr. Jody Rogers for speaking at a session on enhancing employee engagement. The session was called Creating Great Workplaces: The Courage to Lead, and many alumni and student were in attendance.

The students took advantage of their time in Chicago and made sure to explore the city. They tried deep dish pizza and spent time at the Navy Pier, Hancock Tower, and Cloud Gate. The week proved yet another opportunity for them to bond as a class. We are lucky to be able to support our students in their budding careers by sending them to Chicago every year!

Friday, March 10, 2017

Assessing Markets and Community Health Needs

This past Wednesday, the on-campus HCAD first-year students completed a major joint project across the HCAD 5311 (Health Services Organization & Policy II) and HCAD 5313 (Health Economics) courses: the Community Health Needs Assessment (CHNA) and Market Analysis project.  For the third consecutive year, this project asked groups of students to each select a specific market in the U.S. and then complete a detailed analysis of their respective market, simulating both a CHNA that is required for nonprofit hospitals throughout the U.S. as well as an economic market outlook that is a common tool developed by health care strategic groups and consulting firms.  The five markets selected by student groups included Baltimore, Colorado Springs, Des Moines, Las Vegas, and San Diego.

This year's presentations took a different form than previous years, as the traditional format of having each group formally present their individual analysis in half-hour blocks was replaced by a simulation of a board meeting during which groups presented summaries of their analyses in a more conversational style before a wealthy philanthropist.  The scenario put students in the position of working to educate the philanthropist, who was interested in investing her fortune in efforts to improve health care and meaningfully address health needs, about what critical and even unmet or undermet needs should be prioritized.  After the five groups presented their summaries (each taking about 20 minutes), the class then collectively discussed what common themes were heard across multiple markets as well as what unique features seemed to distinguish certain markets from others in terms of their market trends and health factors.  Finally, each student was tasked after the meeting with crafting an individual email - no more than 400 words - to the philanthropist in which they summarized and synthesized the information presented during the meeting and offered guidance in how the philanthropist can most effectively address today's health challenges through her vast resources.

Some of the most common needs identified across multiple markets in this year's presentations included access to primary care services, mental and behavioral health care, efforts to address and prevent obesity, and efforts to address and prevent cardiovascular disease.  Taking a step back, this reflects and is consistent with much of what we hear and read in the literature today about the U.S. health care delivery system: primary care, mental and behavioral health care, preventative care, and chronic disease management have traditionally been underaddressed, fragmented, and siloed as a part of our efforts to address the population's health care needs, and we see increasing calls for more efforts to promote, integrate, and meaningfully support these elements of the health care continuum across health policy, health care organizations, and health markets today.

It is interesting to see the students' quantiative and qualitative work so accurately - yet independently - reflect what today's thought leaders and health experts have pointed to as some of the most pressing real-world health care issues across the country.  More personally, it is gratifying to see our students work together so diligently and effectively in teams to develop these robust and meaningful analyses, and we trust that this project will be a helpful exercise and tool moving forward as they embark upon their careers in health care administration.  Well done, students...time to enjoy your spring break!

Friday, March 3, 2017

Competing in Alabama, Brainstorming in Texas

The past two weeks have been busy ones for our first-year on-campus graduate students as they approach the mid-point of the spring semester.  Between case competitions, ideation sessions, preparations for major group projects and presentations, thinking ahead to ACHE Congress in Chicago in late March and Preceptors' Conference in early May, and studying for upcoming exams, things have heated up in a semester known for being full, busy, challenging, and rewarding.

This past week saw our group of three first-year students compete in the 11th annual University of Alabama at Birmingham (UAB) Health Administration Case Competition.  Jake Abrey, Shirly Ho, and Dillon Rai devoted three weeks to diligently preparing their strategic response to the case presented in the competition, which involved meaningfully addressing the needs of emergency department superutilizers at Bon Secours Hospital in Baltimore.  Their hard work and efforts certainly paid off, and we were thrilled to see them advance to the second round of the competition.  This feat is all the more impressive when you consider that our students are only a few weeks into their second semester in the program, capably competing against other teams primarily fielded by second-year graduate students with at least three semesters under their belts.  We were very impressed with their exceptional work effort and camaraderie, and we knew that regardless of the outcome, we were incredibly proud of what they were able to accomplish.

Back in San Antonio, after emerging from a weekend of intense strategic planning and case development with the Cleveland Clinic Case Competition, our students enjoyed Monday to debrief and decompress, but they were back at it on Tuesday as we kicked off three consecutive days of ideation (i.e., brainstorming) for students to begin preparing for the annual Tiger Tank project, which is a joint project between HCAD 5311 (Health Services Organization & Policy II) and HCAD 5313 (Health Economics) in which small groups of students develop innovative solutions to challenging problems in health care today and then pitch those solutions before a panel of health industry leaders and entrepreneurs, similar to the popular television show, Shark Tank.  Tuesday included a high-energy three-hour session led by the talented and dynamic Dr. Luis Martinez, Director of Trinity University's Center for Innovation & Entrepreneurship, as he introduced and led students through the Business Model Canvas and Lean Canvas: two similar tools entrepreneurs use to fully develop their innovative ideas and identify their critical value proposition.  The next two days were devoted to drawn-out "ideation" sessions, in which students engaged in a variety of creativity exercises in small groups to help identify the critical problems they want to address, potential directions they may initially pursue to find solutions to those problems, and the peers they want to work together with on developing their Tiger Tank concept.



As our Department Chair, Dr. Ed Schumacher, likes to say, "This is our kind of fun."  It may make for a unique definition of "fun" as some people might initially think about it, but our students are truly having fun while they're challenging themselves to learn and grow rapidly, and we couldn't be more proud.

Friday, February 24, 2017

Cleveland, Strategies, and Shared Suffering

Last weekend, Trinity HCAD's first-year On-Campus students participated in the fourth annual Cleveland Clinic Case Competition.  Five teams worked tirelessly from Thursday night, when they received the case by email, through Monday morning, when they electronically submitted their case deliverables, which involved developing a strategy for the Cleveland Clinic's southern region in northeast Ohio.  The students' responses ranged from building microhospitals, to forming joint ventures with other community hospitals in the region, to establishing specialty facilities focusing on geriatric care.

The teams spent almost the entire weekend on Trinity's campus, and each adopted a "home room" to work in.  Each team seemed to develop a different personality over the course of the weekend, with some stocking up on snacks, others playing quiet music, and still others working while basketball games streamed on projector screens in the background.  There were also several class-wide breaks for impromptu football games outside and strolls around the campus.

Trinity HCAD's On-Campus program has participated in the Cleveland Clinic Case Competition for the past three years as part of its HCAD 5340 course (Health Care Strategic Planning & Marketing), and last year, three of our teams were selected among the top 16 teams from across the country.  By advancing, they enjoyed the opportunity to travel to Cleveland, where they presented to a panel of Cleveland Clinic senior executives.  We hope to experience similar success this year, as we are fully confident in our students' skills and abilities.  More importantly, we are once again incredibly proud of our wonderful students, who seized this opportunity of "shared suffering" to grow together and exceed their own expectations in terms of what they can accomplish as young careerists in health care administration.  With all of that intense, challenging work now behind them, the rest of the program should be a breeze! ;-)

Friday, February 17, 2017

Visiting With the Experts

The Trinity HCAD program takes pride in our connection to the field and our blending of the classroom experience with professional practice.  One of the best illustrations of this commitment is the degree to which we have experienced health care executives and experts in health administration visit our program as guest speakers, as well as taking our students to visit varied health care organizations, where they can gain a first-hand perspective on the work that occurs in today's complex and dynamic health care industry.

This semester gives a brief glimpse of how we see such connection to the field be an integral part of the HCAD program experience.  Beginning with the Executive program in early January, our Executive students enjoyed visits by Glenn Robinson, President at Baylor Scott & White Medical Center - Hillcrest in Waco, and Abbe Ulrich, Principal at Korn Ferry, during their three-day on-campus session.  As the on-campus later returned to Trinity to begin their spring semester, they began a series of Friday morning sessions in which they are either visited by health care executives or travel to health care organizations to tour their facilities and speak with their executives on location.  Some of the memorable visits we've already enjoyed, in addition to Mr. Robinson and Ms. Ulrich, include:

  • Wayne Smith, Chairman of the Board and Chief Executive Officer at Community Health Systems (CHS)
  • Brett McClung, Executive Vice President, Texas Health Resources
  • Christann Vasquez, President of Dell Seton Medical Center at The University of Texas, University Medical Center Brackenridge and Seton Shoal Creek Hospital
  • Patrick Halinski, Associate Chief Business Development Officer at Baptist Health System
  • Paula Turicchi, Administrator of Women & Infants Specialty Health at Parkland Health & Hospital System
  • Nicole Cuenca and Matt Frye, Physician Practice Administrators with Community Health Systems (CHS)
  • Vanessa Smith, Houston ‎Market President of Operations, and Amber Wilson, Administrator, with ‎United Surgical Partners International
  • Jennifer Malatek, Coach at The Studer Group
  • Dr. Aubree Shay, Assistant Professor at the University of Texas School of Public Health, San Antonio Regional Campus

A sample of this semester's upcoming guest speakers include:

  • Jon Foster, President - American Group at HCA
  • Bruce Lawrence, President and CEO at INTEGRIS Health
  • Matt Chance, Senior Vice President of Operations at Texas Scottish Rite Hospital for Children
  • David Berry, President of System Clinical Operations at Children's Health
  • Jim Brown, Chief Development Officer at HCA Gulf Coast Division
  • David Huffstutler, President and Chief Executive Officer at St. David's HealthCare (Friday site visit)
  • Felicia Miller, Regional Director of Human Resources at Tenet Healthcare
  • Blake Allison, Chief Operating Officer at the Baylor Scott & White Quality Alliance
  • Buzz White, President and Co-Founder at Afoundria
  • Dr. Jon Larson, CEO and Founder at MedSpoke
  • Craig Desmond, CEO at Southwest General Hospital, IASIS Healthcare
  • John Pierce, Vice President of Strategic Development and Physician Compensation at Health Texas Provider Network
  • Holly Elliott, Vice President of Women's and Children's Services at HCA Gulf Coast Division, and Peyton Elliott, Vice President and Chief Operating Officer at Houston Methodist West Hospital
  • Dr. Luis Martinez, Director of the Center for Innovation & Entrepreneurship at Trinity University

Of course, it certainly helps that Trinity boasts such a strong alumni network that has promoted a "pay it forward" spirit and continually expresses an eager willingness to invest in our students.  We are so thankful and continually humbled by our HCAD family, and we're proud of their professional success as well as the ways in which they exhibit true leadership by helping guide the new generations of health care administrators to a bright future.

Friday, January 27, 2017

Research Spotlight: ACOs & TCE

What might accountable care organizations (ACOs) look like moving forward?  As ACOs continue to grow and evolve in our health care delivery system, how will pursuit of ACO models align with consolidation pressures in the health care industry?  This month's Research Spotlight post shines on a recent article by Dr. Steve Mick (Virginia Commonwealth University) and our own Dr. Patrick Shay, who together considered the question of whether the continued proliferation of ACO models may encourage health care organizations to adopt vertically integrated organizational forms.

Their work, included as part of a special December issue of Medical Care Research and Review dedicated to using organization theory to understand ACOs, applies a perspective known as Transaction Cost Economics (TCE) to explore what degree of vertical integration activity ACO forms may take.  Developed from the work of Nobel laureates Oliver Williamson and Ronald Coase, TCE focuses on the classic "make or buy" decision, helping to explain why organizations may integrate production activities through hierarchical structures versus relying upon external exchanges in the development of a good or service.  At its core, TCE suggests that organizations compare the costs of producing internally (i.e., "make") or externally (i.e., "buy"), factoring in non-production - or transaction - costs that stem from environmental uncertainty, asset specificity, the frequency of exchanges, and bounded rationality.

Ultimately, Mick and Shay (2016) predict that ACOs are likely to yield a spectrum of vertical integration activities, noting that "vertical integration may remedy transaction costs stemming from diverse sources of uncertainty, providing ACOs with a means to limit opportunistic behavior, defend competitive advantages, adeptly pursue adaptive strategies in the face of unforeseen contingencies, and enforce common interpretations and expectations of the organization and external environment" (p. 655).  However, they also acknowledge that ACOs are likely to contribute to increased internal transaction costs due to the "administrative complications and challenges of continually internalizing exchanges wrought by vertical integration" (Mick & Shay, 2016, p. 655), and they furthermore point to the possibility that embedded network relationships characterized by high levels of trust and frequent exchange may allow for the benefits of vertical integration without the necessities of physical integration and common ownership.  Thus, on the one hand, ACO models may promote increased consolidation activities among health care organizations, but on the other hand, in situations where the benefits of vertical integration can be attained without consolidation, or when the costs of vertical integration and consolidation outweigh the benefits, providers may engage in ACO activity while pursuing vertical integration strategies virtually.  Such varied integration activities are consistent with the diversity of ACO forms that have been previously identified by scholars (e.g., Auerbach et al., 2013; Kreindler et al., 2012; Shortell et al., 2014).  As Mick and Shay (2016) suggest, this application of TCE makes the classic "make or buy" decision seem anything but simple, but for a health care industry known for its complexity, perhaps this goes without saying.

Mick, S.S.F., & Shay, P.D. (2016). Accountable care organizations and transaction cost economics. Medical Care Research and Review, 73 (6), 649-659.
Auerbach, D.I., Liu, H., Hussey, P.S., Lau, C., & Mehrotra, A. (2013). Accountable care organization formation is associated with integrated systems but not high medical spending. Health Affairs, 32, 1781-1788.
Kreindler, S.A., Larson, B.K., Wu, F.M., Carluzzo, K.L., Gbemudu, J.N., Struthers, A., & Fisher, E.S. (2012). Interpretations of integration in early accountable care organizations. Milbank Quarterly, 90, 457-483.
Shortell, S.M., Wu, F.M., Lewis, V.A., Colla, C.H., Fisher, E.S. (2014). A taxonomy of accountable care organizations for policy and practice. Health Services Research, 49, 1883-1899.

Friday, January 20, 2017

Back to Work!

The Spring 2017 semester is finally underway.  After welcoming our Executive students to campus last week and then seeing them start the semester strong, we also welcomed back to the Department our On-Campus graduate students late last week.  Many of them enjoyed the winter break to relax, recharge, and reconnect with family and friends, and by the time they arrived back last Thursday, they were eager and ready to begin a fun-filled and challenging semester!

The On-Campus students this spring are looking forward to a great course sequence, including coursework that addresses health economics, health care financial analysis, population health management, health care strategic planning and marketing, health care innovations, and physicians and physician relations.  The spring semester is a very busy one, with numerous highlights such as the Cleveland Clinic Case Competition in February, a community health needs assessment (CHNA) and market analysis project in early March, the trip to Chicago to attend the American College of Healthcare Executives (ACHE) 2017 Congress and the HCAD Alumni Association's Dean Duce Award Dinner, the REACH Symposium in April, a business model project crossing the health care finance and marketing courses, the 3rd annual Tiger Tank pitch competition, an array of esteemed guest speakers visiting the program each week, and, of course, the Preceptors' Conference in early May, which will begin the process of students identifying and securing their administrative residencies for 2018.  That's a lot to swallow, but we know the fast-paced semester will fly by while yielding tremendous development and growth among our students.  It's a fun time to be a Trinity Tiger and HCAD family member...welcome back students!