Friday, February 1, 2013

Strategic and Business Planning for Healthcare Professionals starts today

Today, Tash and I began co-teaching a graduate course in Strategic and Business Planning at Cornell University in Ithaca, NY. Below is the syllabus for the course.

Tash is in her element in front of a class. This photo was taken by Dr. Julie Carmalt at Cornell University, February 1, 2013

Students in PAM 5900, Strategic and Business Planning for Healthcare Professionals

Below is the official syllabus for the course.

New York State College of Human Ecology
A Statutory College of the State University
at Cornell University, Ithaca, NY 14853-4401
Department of Policy Analysis and Management
Sloan Program in Health Administration

PAM 5900: Special Topics in Health Administration and Finance:
Strategic and Business Planning for Healthcare Professionals

Term/Year: Spring 2013
Credits: 2 credits
Meetings: Feb. 1, 1:00 pm – 5:30 pm; Feb. 2, 9:00 am – 5:30 pm
Mar. 8, 1:00 pm – 5:00 pm; Mar. 9, 9:00 am – 4:00 pm
Additional Format: Online readings and support via Cornell BLKBD
Lecturers: Frank A. Niro, M.B.A./Sloan Certificate in HHSA, C.P.A. (retired)
Natasha L. Niro, M.A., Interdisciplinary Studies
Room: MVR 153
Office: 3M07 MVR Hall
Hours: By appointment
Contact information:,

Class size is limited to 20 participants.
S/U option will be made available for this course, upon request.

Course Description:

This 2 credit intensive 4-day seminar, over two weekends, provides students with a comprehensive overview of the key concepts and related terminology that they may encounter during their professional careers concerning the process of business planning in the healthcare environment.

In most industries, a business plan serves two primary purposes: it acts as a roadmap for managers and it helps to secure financing. Healthcare organizations, particularly those operating in the not-for-profit sector, serve multiple constituencies. These may include boards of trustees, tax exempt bond authorities, bond rating agencies, licensing and accreditation agencies, community groups, and venture partners such as physicians and insurance companies. In order to meet the needs of these varied audiences, a standardized approach to business planning for healthcare organizations has evolved.

Premise of the Course:

Students in the Sloan program are exposed to a variety of theoretical concepts in the areas of health policy, management, organizational development, strategic planning, legal and ethical perspectives, marketing, economics, and finance throughout their graduate curriculum experience. Strategic and Business Planning for Healthcare Professionals demonstrates the practical, real world application of many of the theoretical concepts encountered in other courses. This course focuses on ways that healthcare leaders use business plans to communicate a common vision, develop a viable set of strategies, determine financial feasibility, and package the key decision factors in a meaningful way that allows access to the capital needed for achieving organizational and community goals, and long term financial success.

Texts and Reading List:

Piggot, Carolyn. Business planning for healthcare management. 2nd ed.
Philadelphia: Open University Press, 2000.

Zuckerman, Alan. Healthcare strategic planning. 3rd ed. ACHE
Management, 2012.

Payne, Christopher. (May 2012). “Understanding your capital options.”
hfm Magazine May 2012: 69-74.

NOTE: Purchase of the textbooks is optional. Desk copies will be made available for student use. A list of assigned readings will be available prior to the first weekend of classes. Additional articles may be incorporated. Copies of the magazine article will be provided, either in print or by web link.

Learning Outcomes: (Sloan Competencies in brackets)

Upon successful completion of this course students will be able to
• Interpret and understand the information presented in a business plan.
• Illustrate the interrelationship between strategic plans and business plans.
• Bridge the theory-to-practice gap in healthcare planning.
• Identify risks, and ways of reducing risks, to ensure financial success.
(#6 Financial analysis, including reading financial statements; #10 Strategic analysis and management; #17 Problem-solving skills)
• Format and use a business plan as a component of tax exempt bond financing. (#3 Understanding healthcare financing, regulatory, and delivery systems; #6 Financial analysis, including reading financial statements; #10 Strategic analysis and management; #13 Economic analysis, including cost-effectiveness analysis)
• Understand the importance of sensitivity analysis, utilizing electronic tools such as Excel© spreadsheets in the determination of financial feasibility. (#1 Statistical analysis)
• Develop effective written business plans for healthcare organizations and present plans. (#14 Written communication skills; #15 Oral communication and presentation skills)
• Have experience in working with others to critique business plans. (#11 Advocacy, persuasion, and negotiation skills; #14 Written communication skills; #15 Oral communication and presentation skills; #18 Coaching others and providing constructive feedback; #19 Working within diverse groups)
• Continue the practice of reading professional journals and periodicals
(#3 Understanding healthcare financing regulatory, and delivery systems)

Summary of Sloan Program Competencies:

Strategic and Business Planning for Healthcare Professionals is designed to develop and improve student competencies in the following areas:
• # 1 Statistical analysis
• # 3 Understanding healthcare financing, regulatory, and delivery systems
• # 6 Financial analysis, including reading financial statements
• #10 Strategic analysis and management
• #11 Advocacy, persuasion, and negotiation skills
• #13 Economic analysis, including cost-effectiveness analysis
• #14 Written communication skills
• #15 Oral communication and presentation skills
• #17 Problem-solving skills
• #18 Coaching others and providing constructive feedback
• #19 Working within diverse groups

Assessment and Evaluation:

Student understanding of the course materials will be evaluated based on the following combination of assignments and activities:

Participation, 20%. Students are expected to read assigned materials prior to the beginning of class and to actively participate in all classroom discussions and activities. Attendance at the entire seminar is required, unless specific permission is granted by the instructors IN ADVANCE.

Quiz, 10%. A series of three (3) in-class quizzes will be used to assess student understanding throughout the course. A pair of quizzes will be administered to measure students’ initial knowledge and provisional understanding of strategic and business planning concepts at the end of the first day. These two quizzes will be scored for evaluation purposes but will not be graded. A graded quiz will be administered during the second day of the course. Format for all three quizzes will be a combination of True/False and Multiple Choice questions.

Current Readings, 5% The practice of regularly reading professional journals and other print/online sources in order to stay alert to current information regarding healthcare reform, industry changes, etc. is vital to successful strategic and business planners. Each student will share at least one resource with the class through the Blackboard/Forum. Citations should be in proper MLA format.

Written Business Plan, 35%. Each student will submit a written business plan for an entity or project. Plans will include integration of Excel spreadsheets for presentation of financial data. See separate hand-out for specific instructions.

Presentation of Business Plan, 10%. Students will share a brief presentation of their business plan with instructors and classmates. Presentations may be structured as a hospital executive presenting to a Board; a management consultant presenting to a client; or a financial advisor presenting to a lender.

Critique of Business Plans, 20%. Students will provide real-time feedback to one another through a Q & A period following each presentation, as well as by a prepared evaluation form.

Teaching Philosophy:

Because each of us brings a unique perspective to the group, it is important that all students are given an opportunity to engage in the unfolding of knowledge according to their own process and provisional understanding. We, as instructors, believe in providing an environment wherein students can participate in the learning experience to their best advantage. It is our expectation that students will treat one another with the respect properly accorded to colleagues and fellow scholars, recognizing that while we might not always agree with someone else’s interpretation of the data at hand, we can nonetheless continue to collaborate in the learning process. We consider ourselves co-learners with our students and value the insights and revelations offered by each one.

Class Routine:

As a condensed discussion based seminar, in-class participation by all students is essential. Portions of the required texts will be assigned prior to the first weekend and students must be prepared to discuss them. Supplemental printed materials may be provided during class. No off-campus field trips are required as part of this course. Attendance at the Sloan Strategic & Business Planning Colloquium is strongly recommended. A detailed outline of the course schedule is included at the end of the syllabus.

A Blackboard/Forum will be established on the website to facilitate discussion and to allow the students to seek help and input from the instructors and each other. The appropriate url address and protocols for use will be given during the first weekend.


Working knowledge of Microsoft Excel (2007 or later).

Academic Integrity:

The University Faculty Senate has developed a Code of Academic Integrity that governs all student academic undertakings. Absolute integrity is expected of every Cornell University student. A Cornell student’s submission of work for academic credit indicates that the work is the student’s own. All outside assistance shall be acknowledged. For the specifics of this code of conduct, see

Course Framework:

We will start by focusing on the relationship between strategic planning and business planning, initially in the context of acute care hospitals and tax exempt bond financing. As the course progresses, we will build and expand to include diversification activities and specialized projects such as outpatient facilities and congregate housing, as well as additional financing opportunities including hospital-medical staff partnerships, joint ventures and access to venture capital.

We will explore the revenue and expense cycles in healthcare organizations, including third party payments from insurance companies and uncompensated care. We will differentiate between operating budgets and capital costs and explore why the distinction is important for business planning. We will look at interest and depreciation as factors affecting cash flow and financial feasibility.

Also during the first weekend, the students will be presented with the essentials of utilizing Excel© spreadsheets to develop financial pro forma statements including balance sheets, income statements and cash flow forecasts. In this context, we will explore the process of sensitivity analysis and the determination of financial feasibility using key financial ratios and indicators. We will discuss the evolution of commercial spreadsheets since VisiCalc and Lotus 1-2-3 and the advanced analytical tools that have evolved over the different versions of Excel© since 2003.

Case Studies: Actual business plans developed in the past few years by existing healthcare entities will be analyzed in detail during class. We will examine a recent health system prospectus for its bond re-financing, with emphasis on the structure and content of “management’s discussion of future plans” (known as Appendix A).