1. HPM EMP End of Term Simulation Lenovo Instructional Innovation Grant Center for Faculty Excellence, UNC-Chapel Hill

2. Curriculum Integration Year 1Year 2 The Healthcare Context: Macro Level 4 (Hobbs) HPM 754 Healthcare Statistics 3 (Porto) HPM470 Healthcare Statistics 3 (Porto) HPM470 Applied Leadership Integrative Module Financial and Managerial Accounting 5 (Zelman) HPM746 Financial and Managerial Accounting 5 (Zelman) HPM746 Leadership and Workforce Man 4 (Paul/Fried) HPM728 Leadership and Workforce Man 4 (Paul/Fried) HPM728 Applied Leadership Integrative Module Public Health Concepts 3 (Porto/Biddle/Wells) HPM 611 Public Health Concepts 3 (Porto/Biddle/Wells) HPM 611 Finance and Economic Analytics 4 (Vernon) HPM 747 Finance and Economic Analytics 4 (Vernon) HPM 747 Strategic Planning and Marketing 3 (Thomas) HPM 725 Strategic Planning and Marketing 3 (Thomas) HPM 725 Healthcare Policy and Economics of Healthcare Insurance 3 (Vernon/Reiter) HPM748 Healthcare Policy and Economics of Healthcare Insurance 3 (Vernon/Reiter) HPM748 Applied Leadership Integrative Module Health Law 3 (Harris) HPM 710 Health Law 3 (Harris) HPM 710 Capstone 4 (Sloate/Levy) HPM 736 Capstone Business Plan Master of Healthcare Administration (MHA) Program Foundation (On-Campus Workshops & Seminars) Distance Learning Coursework On-Campus Integrated Exercise Applied Leadership Integrative Module BaseCamp II ½ BaseCamp II ½ BaseCamp I ½ BaseCamp I ½ Leadership Practicum & Journaling Advanced Analytics 4 (Wheeler/Hassmiller Lich) HPM777 Advanced Analytics 4 (Wheeler/Hassmiller Lich) HPM777 H I & Quality Tools HPM758 2 (Mandelkehr) H I & Quality Tools HPM758 2 (Mandelkehr) H I & Quality Apps HPM 763 2 (Mandelkehr) H I & Quality Apps HPM 763 2 (Mandelkehr) Applied Leadership Integrative Module

3. Project Team Steering Committee –Jim Porto (EMP Program Director/Faculty) –Roger Ackers (Sheps/Lineberger) –Libby Evans (ITS) –Bob Henshaw (CFE) –Sue Hobbs (HPM Faculty) –Steve Sloate (HPM Faculty) –Scott Williams (ITS) Development –Jay Levy (Project Manager) –Larry Mandelkehr –Jason Morningstar Initial project funding provided by a Lenovo Grant awarded by the Center for Faculty Excellence (CFE)

4. Monroe County, State of Franklin

5. Diverse Population

6. City of Easttowne

7. Governance Environment

8. Decision Variables (Inputs) County Property Tax Rate per $100 Assessed Value Poverty Level Household Income Cutoff –Established that State has exemption to self-fund Medicaid above federal Poverty Level Income Cutoff County Public Health Budget Allocation (% of property tax collections) County Public Hospital Budget Allocation (% of property tax collections)

9. Outcome Variables (Outputs) ** Public Support Index serves as a proxy for public opinion based on political affiliation and changes in variables

10. Linkage Matrix

11. Simulator Rounds Round 1 –Single Decision Variable Input Tax Rate Round 2 –Multiple Decision Variables Input Tax Rate Poverty Level Round 3 –All Decision Variables Input Round 4 –All Decision Variables Input –Introduce Shock Round 5 –All Decision Variables Input after integration of shock

12. Input Document – Round 1

14. Decision and Output Variables Business Rules New Tax Collections Number of Direct Pay Change due to Tax Rate (Offset in Uninsured) New Percent Below Poverty Level Change to Poverty Population Change to Medicaid Covered (Offset by Uninsured) Change in West Franklin Hospital System ED Visits from Change in Uninsured Change in McPherson Hospital ED Visits from Change in Uninsured Change in West Franklin Hospital System ED Visits from Change to Allocations Change in McPherson Hospital ED Visits from Change to Allocations Change in West Franklin Hospital System Charity Write-off Amount from Change in Uninsured Change in McPherson Hospital Charity Write-off Amount from Change in Uninsured New Tax Burden on West Franklin Hospital System Change to West Franklin Hospital System ED Costs Change to McPherson Hospital ED Costs Change to McPherson Hospital Allocation Change to PH Clinic Costs based on Uninsured Change to PH Allocation Change in STD cases from Change in Uninsured Change in STD cases from Change in PH Allocation

15. Public Support Business Rules

16. Round Results with Introduction of Shock

17. Recap Results

18. Preliminary Survey Results Because of this two day integrated exercise, I am better prepared and able to apply the concepts from my courses this fall semester –91% agreed or strongly agreed The Franklin State Simulation is an effective way to visualize the complexity of public health issues in the real world –94% agreed or strongly agreed Overall, the Franklin State Simulation is an effective way to bring together all the topics covered this semester –94% agreed or strongly agreed Evaluation performed by the Center for Faculty Excellence n=53

19. Three pronged approach