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Week 5 discussionAggregate Demand and Aggregate Supply (graded)Go to the BEA website www.bea.gov. On the left tab under Publications, go to the Interactive Data Tables. Select National Income and Product Accounts. From Table 1.1.6 and 1.1.7 examine all four components of GDP (C, I, G, and Xn). Which of these four components of AD declined the most during the 2007 and 2009 recession? Do you think an increase in government’s spending (G) can boost the Aggregate Demand (AD) in a recession? Analyze why the economy may operate below full-employment GDP in the short run. How can the multiplier have a negative effect? What is the relationship between the multiplier and the marginal propensities? Explain.Fiscal Policy (graded)Give an example of an event or incident that has taken place in the U.S. economy which has a major economic impact–be specific, e.g., 9/11 attack, natural disaster, rise or fall in oil prices due to OPEC policies, consumer optimism or pessimism about an expected economic expansion or downturn, increase in government spending on healthcare, tightening of the legal and institutional environment, and so forth. What effect would this event have on AD or AS, other things being constant? What would be the resulting effect on equilibrium price level? Explain. What will be the effect of the different tools of fiscal policy to stabilize the economy? Give an example of a built-in stabilizer and explain how it would work to reduce this rise or fall in the level of AD.

You are going to create the three scenarios now by calculating the Adjusted PMPM Cost (column H) and Inflation Adjusted PMPM Cost (column I) for each item. You will do this by inputting the copay adjustment factors (columns F and G) presented in the case, based on various assumptions. HINT: For all scenarios, you might find it easier to go through Exhibit 5.2 in the case and mark ‘high’, ‘moderate’ and ‘low’ copay amounts. This should make it easier to find the adjustment factors when it comes time to fill in the relevant cells.In the first worksheet, create the ‘moderate premium’ scenario. These will be the rates most likely to be put forward to the business consortium.Use the following assumptions:Mental Health Coverage limited to 60 days.Copays are as follows:Acute Inpatient Care $150/admissionMental Health Inpatient Care $150/admissionInpatient Surgical Services $100/procedureEmergency Care $ 25/visitPrimary Physician Care $ 15/visitSpecialist Physician Care $ 10/visit (at $10 PCP copay level)In the first duplicate worksheet, create a ‘high premium’ scenario using the following assumptions:Mental Health Coverage limited to 90 days.There are no copays with this plan.In the last worksheet, create a ‘low premium’ scenario using the following assumptions:Mental Health Coverage limited to 30 days.Copays are as follows:Acute Inpatient Care $250/admissionMental Health Inpatient Care $250/admissionInpatient Surgical Services $250/procedureEmergency Care $ 50/visitPrimary Physician Care $ 25/visitSpecialist Physician Care $ 15/visit (at $20 PCP copay level)At this point, you should have two premium rates – single and family – for each of the three scenarios. When done, please answer the following questions in a separate document or within each worksheet:1. Calculate the total amount that will be received from the consortium in each scenario, given 75,000 members.2. Assume that the consortium wants employees to pay one half of the final premium. Furthermore, the consortium wants to limit the family coverage premium to twice that of the individual coverage premium. What are the resulting costs to employees under individual and family coverage? Do the calculations for each scenario.HINTS: You will have to drag out some (very simple) algebra for this one! Also, remember that there are 12,000 employees who have single coverage, and 18,000 employees who have family coverage.3. Which plan(s) should Blue Pointe Healthcare offer to the buyer consortium? Why? Think sales strategy.

Assignment- Regulation & matters concerning consumer safety-
4 QuestionQ. 1. What act created the first comprehensive scheme of regulation over matters concerningconsumer safety?Q. 2. Dave receives an unsolicited credit card in the mail. Before he can check the mail, the credit card is stolen from his mailbox. The thief uses Daves credit card and charges exactly$1,252.76 before the credit card company notices the suspicious activity and deactivates the card. How much of those unauthorized charges is Dave liable for?Q. 3. Couch Potato Cable Co. is subject to mandatory workers compensation laws in the states in which it does business. Justin and Phil work for Couch Potato Cable Co. as part of a crew thatinstalls and repairs cable lines. While installing new cable lines at a job site, Justin is injured in an accident that is entirely Phils fault. Justin files a claim for workers compensation. Should theclaim be granted? Why or why not?Q. 4. American Automobile Assemblers Union (AAAU) is a large union whose members consist of various assembly line workers who put automobiles together. The AAAU is the official labor union of the assembly line workers who work at Fords factory in Detroit. After alarge recall in Ford trucks, Ford decides that they will not give their workers a yearly raise andthey will raise their monthly premiums for healthcare. The enraged employees strike for better wages and healthcare. During the strike, Ford hires workers to come in and replace the striking workers. Ford hires exactly as many workers as those who were striking so they can keep production constant. After two months of striking, Ford and AAAU come to an agreement about wages and healthcare premiums which ends the strike. AAAU tells Ford that they must fire the scabs who were hired during the strike so their union members can have their jobs back. Ford says that they arent going to fire anyone and they dont have to. Who is right and why?

IBM in the 21st Century: The Coming of theGlobally Integrated Enterprise“Global integration is the new game. Innovation is the way to win. We must be out thereconnecting across the world.” –Sam Palmisano, Chairman and CEOIn April 2008, members of IBM’s fifth Integration and Values Team (IVT5), were close to finishingtheir deliberations. This high-powered group of high-level executives included country generalmanagers from India and Brazil as well as vice presidents from businesses and functions, chosenfrom a group of about 300 leaders convened by Chairman and CEO Sam Palmisano to view IBMholistically. Senior VP of Corporate Communications and Marketing, Jon Iwata, and the new head ofResearch, John E. Kelly III, were the executive sponsors. IVT5’s focus was on “the global IBMer”defining and developing leaders for the global economy; making the “globally-integrated enterprise”relevant to all employees through global citizenship and the IBM values and culture; and ensuringmarket access in the form of a level playing field for IBM to compete globally. The scope was all 170countries in which IBM operated.iTeam members felt excitement and urgency. Palmisano expected recommendations in late May, asthe next major part of IBM’s transformation to a globally-integrated enterprise. Over its nearly 100year history, IBM had moved from international (exporting from the U.S.) to multi-national (withsubsidiaries in many countries) to global. Starting with the first IV team in 2002, convened toglobally-integrate the supply chain (e.g., one global instrument for requisitions), teams had identifiedways to integrate manufacturing (e.g., test engineering from anywhere in the world, to analyze andfix any line in any plant), create an integrated human capital supply chain (e.g., data bases with acommon definition of skills and experience, global recruitment and on-boarding process), and createinterconnected global solutions centers serving the world (e.g., centers for ERP (enterprise resourceplanning systems in Bangalore, the oil industry in Norway, banking in the U.S. and elsewhere).Other projects were underway. IBM realized considerable efficiencies from all of them.IVT5’s mandate was slightly different and more general, yet critical to making the rest of thetransformation work in practice: the people and the culture that would produce many more globalleaders and global citizens. The team faced the usual challenges of change – identifying the mostimportant needs and barriers, thinking creatively about approaches that would take advantage ofIBM’s strengths while finding new opportunities, setting an inspiring theme that would attractsupport. In addition, there was the uneasy fact that globalization was misunderstood in many places,by the public if not government officials. Outside the U.S., IBM was still a “foreign” company even ifstaffed completely with local citizens, although IBM was able to operate as a trusted partner in________________________________________________________________________________________________________________Professor Rosabeth Moss Kanter prepared this case. HBS cases are developed solely as the basis for class discussion. Cases are not intended toserve as endorsements, sources of primary data, or illustrations of effective or ineffective management.Copyright © 2008, 2009 President and Fellows of Harvard College. To order copies or request permission to reproduce materials, call 1-800-5457685, write Harvard Business School Publishing, Boston, MA 02163, or go to https://monkessays.com/write-my-essay/hbsp.harvard.edu. No part of this publication may bereproduced, stored in a retrieval system, used in a spreadsheet, or transmitted in any form or by any means—electronic, mechanical,photocopying, recording, or otherwise—without the permission of Harvard Business School.This document is authorized for use only by Irene Grant in GB600 Leadership Strategies for a Changing Worldtaught by Kaplan University from June 2012 to June 2017.For the exclusive use of I. Grant308-105stIBM in the 21 Century: The Coming of the Globally Integrated Enterprisevarious geographies. Internally, some IBMers in mature markets who saw IBM shifting attention tothe rapidly-growing BRIC nations (Brazil, Russia, India and China) understood the rationale butfeared the consequences. At the same time, some IBMers outside the U.S. felt that IBM was still toomuch of an American company making too many decisions in New York. So IVT5’s mandate wasnot as simple as leadership development for a globalizing world; team members also had to focus onlocalizing IBM to connect its people not only with each other and with customers and industries butalso with communities and nations.IVT5 members had seen abundant facts and figures, such as IBM’s existing efforts on leadershipdevelopment and international assignments, its array of global corporate citizenship initiatives, andits extensive training and professional development. But to think creatively about the future, theywould have to wrap their minds around the whole system (and ecosystem): IBM’s business model,the implications of global integration, the IBM values, corporate citizenship as an approach and a setof partnerships, how people came to be IBMers and relate to such a diverse global population, andhow people did their work in IBM. That was a great deal to review, the length of at least three,perhaps four, Harvard Business School cases.As leaders who had risen to their positions because they were globally-oriented systems thinkerswho reflected IBM’s emphasis on innovation, they knew that it was necessary to stand back to look atthe big picture – to see how IBM worked now, to view IBM at its best, but also to understand thegaps, dilemmas and opportunities.Company Profile: The International Business of IBMBy 2008, IBM was a self-described “globally-integrated enterprise focused on innovation,” with386,000 employees working in 170 countries generating $99 billion in annual revenues (See Exhibit 1for five-year income statement). Headquarters was in a sleek low building on a verdant park-likesetting in Armonk, New York.International Business Machines Corporation, founded in 1911 in New York State by ThomasWatson, was familiarly known as the Blue Giant or Big Blue after the color on its unchanging logo.That was all that remained unchanged during the information revolution of the second half of thetwentieth century. Most of the machines IBM had produced through the years had disappeared, asIBM shifted its business mix to reflect changes in technology and to push the innovations thatproduced those changes. For example, IBM was credited with introducing the field of computerscience, and the name, as a distinct academic endeavor. Though some considered it a lumberinggiant, IBM was one of the few computer manufacturers to survive more than 25 years, and as IBMheaded for its 100th anniversary, it had transformed into a technology solutions company rather thana maker of boxes.“Big Blue” hit upon rough times in the late 1980s and early 1990s when profits from its mainframeand PC businesses started to tumble. Its resurgence began in 1993 under Chairman and CEO Louis V.Gerstner, Jr., who was a rare external hire. By the end of his nine-year tenure in 2002, IBM wastransformed from primarily a manufacturer of hardware into a provider of software, services, andsystems (See Exhibit 2), and it had embraced the Internet. In 1995, IBM acquired Lotus, a premiersoftware development company based in Cambridge, Massachusetts, for $3.5 billion.ii In 2002, IBMpurchased PricewaterhouseCoopers to round out its consulting offerings, having already boughtmuch smaller Internet-services companies. From 1993 to 2001, the last full fiscal year before Gerstnerstepped down, IBM grew from $63 billion in revenues with a loss of $8 billion to $82 billion withearnings of $8 billion.2This document is authorized for use only by Irene Grant in GB600 Leadership Strategies for a Changing Worldtaught by Kaplan University from June 2012 to June 2017.For the exclusive use of I. GrantstIBM in the 21 Century: The Coming of the Globally Integrated Enterprise308-105In 2002, IBM-lifer Samuel J. Palmisano was appointed Chairman and CEO (See Exhibit 3 for a listof senior executives). Between 2003 and 2007 IBM spent $16 billion to acquire over 50 smallercompanies, mostly in software development.iii In 2005, the company sold its PC business to Lenovo, aChinese manufacturer and long-term IBM business partner. At the same time, the services business,particularly IT systems integration, faced strong competition from the explosive growth of the“outsourcing” industry in emerging countries, especially India.IBM grouped its businesses into four main areas. Global Services included two segments – GlobalTechnology Services (GTS), which focused on client IT infrastructure needs, and Global BusinessServices (GBS), which offered business consulting, systems integration, and application managementexpertise. Together, they accounted for $54 billion in revenues – $36 billion from GTS and $18 billionfrom GBS. GTS grew by nearly $4 billion in 2007, while GBS expanded by over $2 billion. Systemsand Technology, which offered more robust computing and data storage assistance for large clients,accounted for $21 billion in sales, 45% of which was delivered directly to clients, while the remaining55% passed indirectly through business partners. Sales in the latter area had fallen by $600 million in2007. The Software business provided middleware and operating systems to help customersintegrate disparate IT applications within their organization. Industry-specific applications includedinformation management and product lifecycle management programs. The area generated nearly$20 billion in revenues and had grown nearly $2 billion in 2007. Global Financing brought in $2.5billion by offering client and commercial financing. It also remarketed used products through sale orlease. A relatively small fraction of the total business, the unit grew by $137 million in 2007.Global Scope“International” continued to be IBM’s first name and a reason for its success. About 60% of IBM’srevenues stemmed from its non-U.S. operations and 65% of its employees worked outside the U.S. In2007, the company divided its global operations into three super regions: Europe, Middle-East andAfrica (EMEA); Asia Pacific; and the Americas. EMEA employed 25% of IBM’s workforce whileaccounting for 36% of revenues. It had manufacturing plants located in Ireland, Hungary, and France.Asia Pacific had 30% of total employees and contributed 21% of sales. Production facilities operatedin China and Singapore. The Americas accounted for 45% of the workforce and 43% of globalrevenues, with manufacturing sites in New York, Minnesota, California, and Mexico.iv For 2007,IBM’s profits were derived largely from Europe and emerging countries like India, China and Brazil.In 2006, the company moved its global procurement function from Westchester, New York, toShenzhen, China, and integrated supply chain management into one global system.A growing proportion of IBM’s workforce and revenues had shifted outside the U.S. The BRIC(Brazil, Russia, India, and China) countries had expanded at twice the global rate, averaging 21% in2006: 19% in Brazil, 21% in Russia, 38% in India, and 16% in China. To support this growth, IBMtripled the number of employees in these locations. Overall more than 90,000 employees were addedto its emerging market workforce since 2003. By 2008, Russia employed an estimated 2,000 people,China and Brazil 13,000 each, and India 75,000, making it home to the largest number of IBMemployees outside the U.S (See Exhibit 4 depicting the extent of IBM’s global workforce).vHistorically, activities in the BRIC countries were hindered by unfavorable state regulations.vi In1918, an arm of IBM opened offices in Brazil. In 1971, it inaugurated a major manufacturing facility asprotectionist law forbade the company from importing many products. But IBM stayed, partnering inBrazil’s first information technology joint-venture in 1991, which gave it an important presence forthe coming economic liberalization. IBM operated in India from 1951 to 1977, pulled out due todisputes with the government over equity participation and intellectual property, then returned in1992 via a joint venture and, in 1999 as a wholly owned subsidiary. Although IBM had offices in3This document is authorized for use only by Irene Grant in GB600 Leadership Strategies for a Changing Worldtaught by Kaplan University from June 2012 to June 2017.For the exclusive use of I. Grant308-105stIBM in the 21 Century: The Coming of the Globally Integrated EnterpriseChina before the Communist takeover it did not return until 1979, as the Cultural Revolution ended,when it installed a computer for the Shenyang Blower Works, the first of its kind since the foundingof the PRC. With the deepening of economic reform in the mid and late 1980’s, IBM set up offices inBeijing and Shanghai. In 1992, IBM officially announced the establishment of IBM China CompanyLimited, its first solely funded enterprise in China. In 1993, IBM China established offices inGuangzhou and Shanghai and by 2007 had 26 offices covering 320 cities in China. A Russian presencebegan in 1993, following the Cold War. By 2005, the company had taken advantage of statesponsored efforts to promote a technology park in Akademgorodok, which rapidly became a “SiliconSiberia.” Because it was an area of focus, Russia at 800 people had the full set of functions that amature market possessed, as contained in the IBM Corporate Blueprint.Investment expanded in other emerging markets. In December 2007, IBM announced plans toinvest $1.6 billion in developing countries in Asia, the Middle East, and Latin America.vii In 2007,over 50 countries in the IBM family, including Poland, South Africa, and Mexico, grew more than10% (See Exhibit 5 for geographical scope of growth).viii Egypt, where IBM had operatedcontinuously since 1954, was another growth target. “Egypt’s growing like crazy,” Sam Palmisanosaid, referring to the country’s double-digit growth.ix Services, such as call and data centers, hadmoved there. Egypt was also home to a large software laboratory and an expanding commercialexport business, given its ideal positioning between Europe and the Middle East.The Extended Family and Ecosystem NeighborsIBM served every industry, with financial services, telecommunications, distribution (wholesaleand retail), and government leading the list nearly everywhere, with other industries important tosome regions, such as oil and gas in Russia. A similar set of competitors popped up everywhere: HP,Microsoft, Oracle, and Accenture. Sometimes competitors were also collaborators – for example,competing in software with Oracle but partnering with Oracle in business consulting; or competingwith Microsoft in software but partnering with Microsoft in some regions to sell Intel servers. CiscoSystems was a long-time partner more recently entering domains where it competed with IBM. “Thisis the beauty of IT marketing,” an IBM sales executive in an emerging market said. He also said,“IBM is very recognized as an IT company, but still not as a business consulting company. This is stilla surprise for many customers.”IBM leaders counted its extended family as well as IBM employees and wholly ownedsubsidiaries when describing IBM’s size. Corporate communications head Jon Iwata described IBMas also consisting of “33,000 companies in the global supply chain, 100,000 companies in the businesspartner network, and at least one million clients – we say the one million because it is difficult toassess,” he explained.Business partners included resellers, systems integrators, specialist software developers, trainers,even competitors with whom IBM could connect to offer an integrated solution to customers. Fundsfor training business partners came from channels enablement initiatives; there were screens,guidelines, and certification.IBM relied on business partners everywhere, but in emerging markets even more strongly than inmature ones. Sheer geographic size and infrastructure development stage necessitated this, even ifthe co
pany could have added employees fast enough. In Russia, with its 11 time zones and hugegeographic extent, business partners were an important part of the go-to-market strategy. Businesspartners could also use lower-paid employees on smaller projects, making IBM’s technology moreaffordable to more customers, while preserving IBM’s position as a high-end services provider. InChina, planned growth from operations in 22 major cities (such as Beijing, Shanghai, and4This document is authorized for use only by Irene Grant in GB600 Leadership Strategies for a Changing Worldtaught by Kaplan University from June 2012 to June 2017.For the exclusive use of I. GrantstIBM in the 21 Century: The Coming of the Globally Integrated Enterprise308-105Guangzhou) at the beginning of 2007, to reach 300 second, third, and fourth tier cities in remoteregions, would involve business partnerships with companies that already had a foothold in thosecities and could provide local knowledge and local service. Large strategic partners were also criticalin China, especially with the central and local governments; the executive for strategic partnerships,Liu Bo, came to IBM after having founded and headed Red Flag Linux and later served as VP ofMicrosoft China, thus bringing a wealth of connections.Relationships with channel partners could be complex, not only because projects had differingrequirements but also because of local political issues. Managers stressed the need to make a habit ofcollaboration and to have sufficient flexibility to play a variety of roles depending on circumstance.In Russia, there were instances in which a major government entity would want a Russian companyas the prime contractor, even though the domestic company lacked relevant experience; IBM couldbring its global experience to bear as a subcontractor. In other instances, IBM would include businesspartners as subcontractors instead of increasing the size of its delivery organization, solidifying thepartner relationship by giving them the business.IBM had long focused on technology education, e.g., at colleges and universities, which wouldhelp ensure technical competence for both future employee and in partner organizations. In emergingmarkets, IBM’s role in educating business partners and raising standards was more especiallyimportant, and not just in technology but also in business practices, and particularly for small andmid-sized business partners. In Egypt, the country general manager dedicated a staff member towork with small resellers, to make sure that they had the right structure, skills, tactics to deliver toIBM standards; he put personal time into this as well. IBM Egypt offered role-playing courses thatincluded how to speak to customers. Partners were also given customer leads.Small and mid-sized businesses (SMB) were increasingly viewed by IBM as an important target.Not only were they business partners in strategic regions and even potential customers, but theywere a focus of government economic development efforts. By training SMBs and improving theirbusiness practices, IBM could show, as a country general manager put it, “This is the way for me tosay that I’m not just coming and taking money as some Western, some American company, and that’sit. We develop the skills of the market. I am part of this project to contribute to the country’s agenda– to develop the high-tech element of the national agenda.” In 2006, IBM decided to help the SMBcommunity in a philanthropic partnership with the International Finance Corporation of the WorldBank to develop of a Web portal with a range of business tools and resources. It was launched inIndia and South Africa in 2007 with content provided by local partners like ICICI Bank in India.Often, NGOs would serve as intermediaries to introduce the SMB toolkit to the market.Technology and InnovationIBM’s classic emphasis on innovation captured in the famous injunction “Think” and theThinkPad name on IBM’s (now Lenovo’s) laptop computers, was ratcheted up in recent years, wellbeyond research and development labs, which remained significant and a competitive advantage,especially if lab developments could be transferred quickly to customers for IBM services. IBMoperated 61 technology research and development laboratories in 15 countries, including majorresearch centers in the U.S., China, Israel, Switzerland, Japan, and India, with development orapplication centers elsewhere. Since 1993, IBM had registered more U.S. patents than any othercompany in the world.Still, with the emergence of the Internet in the late 1990s and the opening of the World Wide Webin 1993, IBM was perceived by some as losing the innovation edge, the way some saw it had missedthe move to client-server computing in the 1980s. But IBM was agile and adaptive. IBM embraced5This document is authorized for use only by Irene Grant in GB600 Leadership Strategies for a Changing Worldtaught by Kaplan University from June 2012 to June 2017.For the exclusive use of I. Grant308-105stIBM in the 21 Century: The Coming of the Globally Integrated EnterpriseLinux (photos of Linus Torvald could be found in offices in Brazil and elsewhere) and open sourcecomputing; in 2005, 500 IBM software patents were made available, free, to anyone working on opensource projects. IBM moved functions to the Web. It built SOA – service-oriented architecture — thatcan integrate IBM hardware & software platforms to give customer an integrated system. (“Wejumped all over that in a New York minute,” executive vice president of technology and innovationNick Donofrio said). And IBM became a leader in machine-independent “on demand” computing.IBM also made plans to introduce a new academic discipline, akin to its work in establishingcomputer science, called service science management and engineering (SSME). In 2005 IBM began towork with the Ministry of Education in China, responsible for over 1000 universities to deploy theSSME curriculum first in China, together with 40-50 Chinese universities; the director of the IBMChina Research Lab and several senior researchers taught SSME courses at Peking University andTsinghua University.IBM wanted innovation to come from everywhere, inside and outside the company. IBM started aGlobal Innovation Outlook (GIO) research effort involving a hundred internal and external experts.“The whole purpose is to torture ourselves on each of our lines of business. What’s happening to it?Is it changing? What are the fundamental underlying technologies? Where are they going?” Donofriosaid. Donofrio credited senior vice president for strategy, Bruce Herald, with forging strongrelationship with venture capitalist, saying “Ten years ago, we were void of VCs. Now, they all loveus, we know them all, we work with them to buy their companies, we help their companies, we selloff inventions we can’t commercialize within IBM. Because we don’t know everything.”IBM defined innovation to include processes as well as products, and anyone could play.Employees could submit ideas and engage in dialogue about them through ThinkPlace, a site on theIBM intranet. The discussion eventually extended much further. In July 2006, IBM convened anInnovation Jam, billed as the “largest on-line brainstorming session ever.” Participants included IBMemployees and their family, educational institutions and business partners, as well as clients fromnearly 70 companies. The jam took place over two 72-hour sessions, involved 150,000 people in 104countries, and resulted in 46,000 innovation ideas. In November 2006, Palmisano announced that thecompany would invest $100 billion in initiatives resulting from the jam, ranging from healthcare andenvironment to traffic and social utility projects, and it would emphasize virtual worlds, socialnetworking, and other recent developments.Palmisano said: “We must be ahead of strategic shifts. We can’t miss a cycle and catch up. Weannounced a new platform, the on demand network, at the Museum of Natural History, in October2002. People thought IBM was crazy when we announced it. Now IBM and Google are workingtogether. They picked IBM as the only one with the right technology to be their partner.” In October2007, IBM announced a partnership with Google for a cloud computing initiative (cloud computingwas an offshoot of grid computing that could harness the power of multiple unrelated computersthrough the internet); the initiative would eventually donate 4000 computers to universities, fromwhich students and researchers would have the resources needed to not only develop knowledge ofparallel computing, an emerging industry, but create new and open software applications, rangingfrom data mining and social networking to climate modeling and gene sequencing.To decrease lag time between technology innovation and customer orders, IBM sought way todemonstrate the potential for innovation to drive new solutions. Innovation Centers werestrategically-located places that showcased new possibilities, running futuristic prototypes forvarious industries, such as the Innovation Center on the first floor of the China Technology Lab insuburban Beijing. An Innovation Center in Barcelona, Spain, focused on banks of the future. Becausethe realities of banking were different in Latin America (e.g., large population with no access totechnology), an Innovation Center for financial services was established in Brazil, featuring solutions6This document is authorized for use only by Irene Grant in GB600 Leadership Strategies for a Changing Worldtaught by Kaplan University from June 2012 to June 2017.For the exclusive use of I. GrantstIBM in the 21 Century: The Coming of the Globally Integrated Enterprise308-105such as payment through cell phones, or a system based on images from bank’s digital cameras formanaging large queues so that a bank could attend to a customer in 15 minutes, as required by a newBrazilian banking law. In addition, IBM also demonstrated new technology through public-facingprojects contributing solutions to societal problems, such as scientific research on disease or K-12public education, which also reflected IBM values.In IBM’s strategic planning process, the lines of business examined technology trends andresponded. To think across the businesses, there were three global councils consisting of a crosssection of top leaders, for technology, strategy, and operations to help ensure that there was a flow, astechnology became part of strategy, and strategy was implemented. Integration was among IBM’sbiggest challenges.Management by Flying AroundWhen Sam Palmisano became CEO, he saw the company’s fortunes tied to the reality ofglobalization and historic changes in technology. Web 2.0 moved more applications directly to theWeb, and open standards-based computing was more prevalent, making it harder for companies tolock in customers to their standard. The Internet was making the world smaller and more connected,and freer trade meant that IBM customers crossed borders in numerous ways. Emerging nationswere not only sources of market growth but also had a skilled population and were major producersof IT talent. These changes stimulated Palmisano to define a new concept of the corporation: that itmust become a globally-integrated enterprise (GIE).Trade liberalization, open source software, and a freer movement of people across nations werethe main themes on the IBM public policy agenda in every country, coordinated by governmentrelations staffs worldwide, and echoed in Palmisano’s speeches as well presentation by IBM leaderseverywhere. Palmisano told the world that IBM would make location decisions based not only oncosts and the availability of talent but also on the openness of the environment.Palmisano spent about half his time externally focused. He was attuned to the external world,having started at IBM in sales and service, a market-facing job where the laboratory was thecustomer’s office. His leadership was seasoned by postings in Japan, eventually assuming a top postin the Asia-Pacific region, which, he said, changed his perspective: If you live and work in alanguage that’s not your native tongue, you learn a lot. I built relationships throughout Asia. Thatmakes a difference. Our big strategic deals in Asia are all a result of personal relationships, some ofwhich I established when I was there. You can’t be transactional, Asia is relational. They want toknow your company is sustainable, will be there in a hundred years, is committed to the society – notjust selling PCs in stores.” Thus, Palmisano spent a great deal of time talking with governmentofficials about public policy and societal issues, especially in the developing world, combined withtown hall meetings with IBMers in selected areas, judiciously-chosen speeches and occasional mealswith major customers, such as a lunch in São Paolo with a few leading bank CEOs and Latin Americageneral manager Rogerio Oliveira before addressing a major conference on innovation. Jon Iwataobserved, “He is invited to talk with political leaders in a different way than in the past. It used to beabout IBM investing in their country or as an employer. The discussion now is about nationalcompetitiveness – what will create jobs – policies on education, infrastructure, the environment.”In a typical week in the fall of 2007, he met with the Chancellor of Germany in Berlin and returnedto New York to announce the initiative with Google to train future computer scientists. A yearearlier, in November 2006, Palmisano stood with high-ranking officials in Beijing, China: to makethree important announcements that signaled IBM’s future directions; first, with the Chinese7This document is authorized for use only by Irene Grant in GB600 Leadership Strategies for a Changing Worldtaught by Kaplan University from June 2012 to June 2017.
1. A brief summary of the case.2. What global forces drove IBM to become a globally-integrated enterprise?3. How has IBM adapted thus far? Have they been successful?4.?What skills should global leaders have?5. If you were Jon Iwata and John Kelly, what recommendations would you make to Sam Palmisano? How would youimplement them?

Industry Analysis Term Paper1. PurposeThe purpose of this term paper is to provide each student with the opportunity to apply economic analysis to a U.S. healthcare related industry and to learn how to deal with business problems from an economic perspective. There are five industries related to U.S. healthcare for choices:• private health insurance• physician services• hospital services• pharmaceutical• long-term careStudents are supposed to choose one among the five choices to develop analysis paper for the industry in the U.S. operation.2. Defining the IndustryIt is very important to define the industry precisely; otherwise, there will be a tremendous amount of unrelated data available. The U.S. Standard Industrial Classification (SIC) system has been replaced by the North American Industry Classification System (NAICS) (you can find them trough any website search engine). These codes are widely adopted for record keeping purposes and are often used to index private publication such as market guides, directories of companies, and periodical indexes. Familiarize yourself with the SIC/NAICS categories. Remember: it is important to either narrow or broaden your industry definition based on how much information you are finding.3. Data CollectionFor any strategic planning process, it is important to understand the industry in which you are or will be operating, for without an understanding of that industry, your strategy is unlikely to succeed. Every manager must determine for him/herself the information required to address the decision at hand. In an increasingly competitive and dynamic business environment, success depends on a continuous updating of information on market trends, competitors, and customers.There are two types of data that can be collected and analyzed: (a) primary data collected from government record; (b) secondary data collected from reference materials. Prior to conducting any primary research, savvy managers know that secondary research should be the starting point in the data collection process. The government and other agencies publish a great deal of information whichcan be invaluable in an industry assessment, and which is readily available if you know where to look. While you may not be able to find out everything you need to know, secondary information is an essential management tool. The sources of this information are abundant (in printed documents, via the Internet, etc.), however, they are not always easy to find. Your first challenge is to know where to look and find the most current, relevant, accurate, and reliable information, in a timely manner, when there are so many sources to choose from and investigate. Data must be current, reliable, unbiased, accurate, and relevant to the problem at hand if they are to be useful to the manager. Good managersrely on this information to make decisions that are based on the realities of the marketplace, not their opinions or conjectures. Decisions based on information, however, are only as good as the information itself.Description. This is to be a general introduction to the particular industry. What does the industry produce? What is SIC/NAICS code and description? (4%)History. A brief history. How has the organization of and the nature of competition in the industry evolved from its earliest beginnings? (3%)
Organization. What parts of the chain of production/service do the firms undertake themselves and what do they buy from outside suppliers or pass on to independent distributors or retailers? (3%)Relevant governmental or environmental factors. What role does government play in the industry? How does (will) regulation or other government (future) policy (e.g. reform, trade policy …etc.) affect the industry? (5%)IV. Market Structure (1 page): 10%You need to answer the following two questions precisely: A. How can the market structure of the industry best be characterized: perfect competition, monopolistic competition, oligopoly, or monopoly?Briefly go over the market characteristics to confirm your definition here. (5%)If your industry is competitive, your article should address at least one of the following: large number of firms, a low market share of the firms in a market, low barriers to entry (e.g., the small size of firms that have entered), product/service that is relatively homogeneous (indistinguishable amongcompetitors), and the availability of many substitutes or foreign competition, marginal cost pricing (pricing at the cost of producing an extra item), lack of market power (in other words, price taking, not price making), rapid adoption of new technologies, and the responsiveness of production to increasedprofitability, low long-run profits in the market, low or constantly falling prices, adequate availability of commodity, efficient utilization of a firm’s capacity (price is at minimum average cost), and efficient resource utilization (price equals marginal cost).If your industry is oligopoly or (near) monopoly, your article should address at least one of the following: few firms in the market close to a 100 percent market share of the firms, blockaded entry or high barriers to entry, existence of economies of scale, product/service that is unique when compared with anything produced by anyone else, the lack of substitutes or foreign competition, lack of entry, the ability to set prices for the market (price making), price discrimination, reliable long-run profits in the market; excessively high or rising prices; inadequate availability of commodity and even shortages; inefficient utilization of a firm’s capacity (price far above average cost); inefficient resource utilization (price above the marginal cost of resources).B. How many major firms (up to top four if applicable) are there in the industry and what is their market share? A table showing the market shares in the U.S. is required here. (5%)V. Industry Demand (1~2 pages): 15%
A. What are the key determinants of the market demand in your chosen industry? (10%)B. Describe the current change (at least one) in the determinants that has caused the demand change. (5%)You may want to think about the following factors: population and demographic changes, new regulation (reform), income and wealth trends, consumer tastes and preferences, prices of substitutes and complements in consumption, introduction of new substitutes or complements in consumption,expectations about the future prices of this particular good/service. In general, your insight in this section will determine significantly the quality of paper.VI. Cost Structure (1 page): 10%You need to answer the following two questions precisely:A. What are the key determinants of an existing firm’s (1) fixed costs and (2) variable costs in the short-run? (5%)B. What is the shape of the existing firm’s (1) average cost cure and (2) marginal cost curve (i.e. U-shaped or L-shaped)? A graph illustration here will be a plus. (5%)VII. SWOT Analysis (1 page): 10%SWOT analysis is a structured planning method used to evaluate the Strengths, Weaknesses, Opportunities, and Threats involved in a business venture. A SWOT analysis involves specifying the objective (i.e. profit growth) of the business venture and identifying the internal and external factors that are favorable and unfavorable to achieve that objective. Setting the objective should be done after the SWOT analysis has been performed. This would allow achievable goals or objectives to be set for the organization. Please choose one of the top 4 firms in the industry to analyze the firm’s objective of profit growth:Strengths: characteristics of the firm that give it an advantage over others
Weaknesses: are characteristics that the firm at a disadvantage relative to othersOpportunities: external chances to improve performance (e.g. make greater profits) in the environmentThreats: external elements in the environment that could cause trouble for the firmPlease summarize the analysis in a SWOT Matrix. The following matrix serves as an example:VIII. Analysis of Competitive Forces (Porter’s five forces) (2 pages): 20% Please consider each of the following five forces for the industry. In the beginning of each force, please highlight the force as “strong”, “moderate” or “weak”.A. The threat of entry by new competitors (4%)For example, those industries with high entry barriers, such as pharmaceutical manufacturing, will have fewer firms entering. With fewer firms, there is less environmental complexity, and it is easier for one firm to begin to dominate the industry. Economic rents are usually higher in such an environment and entry becomes more attractive. For industries with a low barrier to entry, such as the physician service, new service providers come and go with great rapidity. This prevents dominance byany one, or a few, firms. Economic rents are usually low.B. The intensity of rivalry among existing competitors (4%) What are the current top firms and their market shares in the U.S.? How they compete (i.e. price or quality)? Any alliance or particular strategy is practiced now for competition? An industry characterized by high rivalry is unattractive because it limits the ability to achieve above normal economic rents. At the other extreme, industries with no rivalry are usually dominated by a few major firms which could limit strategic flexibility. C. Pressure from substitute products (4%)Are the industry’s products/services differentiated and, if so, according to what characteristics (design, function, price range, geographic market, etc.)? How innovative is the industry, and what are the sources of innovation? An industry will be attractive if there is no threat from substitute products. A substitute is any product or service that will fulfill the same need while using a different technology. The relevance is that substitutes can render obsolete the present capital investment of the industry.D. The bargaining power of buyers (4%)First, determine who the buyers are. What are the channels of distribution for the industry? Do not only consider the ultimate consumers unless there are no intermediaries. Identify significant macro-environmental trends, such as changes in customer demographics, needs, wants, lifestyle, etc.that have/will positively/negatively affect the industry. Do buyers have strong power over firms to negotiate price in this industry? How the power is exercised?E. The bargaining power of suppliers (4%)What are the markets for inputs (labor, machinery, capital, raw materials, etc.) like? While we were concerned about threats in the “entrants” section, here we are concerned with power. Do suppliers have power over firms in this industry? The first step is to determine what this industry purchases. Not in detail, but as a generalization. Focus on suppliers of key items that firms in this industry must have. Would firms have access to labor on favorable terms? Does this industry have unions? If so, they limitaccess to labor and usually increase costs. Do firms in this industry require highly skilled knowledge workers? How is the present labor market for this industry?IX. Conclusion (1 page): 10%Your analysis should lead you to reasonable conclusions. You have, by now, discovered a number of factors. State what you consider to be the opportunities and threats for this industry. Support your final argument as to whether this industry will be more profitable; or, what managerial strategies of profit growth for existing firms should be most effective. Make sure that  conclusion/recommendation and executive summary are consistent. Do not just repeat the sentences in the previous sections.X. References: 3%Please list the references that you cite, but also a listing of the material that contributed to your body of knowledge.XI. Appendices (Optional)Here you might put your tables, charts, or anything else that you think is important to an understanding of this industry.

IBM in the 21st Century: The Coming of theGlobally Integrated Enterprise“Global integration is the new game. Innovation is the way to win. We must be out thereconnecting across the world.” –Sam Palmisano, Chairman and CEOIn April 2008, members of IBM’s fifth Integration and Values Team (IVT5), were close to finishingtheir deliberations. This high-powered group of high-level executives included country generalmanagers from India and Brazil as well as vice presidents from businesses and functions, chosenfrom a group of about 300 leaders convened by Chairman and CEO Sam Palmisano to view IBMholistically. Senior VP of Corporate Communications and Marketing, Jon Iwata, and the new head ofResearch, John E. Kelly III, were the executive sponsors. IVT5’s focus was on “the global IBMer”defining and developing leaders for the global economy; making the “globally-integrated enterprise”relevant to all employees through global citizenship and the IBM values and culture; and ensuringmarket access in the form of a level playing field for IBM to compete globally. The scope was all 170countries in which IBM operated.iTeam members felt excitement and urgency. Palmisano expected recommendations in late May, asthe next major part of IBM’s transformation to a globally-integrated enterprise. Over its nearly 100year history, IBM had moved from international (exporting from the U.S.) to multi-national (withsubsidiaries in many countries) to global. Starting with the first IV team in 2002, convened toglobally-integrate the supply chain (e.g., one global instrument for requisitions), teams had identifiedways to integrate manufacturing (e.g., test engineering from anywhere in the world, to analyze andfix any line in any plant), create an integrated human capital supply chain (e.g., data bases with acommon definition of skills and experience, global recruitment and on-boarding process), and createinterconnected global solutions centers serving the world (e.g., centers for ERP (enterprise resourceplanning systems in Bangalore, the oil industry in Norway, banking in the U.S. and elsewhere).Other projects were underway. IBM realized considerable efficiencies from all of them.IVT5’s mandate was slightly different and more general, yet critical to making the rest of thetransformation work in practice: the people and the culture that would produce many more globalleaders and global citizens. The team faced the usual challenges of change – identifying the mostimportant needs and barriers, thinking creatively about approaches that would take advantage ofIBM’s strengths while finding new opportunities, setting an inspiring theme that would attractsupport. In addition, there was the uneasy fact that globalization was misunderstood in many places,by the public if not government officials. Outside the U.S., IBM was still a “foreign” company even ifstaffed completely with local citizens, although IBM was able to operate as a trusted partner in________________________________________________________________________________________________________________Professor Rosabeth Moss Kanter prepared this case. HBS cases are developed solely as the basis for class discussion. Cases are not intended toserve as endorsements, sources of primary data, or illustrations of effective or ineffective management.Copyright © 2008, 2009 President and Fellows of Harvard College. To order copies or request permission to reproduce materials, call1-800-5457685.https://monkessays.com/answer/view/11535#”>.https://monkessays.com/answer/view/11535#”>, write Harvard Business School Publishing, Boston, MA 02163, or go to https://monkessays.com/write-my-essay/hbsp.harvard.edu. No part of this publication may bereproduced, stored in a retrieval system, used in a spreadsheet, or transmitted in any form or by any means—electronic, mechanical,photocopying, recording, or otherwise—without the permission of Harvard Business School.This document is authorized for use only by Irene Grant in GB600 Leadership Strategies for a Changing Worldtaught by Kaplan University from June 2012 to June 2017.For the exclusive use of I. Grant308-105stIBM in the 21 Century: The Coming of the Globally Integrated Enterprisevarious geographies. Internally, some IBMers in mature markets who saw IBM shifting attention tothe rapidly-growing BRIC nations (Brazil, Russia, India and China) understood the rationale butfeared the consequences. At the same time, some IBMers outside the U.S. felt that IBM was still toomuch of an American company making too many decisions in New York. So IVT5’s mandate wasnot as simple as leadership development for a globalizing world; team members also had to focus onlocalizing IBM to connect its people not only with each other and with customers and industries butalso with communities and nations.IVT5 members had seen abundant facts and figures, such as IBM’s existing efforts on leadershipdevelopment and international assignments, its array of global corporate citizenship initiatives, andits extensive training and professional development. But to think creatively about the future, theywould have to wrap their minds around the whole system (and ecosystem): IBM’s business model,the implications of global integration, the IBM values, corporate citizenship as an approach and a setof partnerships, how people came to be IBMers and relate to such a diverse global population, andhow people did their work in IBM. That was a great deal to review, the length of at least three,perhaps four, Harvard Business School cases.As leaders who had risen to their positions because they were globally-oriented systems thinkerswho reflected IBM’s emphasis on innovation, they knew that it was necessary to stand back to look atthe big picture – to see how IBM worked now, to view IBM at its best, but also to understand thegaps, dilemmas and opportunities.Company Profile: The International Business of IBMBy 2008, IBM was a self-described “globally-integrated enterprise focused on innovation,” with386,000 employees working in 170 countries generating $99 billion in annual revenues (See Exhibit 1for five-year income statement). Headquarters was in a sleek low building on a verdant park-likesetting in Armonk, New York.International Business Machines Corporation, founded in 1911 in New York State by ThomasWatson, was familiarly known as the Blue Giant or Big Blue after the color on its unchanging logo.That was all that remained unchanged during the information revolution of the second half of thetwentieth century. Most of the machines IBM had produced through the years had disappeared, asIBM shifted its business mix to reflect changes in technology and to push the innovations thatproduced those changes. For example, IBM was credited with introducing the field of computerscience, and the name, as a distinct academic endeavor. Though some considered it a lumberinggiant, IBM was one of the few computer manufacturers to survive more than 25 years, and as IBMheaded for its 100th anniversary, it had transformed into a technology solutions company rather thana maker of boxes.“Big Blue” hit upon rough times in the late 1980s and early 1990s when profits from its mainframeand PC businesses started to tumble. Its resurgence began in 1993 under Chairman and CEO Louis V.Gerstner, Jr., who was a rare external hire. By the end of his nine-year tenure in 2002, IBM wastransformed from primarily a manufacturer of hardware into a provider of software, services, andsystems (See Exhibit 2), and it had embraced the Internet. In 1995, IBM acquired Lotus, a premiersoftware development company based in Cambridge, Massachusetts, for $3.5 billion.ii In 2002, IBMpurchased PricewaterhouseCoopers to round out its consulting offerings, having already boughtmuch smaller Internet-services companies. From 1993 to 2001, the last full fiscal year before Gerstnerstepped down, IBM grew from $63 billion in revenues with a loss of $8 billion to $82 billion withearnings of $8 billion.2This document is authorized for use only by Irene Grant in GB600 Leadership Strategies for a Changing Worldtaught by Kaplan University from June 2012 to June 2017.For the exclusive use of I. GrantstIBM in the 21 Century: The Coming of the Globally Integrated Enterprise308-105In 2002, IBM-lifer Samuel J. Palmisano was appointed Chairman and CEO (See Exhibit 3 for a listof senior executives). Between 2003 and 2007 IBM spent $16 billion to acquire over 50 smallercompanies, mostly in software development.iii In 2005, the company sold its PC business to Lenovo, aChinese manufacturer and long-term IBM business partner. At the same time, the services business,particularly IT systems integration, faced strong competition from the explosive growth of the“outsourcing” industry in emerging countries, especially India.IBM grouped its businesses into four main areas. Global Services included two segments – GlobalTechnology Services (GTS), which focused on client IT infrastructure needs, and Global BusinessServices (GBS), which offered business consulting, systems integration, and application managementexpertise. Together, they accounted for $54 billion in revenues – $36 billion from GTS and $18 billionfrom GBS. GTS grew by nearly $4 billion in 2007, while GBS expanded by over $2 billion. Systemsand Technology, which offered more robust computing and data storage assistance for large clients,accounted for $21 billion in sales, 45% of which was delivered directly to clients, while the remaining55% passed indirectly through business partners. Sales in the latter area had fallen by $600 million in2007. The Software business provided middleware and operating systems to help customersintegrate disparate IT applications within their organization. Industry-specific applications includedinformation management and product lifecycle management programs. The area generated nearly$20 billion in revenues and had grown nearly $2 billion in 2007. Global Financing brought in $2.5billion by offering client and commercial financing. It also remarketed used products through sale orlease. A relatively small fraction of the total business, the unit grew by $137 million in 2007.Global Scope“International” continued to be IBM’s first name and a reason for its success. About 60% of IBM’srevenues stemmed from its non-U.S. operations and 65% of its employees worked outside the U.S. In2007, the company divided its global operations into three super regions: Europe, Middle-East andAfrica (EMEA); Asia Pacific; and the Americas. EMEA employed 25% of IBM’s workforce whileaccounting for 36% of revenues. It had manufacturing plants located in Ireland, Hungary, and France.Asia Pacific had 30% of total employees and contributed 21% of sales. Production facilities operatedin China and Singapore. The Americas accounted for 45% of the workforce and 43% of globalrevenues, with manufacturing sites in New York, Minnesota, California, and Mexico.iv For 2007,IBM’s profits were derived largely from Europe and emerging countries like India, China and Brazil.In 2006, the company moved its global procurement function from Westchester, New York, toShenzhen, China, and integrated supply chain management into one global system.A growing proportion of IBM’s workforce and revenues had shifted outside the U.S. The BRIC(Brazil, Russia, India, and China) countries had expanded at twice the global rate, averaging 21% in2006: 19% in Brazil, 21% in Russia, 38% in India, and 16% in China. To support this growth, IBMtripled the number of employees in these locations. Overall more than 90,000 employees were addedto its emerging market workforce since 2003. By 2008, Russia employed an estimated 2,000 people,China and Brazil 13,000 each, and India 75,000, making it home to the largest number of IBMemployees outside the U.S (See Exhibit 4 depicting the extent of IBM’s global workforce).vHistorically, activities in the BRIC countries were hindered by unfavorable state regulations.vi In1918, an arm of IBM opened offices in Brazil. In 1971, it inaugurated a major manufacturing facility asprotectionist law forbade the company from importing many products. But IBM stayed, partnering inBrazil’s first information technology joint-venture in 1991, which gave it an important presence forthe coming economic liberalization. IBM operated in India from 1951 to 1977, pulled out due todisputes with the government over equity participation and intellectual property, then returned in1992 via a joint venture and, in 1999 as a wholly owned subsidiary. Although IBM had offices in3This document is authorized for use only by Irene Grant in GB600 Leadership Strategies for a Changing Worldtaught by Kaplan University from June 2012 to June 2017.For the exclusive use of I. Grant308-105stIBM in the 21 Century: The Coming of the Globally Integrated EnterpriseChina before the Communist takeover it did not return until 1979, as the Cultural Revolution ended,when it installed a computer for the Shenyang Blower Works, the first of its kind since the foundingof the PRC. With the deepening of economic reform in the mid and late 1980’s, IBM set up offices inBeijing and Shanghai. In 1992, IBM officially announced the establishment of IBM China CompanyLimited, its first solely funded enterprise in China. In 1993, IBM China established offices inGuangzhou and Shanghai and by 2007 had 26 offices covering 320 cities in China. A Russian presencebegan in 1993, following the Cold War. By 2005, the company had taken advantage of statesponsored efforts to promote a technology park in Akademgorodok, which rapidly became a “SiliconSiberia.” Because it was an area of focus, Russia at 800 people had the full set of functions that amature market possessed, as contained in the IBM Corporate Blueprint.Investment expanded in other emerging markets. In December 2007, IBM announced plans toinvest $1.6 billion in developing countries in Asia, the Middle East, and Latin America.vii In 2007,over 50 countries in the IBM family, including Poland, South Africa, and Mexico, grew more than10% (See Exhibit 5 for geographical scope of growth).viii Egypt, where IBM had operatedcontinuously since 1954, was another growth target. “Egypt’s growing like crazy,” Sam Palmisanosaid, referring to the country’s double-digit growth.ix Services, such as call and data centers, hadmoved there. Egypt was also home to a large software laboratory and an expanding commercialexport business, given its ideal positioning between Europe and the Middle East.The Extended Family and Ecosystem NeighborsIBM served every industry, with financial services, telecommunications, distribution (wholesaleand retail), and government leading the list nearly everywhere, with other industries important tosome regions, such as oil and gas in Russia. A similar set of competitors popped up everywhere: HP,Microsoft, Oracle, and Accenture. Sometimes competitors were also collaborators – for example,competing in software with Oracle but partnering with Oracle in business consulting; or competingwith Microsoft in software but partnering with Microsoft in some regions to sell Intel servers. CiscoSystems was a long-time partner more recently entering domains where it competed with IBM. “Thisis the beauty of IT marketing,” an IBM sales executive in an emerging market said. He also said,“IBM is very recognized as an IT company, but still not as a business consulting company. This is stilla surprise for many customers.”IBM leaders counted its extended family as well as IBM employees and wholly ownedsubsidiaries when describing IBM’s size. Corporate communications head Jon Iwata described IBMas also consisting of “33,000 companies in the global supply chain, 100,000 companies in the businesspartner network, and at least one million clients – we say the one million because it is difficult toassess,” he explained.Business partners included resellers, systems integrators, specialist software developers, trainers,even competitors with whom IBM could connect to offer an integrated solution to customers. Fundsfor training business partners came from channels enablement initiatives; there were screens,guidelines, and certification.IBM relied on business partners everywhere, but in emerging markets even more strongly than inmature ones. Sheer geographic size and infrastructure development stage necessitated this, even ifthe company could have added employees fast enough. In Russia, with its 11 time zones and hugegeographic extent, business partners were an important part of the go-to-market strategy. Businesspartners could also use lower-paid employees on smaller projects, making IBM’s technology moreaffordable to more customers, while preserving IBM’s position as a high-end services provider. InChina, planned growth from operations in 22 major cities (such as Beijing, Shanghai, and4This document is authorized for use only by Irene Grant in GB600 Leadership Strategies for a Changing Worldtaught by Kaplan University from June 2012 to June 2017.For the exclusive use of I. GrantstIBM in the 21 Century: The Coming of the Globally Integrated Enterprise308-105Guangzhou) at the beginning of 2007, to reach 300 second, third, and fourth tier cities in remoteregions, would involve business partnerships with companies that already had a foothold in thosecities and could provide local knowledge and local service. Large strategic partners were also criticalin China, especially with the central and local governments; the executive for strategic partnerships,Liu Bo, came to IBM after having founded and headed Red Flag Linux and later served as VP ofMicrosoft China, thus bringing a wealth of connections.Relationships with channel partners could be complex, not only because projects had differingrequirements but also because of local political issues. Managers stressed the need to make a habit ofcollaboration and to have sufficient flexibility to play a variety of roles depending on circumstance.In Russia, there were instances in which a major government entity would want a Russian companyas the prime contractor, even though the domestic company lacked relevant experience; IBM couldbring its global experience to bear as a subcontractor. In other instances, IBM would include businesspartners as subcontractors instead of increasing the size of its delivery organization, solidifying thepartner relationship by giving them the business.IBM had long focused on technology education, e.g., at colleges and universities, which wouldhelp ensure technical competence for both future employee and in partner organizations. In emergingmarkets, IBM’s role in educating business partners and raising standards was more especiallyimportant, and not just in technology but also in business practices, and particularly for small andmid-sized business partners. In Egypt, the country general manager dedicated a staff member towork with small resellers, to make sure that they had the right structure, skills, tactics to deliver toIBM standards; he put personal time into this as well. IBM Egypt offered role-playing courses thatincluded how to speak to customers. Partners were also given customer leads.Small and mid-sized businesses (SMB) were increasingly viewed by IBM as an important target.Not only were they business partners in strategic regions and even potential customers, but theywere a focus of government economic development efforts. By training SMBs and improving theirbusiness practices, IBM could show, as a country general manager put it, “This is the way for me tosay that I’m not just coming and taking money as some Western, some American company, and that’sit. We develop the skills of the market. I am part of this project to contribute to the country’s agenda– to develop the high-tech element of the national agenda.” In 2006, IBM decided to help the SMBcommunity in a philanthropic partnership with the International Finance Corporation of the WorldBank to develop of a Web portal with a range of business tools and resources. It was launched inIndia and South Africa in 2007 with content provided by local partners like ICICI Bank in India.Often, NGOs would serve as intermediaries to introduce the SMB toolkit to the market.Technology and InnovationIBM’s classic emphasis on innovation captured in the famous injunction “Think” and theThinkPad name on IBM’s (now Lenovo’s) laptop computers, was ratcheted up in recent years, wellbeyond research and development labs, which remained significant and a competitive advantage,especially if lab developments could be transferred quickly to customers for IBM services. IBMoperated 61 technology research and development laboratories in 15 countries, including majorresearch centers in the U.S., China, Israel, Switzerland, Japan, and India, with development orapplication centers elsewhere. Since 1993, IBM had registered more U.S. patents than any othercompany in the world.Still, with the emergence of the Internet in the late 1990s and the opening of the World Wide Webin 1993, IBM was perceived by some as losing the innovation edge, the way some saw it had missedthe move to client-server computing in the 1980s. But IBM was agile and adaptive. IBM embraced5This document is authorized for use only by Irene Grant in GB600 Leadership Strategies for a Changing Worldtaught by Kaplan University from June 2012 to June 2017.For the exclusive use of I. Grant308-105stIBM in the 21 Century: The Coming of the Globally Integrated EnterpriseLinux (photos of Linus Torvald could be found in offices in Brazil and elsewhere) and open sourcecomputing; in 2005, 500 IBM software patents were made available, free, to anyone working on opensource projects. IBM moved functions to the Web. It built SOA – service-oriented architecture — thatcan integrate IBM hardware & software platforms to give customer an integrated system. (“Wejumped all over that in a New York minute,” executive vice president of technology and innovationNick Donofrio said). And IBM became a leader in machine-independent “on demand” computing.IBM also made plans to introduce a new academic discipline, akin to its work in establishingcomputer science, called service science management and engineering (SSME). In 2005 IBM began towork with the Ministry of Education in China, responsible for over 1000 universities to deploy theSSME curriculum first in China, together with 40-50 Chinese universities; the director of the IBMChina Research Lab and several senior researchers taught SSME courses at Peking University andTsinghua University.IBM wanted innovation to come from everywhere, inside and outside the company. IBM started aGlobal Innovation Outlook (GIO) research effort involving a hundred internal and external experts.“The whole purpose is to torture ourselves on each of our lines of business. What’s happening to it?Is it changing? What are the fundamental underlying technologies? Where are they going?” Donofriosaid. Donofrio credited senior vice president for strategy, Bruce Herald, with forging strongrelationship with venture capitalist, saying “Ten years ago, we were void of VCs. Now, they all loveus, we know them all, we work with them to buy their companies, we help their companies, we selloff inventions we can’t commercialize within IBM. Because we don’t know everything.”IBM defined innovation to include processes as well as products, and anyone could play.Employees could submit ideas and engage in dialogue about them through ThinkPlace, a site on theIBM intranet. The discussion eventually extended much further. In July 2006, IBM convened anInnovation Jam, billed as the “largest on-line brainstorming session ever.” Participants included IBMemployees and their family, educational institutions and business partners, as well as clients fromnearly 70 companies. The jam took place over two 72-hour sessions, involved 150,000 people in 104countries, and resulted in 46,000 innovation ideas. In November 2006, Palmisano announced that thecompany would invest $100 billion in initiatives resulting from the jam, ranging from healthcare andenvironment to traffic and social utility projects, and it would emphasize virtual worlds, socialnetworking, and other recent developments.Palmisano said: “We must be ahead of strategic shifts. We can’t miss a cycle and catch up. Weannounced a new platform, the on demand network, at the Museum of Natural History, in October2002. People thought IBM was crazy when we announced it. Now IBM and Google are workingtogether. They picked IBM as the only one with the right technology to be their partner.” In October2007, IBM announced a partnership with Google for a cloud computing initiative (cloud computingwas an offshoot of grid computing that could harness the power of multiple unrelated computersthrough the internet); the initiative would eventually donate 4000 computers to universities, fromwhich students and researchers would have the resources needed to not only develop knowledge ofparallel computing, an emerging industry, but create new and open software applications, rangingfrom data mining and social networking to climate modeling and gene sequencing.To decrease lag time between technology innovation and customer orders, IBM sought way todemonstrate the potential for innovation to drive new solutions. Innovation Centers werestrategically-located places that showcased new possibilities, running futuristic prototypes forvarious industries, such as the Innovation Center on the first floor of the China Technology Lab insuburban Beijing. An Innovation Center in Barcelona, Spain, focused on banks of the future. Becausethe realities of banking were different in Latin America (e.g., large population with no access totechnology), an Innovation Center for financial services was established in Brazil, featuring solutions6This document is authorized for use only by Irene Grant in GB600 Leadership Strategies for a Changing Worldtaught by Kaplan University from June 2012 to June 2017.For the exclusive use of I. GrantstIBM in the 21 Century: The Coming of the Globally Integrated Enterprise308-105such as payment through cell phones, or a system based on images from bank’s digital cameras formanaging large queues so that a bank could attend to a customer in 15 minutes, as required by a newBrazilian banking law. In addition, IBM also demonstrated new technology through public-facingprojects contributing solutions to societal problems, such as scientific research on disease or K-12public education, which also reflected IBM values.In IBM’s strategic planning process, the lines of business examined technology trends andresponded. To think across the businesses, there were three global councils consisting of a crosssection of top leaders, for technology, strategy, and operations to help ensure that there was a flow, astechnology became part of strategy, and strategy was implemented. Integration was among IBM’sbiggest challenges.Management by Flying AroundWhen Sam Palmisano became CEO, he saw the company’s fortunes tied to the reality ofglobalization and historic changes in technology. Web 2.0 moved more applications directly to theWeb, and open standards-based computing was more prevalent, making it harder for companies tolock in customers to their standard. The Internet was making the world smaller and more connected,and freer trade meant that IBM customers crossed borders in numerous ways. Emerging nationswere not only sources of market growth but also had a skilled population and were major producersof IT talent. These changes stimulated Palmisano to define a new concept of the corporation: that itmust become a globally-integrated enterprise (GIE).Trade liberalization, open source software, and a freer movement of people across nations werethe main themes on the IBM public policy agenda in every country, coordinated by governmentrelations staffs worldwide, and echoed in Palmisano’s speeches as well presentation by IBM leaderseverywhere. Palmisano told the world that IBM would make location decisions based not only oncosts and the availability of talent but also on the openness of the environment.Palmisano spent about half his time externally focused. He was attuned to the external world,having started at IBM in sales and service, a market-facing job where the laboratory was thecustomer’s office. His leadership was seasoned by postings in Japan, eventually assuming a top postin the Asia-Pacific region, which, he said, changed his perspective: If you live and work in alanguage that’s not your native tongue, you learn a lot. I built relationships throughout Asia. Thatmakes a difference. Our big strategic deals in Asia are all a result of personal relationships, some ofwhich I established when I was there. You can’t be transactional, Asia is relational. They want toknow your company is sustainable, will be there in a hundred years, is committed to the society – notjust selling PCs in stores.” Thus, Palmisano spent a great deal of time talking with governmentofficials about public policy and societal issues, especially in the developing world, combined withtown hall meetings with IBMers in selected areas, judiciously-chosen speeches and occasional mealswith major customers, such as a lunch in São Paolo with a few leading bank CEOs and Latin Americageneral manager Rogerio Oliveira before addressing a major conference on innovation. Jon Iwataobserved, “He is invited to talk with political leaders in a different way than in the past. It used to beabout IBM investing in their country or as an employer. The discussion now is about nationalcompetitiveness – what will create jobs – policies on education, infrastructure, the environment.”In a typical week in the fall of 2007, he met with the Chancellor of Germany in Berlin and returnedto New York to announce the initiative with Google to train future computer scientists. A yearearlier, in November 2006, Palmisano stood with high-ranking officials in Beijing, China: to makethree important announcements that signaled IBM’s future directions; first, with the Chinese7This document is authorized for use only by Irene Grant in GB600 Leadership Strategies for a Changing Worldtaught by Kaplan University from June 2012 to June 2017.1. A brief summary of the case.2. What global forces drove IBM to become a globally-integrated enterprise?3. How has IBM adapted thus far? Have they been successful?4.?What skills should global leaders have?5. If you were Jon Iwata and John Kelly, what recommendations would you make to Sam Palmisano? How would youimplement them?

Study Guide -Delivering Healthcare in America: A Systems ApproachLeiyu Shi & Douglas A. Singh
Chapter 1: A Distinctive System of Health Care Delivery
Multiple Choice Questions
1. The primary objectives of a healthcare system include all of the following except:a. Enabling all citizens to receive healthcare servicesb. Delivering healthcare services that are cost-effectivec. Delivering healthcare services using the most current technology, regardless of costd. Delivering healthcare services that meet established standards of quality
2. The U.S. healthcare system can best be described as:a. Expensiveb. Fragmentedc. Market-orientedd. All of the above
3. For most privately insured Americans, health insurance is:a. Employer-basedb. Financed by the governmentc. Privately purchasedd. None of the above
4. Medicare is primarily for people who meet the following eligibility requirement:a. Elderly b. Low-incomec. Childrend. Disabled5. Medicaid is primarily for people who meet the following eligibility requirement:a. Elderlyb. Low-incomec. Childrend. Disabled 6. The role of the government in the U.S. healthcare system is:a. Regulatorb. Major financerc. Medicare and Medicaid reimbursement rate-setterd. All of the above7. Which of the following is a characteristic of a socialized health insurance system?a. Health care is financed through government-mandated contributions by employers and employeesb. Health care is delivered by government-employed providersc. Both a and bd. Neither a nor b
8. Which of the following is an overarching goal of Healthy People 2010?a. Decrease health care costsb. Create a more coordinated health care systemc. Establish a national health insurance programd. Increase quality and years of healthy life
9. Which of the following is a dimension of social health?a. Sociabilityb. Community involvementc. Marital satisfactiond. All of the above
10. Supplier-induced demand is created by:a. Patients b. Providers c. Health insurance companiesd. The government
Chapter 2: Beliefs, Values, and Health
Multiple Choice Questions
1. The elements of the Epidemiology Triangle of disease occurrence include all of the following except:a. Environmentb. Agentc. Societyd. Host
2. Which of the following factors is the leading cause of preventable disease and death in the United States?a. High fat dietb. Heredity c. Smokingd. Unsafe sex
3. Which of the following is not a behavioral risk factor?a. Irresponsible motor vehicle useb. Inadequate physical exercisec. Unsafe neighborhoodsd. Alcohol abuse
4. What is tertiary prevention?a. Early detection and treatment of diseaseb. Rehabilitative therapies and monitoring of health to prevent complications or further illness, injury, or disabilityc. Reduction of the probability that a disease will develop in the futured. None of the above
5. According to the CDC, which factor contributes most to premature death in the U.S. population?a. Lifestyle and behaviorsb. Lack of medical carec. Social and environmental factorsd. Genetic makeup
6. Which of the following can be considered an environmental factor contributing to health status?a. Air qualityb. Access to health carec. Safety of neighborhoodsd. All of the above
7. Healthcare is considered a social good in:a. Market justiceb. Social justicec. Both a and bd. The total number of cases at a specific point in time divided by the population at risk
8. Demand-side rationing is the same thing as:a. Nonprice rationingb. Price rationingc. Both a and bd. Neither a nor b
9. Prevalence is:a. The number of new cases occurring during a specified period divided by the total populationb. The total number of cases at a specific point in time divided by the specified populationc. The number of new cases occurring during a specified period divided by the population at riskd. The total number of cases at a specific point in time divided by the population at risk
10. Holistic health adds which element to the World Health Organization definition of health?a. Physical b. Mentalc. Spirituald. Social

Chapter 3: The Evolution of Health Services in the United States
Multiple Choice Questions
1. Which of the following forces remains relatively stable, and major shifts in this area would be necessary to bring about any fundamental change in the US health care delivery system?a. Economic forcesb. Political changec. Beliefs and valuesd. Social forces
2. In its historical context, which of the following has played a major role in revolutionizing health care delivery?a. Beliefs and valuesb. Science and technologyc. Medical educationd. Economic growth
3. In the preindustrial era, _____ often functioned as surgeons.a. butchersb. tailorsc. clergymend. barbers
4. Hospitals in the United States evolved froma. alms housesb. sick homesc. pest housesd. inns
5. What was the function of a pest house in the preindustrial period?a. To house people who had a contagious disease.b. To provide refuge to those who were threatened by pests.c. To eradicate pests.d. To treat contagious diseases.
6. Which of the following factors was particularly important in promoting the growth of office-based medical practice in the postindustrial period?a. Urbanizationb. Educational reformc. Science and technologyd. Dependencye. licensing
7. Development of the hospital and ______ happened almost hand in hand in a symbiotic relationship between the two.a. dependency of patientsb. growth of scientific knowledgec. professionalization of medical practiced. cohesiveness of the medical profession
8. Why did physicians remain independent of corporate settings even after the medical profession became well recognized?a. Hospitals were unable to pay high enough salaries to physicians.b. Physicians disliked salary arrangements.c. Licensure laws had not yet been passed.d. Physicians who took up practice in a corporate setting were castigated by the medical profession.
9. Since the early 1900s, the burden of disease in developed countries has shifteda. to underdeveloped countriesb. from infectious to chronic diseasec. from chronic to infectious diseased. from the rich to the poor
10. The inception of _____ was used as a trial balloon for the idea of government-sponsored universal health insurance.a. workers’ compensationb. trade unions c. public health d. health care for the veterans
Chapter 4: Health Services Professionals
Multiple Choice Questions
1. A major factor influencing growth in the health care sector of the U.S. economy is:a. The aging of the populationb. Increasing fertility ratesc. Declining death ratesd. All of the above
2. Which type of health care facility employs the most people in the U.S.?a. Physicians’ offices and clinicsb. Hospitalsc. Nursing and personal care facilitiesd. None of the above
3. When patients have multiple health problems, this is called:a. Coaffliction b. Comortalityc. Codependencyd. Comorbidity
4. The basic source of the physician distribution problem in the U.S. is:a. Lack of health care coverage for all b. The need-based modelc. Lack of awareness that there is a problemd. A shortage of MDs
5. The Nurse Reinvestment Act of 2002 provides:a. Grants and scholarships for nursesb. Funding for nurse retention programsc. Funding for further education for nursesd. All of the above
6. Allied health professionals include:a. Osteopathsb. Dentistsc. Physician assistantsd. None of the above
7. Physician maldistribution occurs by:a. Specialtyb. Geography c. Both a and bd. Neither a nor b8. Primary care is:a. Longitudinalb. The portal to the healthcare systemc. Holisticd. All of the above
9. The principle source of graduate medical education is:a. Medicaidb. Medicarec. Private fundsd. State grant funds
10. Which of the following is a major criticism of managed care?a. Quality of care may be sacrificedb. Managed care is inefficientc. Utilization may increased. Managed care will worsen the physician oversupply
Chapter 5: Medical Technology
Multiple Choice Questions
1. At a fundamental level, medical technology deals with a. production of new equipment to provide more advanced health care b. the application of knowledge produced by biomedical researchc. using discoveries made in basic sciences to improve health care d. new drugs and devices
2. Telemedicine technology that allows a specialist located at a distance to directly interview and examine a patient is referred to as a. telehealthb. simultaneous c. analogous d. synchronous
3. The asynchronous form of telemedicine uses_____ technology. a. store-and- forwardb. access-when-needed c. delayed-accessd. forward-and-retrieve
4. The expectations that Americans have about what medical technology can do to cure illness is based on a. the technological imperative b. cultural beliefs and valuesc. a higher rate of technology diffusion in the US compared to other countries d. medical specialization
5. What is the main intent of the Stark laws? a. Require that personal health information be kept confidential b. Require demonstration of cost-efficiency of new technology c. Prohibit self-referral by physicians to facilities in which they have an ownership interestd. Disclosure of potential harm from a procedure or device
6. Supply-side rationing. a. Curtailment in governing funding for medical research b. Managed care c. Curtailment in payments for new technologyd. Central planning
7. Certain allergy medications containing pseudoephedrine are available without prescription, but must be kept behind the pharmacy counter and sold only in limited quantities upon verification of a person’s identity. a. Food and Drugs Act, 1906 b. Food, Drug, and Cosmetic Act, 1938 c. Kefauver-Harris Drug Amendments, 1962 d. Patriot Act 2006
8. The FDA was given the authority to review the effectiveness and safety of a new drug before it could be marketed. a. Food and Drugs Act, 1906 b. Prescription Drug User Fee Act, 1992 c. Kefauver-Harris Drug Amendments, 1962d. Food, Drug, and Cosmetic Act, 1938
9. This made additional resources available to the FDA, and resulted in a shortened approval process for new drugs. a. Kefauver-Harris Drug Amendments, 1962 b. Food and Drug Administration Modernization Act, 1997c. Orphan Drug Act, 1983 d. Prescription Drug User Fee Act, 1992
10. The Safe Medical Devices Act, 1990 requires a. that injuries, illness, or death from any device be reportedb. premarket approval of devices c. safety testing of devices before and after they have been marketed d. that all problems and potential problems be reported to the FDA
Chapter 6: Health Services Financing
Multiple Choice Questions
1. What is the primary reason that a segment of the U.S. population is uninsured? a. Medicare and Medicaid are the only public insurance programs b. The U.S. has a voluntary system of health insurancec. The poor cannot afford health insurance d. U.S. health insurance is dominated by managed care
2. What is the central role of health services financing in the United States? a. Fund health insuranceb. Underwrite medical risk c. Support managed care d. Balance the supply of health care professionals
3. What is the primary mechanism that enables people to obtain health care services? a. Availability of services b. Health insurancec. Payment for services d. Control of expenditures
4. In national health care systems, total expenditures are controlled mainly through a. cost shifting b. underwriting c. supply-side rationingd. demand-side rationing
5. In a general sense, what is the primary purpose of insurance? a. Predicting risk b. Risk assessment c. Protection against riskd. Underwriting
6. What is the primary function of insurance? a. Pay claims on behalf of the insured b. Underwrite policies c. Provide comprehensive coverage d. Protection against catastrophic risk
7. What is the main advantage of group insurance?a. More people can obtain insurance from a single insurerb. Risk is spread out among a large number of insuredc. More comprehensive services can be covered than under an individual pland. The employer has to deal with only one insurance company
8. The majority of beneficiaries receiving health care through Medicare are a. elderlyb. disabled c. financially poor d. those suffering from end-stage renal disease
9. For Medicare beneficiaries, the maximum stay in a SNF during a benefit period cannot exceed a. 30 days b. 60 days c. 100 daysd. None of the above
10. The dependents of U.S. military personnel receive health care through a. CHAMPUS b. Military Health Services System c. VHA d. TriCare
Chapter 7: Outpatient and Primary Care Services
Multiple Choice Questions:
1. Typically, tertiary care:a. Is highly specializedb. Does not depend on technologyc. Takes place outside of traditional healthcare facilitiesd. All of the above
2. What is gatekeeping?a. The process by which patients are denied needed careb. The process by which primary care physicians refer patients to specialists c. The concept that specialists use more diagnostic tests than primary care physiciansd. The idea that patients should be allowed to choose their own doctors
3. Which country’s health care system is founded on the principles of gatekeeping?a. UKb. USc. Australiad. China
4. Countries whose health systems are oriented more toward primary care achieve:a. Higher satisfaction with health services among their populationsb. Higher expenditures in the overall delivery of carec. Worse health outcomesd. None of the above
5. The most prominent reason for the decline in the number of procedures performed in hospitals is:a. Most of these procedures were shifted to outpatient settingb. Most of these procedures were deemed outdated c. Most of these procedures were unsafed. Most of these procedures used technology that was too expensive
6. What does “PPS” stand for?a. Preferred Provider Systemb. Primary Physician Systemc. Private Practice Systemd. Prospective Payment System
7. One reason women’s health centers were created is:a. Women have more money than men b. Women seek care more often than menc. Women have shorter life spans than mend. None of the above
8. Hospice services are primarily for people with:a. Chronic illnessesb. Rehabilitative needsc. Terminal illnessesd. None of the above
9. What is palliation?a. Pain and symptom managementb. Psychosocial supportc. A surgical interventiond. Bed rest
10. Community health centers serve primarily: a. High-income neighborhoodsb. Populations with insurance c. Populations which are medically underservedd. Both a and b
Chapter 8: Inpatient Facilities and Services
Multiple choice Questions
1. Inpatient care a. Services delivered by a hospital b. Treatment of acute conditions c. Health care delivered in conjunction with an overnight stay in a facility d. Care delivered in a licensed facility
2. The biggest share of national health spending is used by a. hospitalsb. physicians c. prescription drugs d. nursing home care
3. The first hospitals in the United States served mainly a. the poorb. the wealthy c. those needing surgery d. government officials
4. What is the meaning of “excess capacity” in the health care inpatient sector? a. Hospital consolidation b. Few hospitals c. Large institutions d. Empty beds
5. The Hill-Burton Act was passed to a. make it mandatory for private insurers to cover hospital services b. relieve shortage of hospitalsc. curtail the utilization of hospital beds d. have federal control over community hospitals
6. ALOS is an indicator of a. use of hospital capacity b. frequency of use c. severity of illnessd. access
7. Which ownership type constitutes the largest group of hospitals and hospital beds in the United States? a. Private for-profit b. Federal c. Private nonprofitd. State and local government
8. In a hospital classified as short stay, the ALOS is less thana. 5 days b. 10 days c. 15 days d. 25 days
9. To be classified as a Critical Access Hospital, the number of acute care beds should not exceed a. 20 b. 25c. 35 d. 50
10. According to US law, nonprofit organizations a. can make only a limited amount of profit b. are tax exemptc. cannot have a governing body d. must pay taxes only if they are profitable
Chapter 9: Managed Care and Integrated Organizations
Multiple Choice Questions
1. The managed care phenomenon was welcomed mostly by a. employersb. workers c. private insurance d. the government
2. With the growth of managed care, the balance of power in the medical marketplace swung toward a. providers b. the supply side c. the demand sided. more regulation
3. A managed care organization functions like a. a provider b. an insurerc. a regulator d. a financier
4. What is the purpose of cost sharing with providers? a. It makes providers immune to costs b. It makes providers cost consciousc. It rewards providers for quality d. It keeps insurance premiums low
5. Capitation is best described as a. monthly lump sum payment regardless of utilizationb. monthly lump sum payment regardless of cost c. per member per month paymentd. payments capped to a maximum cost for delivering services
6. Under capitation, risk is shifted a. from the insured to the employer b. from the provider to the MCO c. from the employer to the MCO d. from the MCO to the provider
7. Under which payment method is a fee schedule used? a. prospective payment b. capitation c. discounted feesd. fee for service8. The HMO Act of 1973 required a. health care providers to contract with HMOs b. managed care organizations to offer HMO alternatives c. insurers to switch to managed care d. employers to offer an HMO alternative to conventional health insurance
9. In the term, managed care, ‘manage’ refers to a. management of utilizationb. management of premiums c. management of risk d. management of the supply of services
10. Under the fee-for-service system, providers had the incentive to a. deliver more services than what would be medically necessary because a greater volume would increase their incomesb. use less technology because they could increase their incomes by not using costly procedures c. indiscriminate cost increases because they could get paid whatever they would charge d. increase the level of quality in order to attract more patients
Chapter 10: Long-Term Care
Multiple Choice Questions
1. Low cognitive functioning places an elderly person at a high risk for a. clinical depression b. functional declinec. chronic ailments d. acute ailments
2. The elderly do not constitute a homogeneous group; hence a. they have more chronic ailments than acute episodes b. the LTC system must be integrated with the rest of the health care delivery system c. most elderly people live independently d. a variety of long-term care services are demanded
3. Which of the following plays a primary role in individualizing long-term care services to the patient’s needs? a. Coordination of various services b. Physician’s orders c. An individual assessmentd. A discharge report from the hospital
4. In the delivery of long-term care, customized interventions are carried out according to a. an individual assessment b. a plan of carec. weekly evaluations by the patient’s physician d. the philosophy of total care
5. What is the key determinant of the need for long-term care? a. A disabling accident b. An acute episode c. Presence of multiple chronic conditions d. Limitations in a person’s ability to perform tasks of daily living
6. What is the goal of long-term care? a. Promote functional independenceb. Return a person to independent living c. Reverse the decline in activities of daily living d. Cope with multiple chronic conditions
7. Which of the following can contribute positively to a person’s quality of life? a. Palliationb. Assessment c. Plan of care d. Total care
8. Why is the assessment of psychiatric illness particularly difficult in geriatric patients? a. Mental illness cannot be ruled out b. The elderly often fake mental illness. c. Psychiatric illness can be intermittent d. Comorbidities can obscure diagnosis
9. Personal care is a. Individualized care b. Basic assistance with ADLsc. Services that are nurse-intensive d. Long-term care provided by unpaid caregivers
10. Maintenance rather than restoration of functioning is particularly the domain of a. custodial careb. restorative care c. skilled nursing care d. personal care
Chapter 11: Health Services for Special Populations
Multiple Choice Questions
1. Which racial/ethnic group is most likely to drink alcohol?a. Whiteb. Black or African Americanc. Asian or Pacific Islander d. Hispanic
2. Which racial/ethnic group is growing the fastest?a. Whiteb. Black or African Americanc. Asian or Pacific Islander d. Hispanic
3. Which racial/ethnic group is least likely to use mammography?a. Whiteb. Black or African Americanc. Asian or Pacific Islander d. Hispanic
4. Approximately how many Americans are uninsured?a. 16 millionb. 26 million c. 46 milliond. 66 million
5. Lack of insurance can result in: a. Decreased utilization of lower cost preventive servicesb. Increased need for more expensive, emergency health carec. The spread of infectious diseasesd. All of the above
6. Which legislation created the State Children’s Health Insurance Plan (SCHIP)?a. Balanced Budget Act of 1997b. State Children’s Health Insurance Act of 1997c. Kids First Act of 1997d. Omnibus Reconciliation Act of 1997
7. What does “MUA” stand for?a. Metropolitan Utilization Areab. Medically Underserved Areac. Metropolitan Underserved Aread. Medical Utilization Area
8. What is the primary purpose of the National Health Service Corps?a. To recruit physicians to provide services in physician shortage areas in the U.S.b. To recruit physicians from abroad to work in the United Statesc. To send U.S. physicians to developing countries to provide services to the indigentd. To recruit physicians into the military9. Among women, which racial/ethnic group has the highest percentage distribution of AIDS?a. White, non-Hispanicb. Black, non-Hispanicc. Hispanicd. American Indian
10. What does the federal Ryan White CARE Act fund?a. Care for underserved rural and urban populations b. Skin cancer screening programsc. School-based health services in predominantly minority neighborhoodsd. Development of treatment and care options for persons with HIV and AIDS

Chapter 12: Cost, Access and Quality
Multiple Choice Questions
1. What is Gross Domestic Product (GDP)?a. A measure of all the goods and services produced by a nation in a given yearb. A measure of all the goods and services produced by a nation in a given year, divided by the populationc. A measure of all the goods and services produced by a nation in a given year, minus the amount of money spent by the governmentd. A measure of all the goods and services produced by a nation in a given year, divided by the amount of money spent by the government
2. What is a PRO?a. Price Rationing Organizationb. Political Review of Outcomes c. Peer Review Organizationd. President’s Review of Organizations
3. What is meant by the term “health care costs”?a. The price of health careb. How much a nation spends on health carec. Cost of producing health cared. All of the above
4. Medical cost inflation is influenced by all of the following factors except:a. Waste and abuseb. Increase in elderly populationc. Decrease in uninsuredd. Growth of technology
5. What are administrative costs?a. Costs associated with management of the financing, insurance, delivery, and payment functions of health careb. Costs associated with financing and insurance onlyc. Costs associated with delivery and payment functions onlyd. None of the above
6. What is the main reason for the lack of success of health care cost control efforts in the U.S.?a. Malpractice lawsuitsb. Cost shifting by providersc. Dislike of the practice by consumersd. Growth of technology
7. Fill in the blank: The distinction between predisposing and enabling conditions can be applied to assess the _______ of a health care system.a. costb. equityc. efficiencyd. effectiveness
8. What is the purpose of clinical practice guidelines?a. To provide a plan to manage a clinical problem based on evidence or consensusb. To lower costsc. To improve outcomesd. All of the above
9. What is the Health Plan Employer Data and Information Set (HEDIS)?a. A quality report card b. A cost report cardc. A government database on health plansd. None of the above
10. What are the main activities of risk management?a. Proactive efforts to prevent adverse events related to clinical care and facilities operationsb. Retrospective studies of adverse eventsc. Both a and bd. Neither a nor b
Chapter 13: Health Policy
Multiple Choice Questions:
1. Which major public insurance program was legislated in 1965?a. Medicareb. Medicaidc. Both a and bd. Neither a nor b
2. Health policies are used in what capacity?a. Regulation of behaviorsb. Allocation of income, services, or goodsc. Both a and bd. Neither a nor b
3. What is incrementalism?a. The fact that in the U.S., health care is financed by multiple entitiesb. The fragmented, uncoordinated delivery of health services c. Small policy changes that reflect a compromise amongst different groups’ demandsd. None of the above
4. Which of the following branches of government is a supplier of policy?a. Executiveb. Legislativec. Judiciald. All of the above
5. What is an interest group?a. A group of lawmakers within Congress with a particular area of interestb. A group of appointed judges with a particular political view pointc. An independent, non-governmental group united by a policy area, which lobbies and advocates its point of view to lawmakers d. None of the above
6. What was the main purpose of the Kerr-Mills program (1960)?a. Provision of federal grants to state government programs assisting the elderlyb. Provision of federal grants to state government programs assisting the poorc. Provision of federal grants to state government programs assisting childrend. None of the above
7. For what is the National Health Planning and Resources Development Act of 1974 noted? a. The shift from cost containment to improvement of quality as the principal theme in federal health policyb. The shift from cost containment to improvement of access as the principal theme in federal health policyc. The shift from improvement of access to cost containment as the principal theme in federal health policyd. The shift from improvement of quality to cost containment as the principal theme in federal health policy
8. What does “CON” stand for?a. Certificate of Needb. Certificate of Nursingc. Certificate of Naturopathyd. Certificate of Nationality
9. In what way does research influence policymaking?a. Prescriptionb. Documentationc. Analysisd. All of the above
10. All of the following were identified by the Institute of Medicine (Crossing the Quality Chasm, 2001) as areas for quality improvement, except:a. Timelinessb. Safetyc. Efficacyd. Patient-centeredness

HCA 501 Health Care in America Text: Delivering Health Care in America Fourth Edition, 2008 ISBN-13: 9780763745127, ISBN-10:076374512X Authors: Leiyu Shi and Douglas A. Singh Publisher: Jones & Bartlett
Multiple Choice Questions (Enter your answers on the enclosed answer sheet) 1. Which of the following is a characteristic of a national health insurance system? a. The government finances health care through general taxes b. Health care is delivered by private providers c. Both a and b d. Neither a nor b 2. Which of the following is a characteristic of a socialized health insurance system? a. Health care is financed through government-mandated contributions by employers and employees b. Health care is delivered by government-employed providers c. Both a and b d. Neither a nor b 3. In 1984, Australia switched: a. From the Medicare program to a universal national health care program b. From a universal national health care program to a privately financed system c. From a privately financed system to the Medicare program d. None of the above 4. A free market in health care requires: a. Adequate information for patients b. Independent actions between buyers (patients) and sellers (providers) c. Unencumbered interaction of the forces of supply and demand d. All of the above 5. A multiple payer system is more cumbersome than a single payer system for all of the following reasons except: a. There are numerous health plans, which is difficult for providers to handle b. Payments are not standard ized across health plans c. Some health care services are covered for people in the north, but not in the south d. Government programs require extensive documentation proving services were provided before payi ng providers 6. Which of the following entities in the U,S, employs lobbyists? a. Physicians b. Insurance companies c. Large employers d. All of the above 7, The ownership of Canada’s health care system is best described as: a. Private b. Public c. Combination of private and public d. None of the above 8, Supplier-induced demand is created by: a, Patients b. Providers c. Health insurance companies d. The government 9. Which country spends the most in administrative health care costs? B. United States b. Germany c. UK d. Australia 10. Demand-side rationing IS the same thing as: a. Nonprice rationing b. Price rationing c. Both a and b d. Neither a nor b 11. Deontology asserts: a. That no one has a duty to do what is right b. That it is society’s duty to do what is right c. That it is an individual’s duty to do what is right d. None of the above
12. Utilitarianism emphasizes: a. Happiness and welfare for the poor b. Happiness and welfare for the deserving c. Happiness and welfare for the most people possible d. None of the above 13. Supply-side rationing is also referred to as: a. Nonprice rationing b. Price rationing c. Planned rationing d. Both a and c 14. The limitations of market justice include: a. Social problems are not adequately addressed b. Society is not always protected from the consequences of ill health c. It leads to inequitable access to health care d. All of the above 15. Prevalence is: a. The number of new cases occurring during a specified period divided by the total population b. The total number of cases at a specific point in time divided by the specified population c. The number of new cases occurring during a specified period divided by the population at risk d. The total number of cases at a specific point in time divided by the population at risk 16. Crude rates refer to: a. A specific age group b. A specific gender c. The total population d. None of the above 17. Holistic health adds which element to the World Health Organization definition of health? a. Physical b. Mental c. Spiritual d. Social 18. What was the main consequence of early proprietary medical schools, as opposed to state-sponsored schools, in the preindustrial era? a. Standards were low. b. The cost of medical education became too high. c. Medical education became regulated. d. Science and research became part of medical education. 19. Which of the following factors was particularly important in promoting the growth of office- based medical practice in the postindustrial period? a. Urbanization b. Educational reform c. Science and technology d. Dependency 20. When a profession’s services are generally accepted and are legitimized, they impart __ to the profession. a. Specialization b. Organ ized strength c. Cohesiveness d. Cu Itural authority 21. Cultural authority was conveyed to the medical profession mainly through a. The development of the AMA b. Advances in medical science c. Patients’ dependency d. Licensi ng 22. Development of the hospital and __ happened almost hand in hand in a symbiotic relationship between the two. a. Dependency of patients b. Growth of scientific knowledge c. Professionalization of medical practice d. Cohesiveness of the medical profession 23. Even though hospitals incurred frequent deaths in the early 1900s, their use was on the rise mainly because a. Most people had poor living conditions in their homes b. People had no other choice but use the hospitals c. A large number of immigrants were settling in American cities d. Technology was advancing at a rapid pace 24. Why did physicians remain independent of corporate settings even after the medical profession became well recognized? a. Hospitals were unable to pay high enough salaries to physicians. b. Physicians disliked salary arrangements. c. Licensure laws had not yet been passed. d. Physicians who took up practice in a corporate setting were castigated by the medical profession. 25. Organized medicine a. Concerted activities of physicians through the American Medical Association b. Affiliation of physicians with medical schools c. Standardized practice of medicine d. Unionization of physicians e.
a. Multiple Choice Questions (Enter your answers on the enclosed answer sheet) 1. Nonphysician practitioners (N PPs) i ncl ude: a. Osteopaths b. Dentists c. Physician assistants d. None of the above 2. Allied health professionals incl ude: a. Osteopaths b. Dentists c. Physician assistants d. None of the above 3. Physician maldistribution occurs by: a. Specialty b. Geography c. Both a and b d. Neither a nor b 4. Compared to metropolitan and suburban areas, there is a/an __ of physicians in rural areas. a. Shortage b. Surplus C. Equal amount d. Unknown number 5. The roles and responsibilities of health services administrators include: a. Leadership and strategic direction b. Departmental management c. Program oversight d. All of the above 6. Primary care is: a. Longitudinal b. The portal to the health care system c. Holistic d. All of the above 7. The principal source of funding for graduate medical education is: a. Medicaid b. Medicare c. Private funds d. State grant programs 8. Which of the following is a major criticism of managed care? a. Qua I ity of care may be sacrificed b. Managed care is inefficient c. Utilization may increase d. Managed care will worsen the physician oversupply 9. The percentage of active primary care generalist physicians has: a. Decreased since 1949 b. Increased si nce 1949 c. Remained steady since 1949 d. Unknown: this number has only been tracked since 1970 10. Which of the following medical specialty earns the highest salary? a. Emergency medicine b. Radiology c. Pediatrics d. Obstetrics/Gynecology 11. This law was criticized for slowing down the introduction of new drugs. a. Prescri ption Drug User Fee Act, 1992 b. Kefauver-Harris Drug Amendments, 1962 c. Food and Drug Administration Modernization Act, 1997 d. Food, Drug, and Cosmetic Act, 1938 12. This law provided incentives for pharmaceutical firms to develop new drugs for health problems that affected a relatively small number of people. a. Prescription Drug User Fee Act, 1992 b. Kefauver-Harris Drug Amendments, 1962 c. Orphan Drug Act, 1983 d. Food and Drug Administration Modernization Act, 1997
13. This made additional resources available to the FDA, and resulted in a shortened approval process for new drugs. a. Kefauver-Harris Drug Amendments, 1962 b. Food and Drug Administration Modernization Act, 1997 c. Orphan Drug Act, 1983 d. Prescription Drug User Fee Act, 1992 14. The most stringent requirements of premarket approval regarding safety and effectiveness apply to __ devices. a. Class I b. Class II c. Class III d. Class IV 15. The Safe Medical Devices Act, 1990 requires: a. That injuries, illness, or death from any device be reported b. Premarket approval of devices c. Safety testing of devices before and after they have been marketed d. That all problems and potential problems be reported to the FDA 16. What was the purpose of certificate of need (CON) laws? a. Monitor the diffusion of new technology b. Control the flow of federal funds for private projects c. Control new health service programs d. Control new construction and modernization projects 17. Which department of the DHHS supports research on health care quality, cost, and access? a. National Institutes of Health b. Agency for Healthcare Research and Qual ity c. Institute of Medicine d. American Health Quality Association 18. What is the main function of the National Institutes of Health? a. Conduct and support research on health care quality, cost, and access b. Establish medical subspecialties in US medical schools c. Provide specialized training for medical specialists d. Conduct and support biomedical research 19. Which area of personal health expenditures has seen the greatest rise in recent years? a. Long-term care b. Hospital services c. Prescription drugs d. Durable medical equipment 20. According to the Institute of Medicine, the rise in prescription drug costs is mainly attributed to: a. price inflation b. increased use of existing drugs c. research and development costs d. replacement of older drugs by newer ones 21. Evaluation of the appropriateness of medical technology. a. Cost -effectiveness b. Health technology assessment c. Clinical trial d. Efficacy 22. In technology assessment, what role do clinical trials play? a. They are used for experimentation with potentially useful drugs b. They are used for establishing the rights of participants c. They are used for determining cost-effectiveness d. They are used for evaluating efficacy and safety 23. What is the role of an institutional review board (IRB)? a. Establish guidelines for the method of conducting research b. Verify the results of clinical trials c. Approve and monitor research that involves human subjects d. All of the above 24. Usefulness of a new technology. a. Quality b. Efficacy c. Assessment d. Appropriateness 25. Cost-efficiency evaluates marginal benefits in relation to: a. Marginal safety b. Marginal costs c. Flat of the curve d. Outcomes
Multiple Choice Questions (Enter your answers on the enclosed answer sheet) 1. What has been the effect of intense consolidation in certain hospital markets? a. Increased competition b. Better access c. Dilution of competition d. Improved quality 2. Who pioneered the transformation of nursing into a recognized profession? a. Madame Curie b. Florence Nightingale c. Cicely Saunders d. Sylvia Lack 3. The Hill-Burton Act was passed to a. Make it mandatory for private insurers to cover hospital services b. Rei ieve shortage of hospitals c. Curtail the utilization of hospital beds d. Have federal control over community hospitals 4. Under the Hospital Survey and Construction Act of 1946, the responsibility for hospital planning a. Remained in the hands of the federal government b. Was delegated to local county and city governments c. Was given to the states d. Was given to private insurers 5. Under the Hill-Burton Act, federal grants were given on the basis of a. Bed-to-population ratios b. Poverty ranking for each state c. Number of hospital beds already in existence d. Hospital size needed to adequately serve each community 6. Which factor was the most instrumental in the growth of nonprofit community hospitals in the United States? a. Hill-Burton Act b. Growth of private health insurance c. Medical technology d. Tax Equity and Fiscal Responsibility Act 7. Since 1980, the share of national health expenditures consumed by hospital care has a. Increased b. Declined c. Remained the same d. Remained unknown 8. Which factor had the most dramatic effect on hospital downsizing in the United States? a. Increase in the number of uninsured Americans b. Closing of rural hospitals c. Managed care d. Prospective reimbursement 9. Why are discharge statistics more accurate than admission statistics as a count of inpatients served by a hospital? a. Deaths are not counted as discharges b. Deaths are counted as discharges c. Babies are born in hospitals d. Some newborn infants need critical care 10. ALOS is an indicator of a. use of hospital capacity b. frequency of use c. severity of illness d. access 11. How is average length of stay calculated? a. Days of care/d ischarges b. By cumulating patient days c. Inpatient days/capacity d. Discharges X inpatient days 12. Average dai Iy census is a measure of a hospital’s a. Daily capacity b. Average admissions per day c. Days of care d. Number of patients served daily 13. The proportion of a hospital’s capacity that is actually utilized. a. Days of care b.ALOS c. Average daily census d. Occupancy rate 14. Which of these hospitals types is not likely to serve the general public? a. County and city hospitals b. Proprietary hospitals c. Federal hospitals d. Community hospitals 15. Which ownership type constitutes the largest group of hospitals and hospital beds in the United States? a. Private for-profit b. Federal c. Private nonprofit d. State and local government 16. For whose financial benefit are proprietary hospitals operated? a. Stockholders b. The American public c. The local community d. The governing body 17. In a hospital classified as short stay, the ALOS is less than a. 5 days b. 10 days c. 15 days d. 25 days 18. Which hospitals provide services to children in communities that do not have specialty children’s hospitals. a. Rehabilitation hospitals b. General hospitals c. Long-term care hospitals d. Specialized hospitals 19. To be classified as a community hospital, the hospital must be a. A public hospital b. A nonfederal hospital c. A nonprofit hospital d. A nongovernmental hospital 20. Which of the following cannot be classified as a community hospital? a. Specialty hospital b. Proprietary hospital c. Long-stay hospital d. Children’s hospital 21. To be classified as a Critical Access Hospital, the number of acute care beds should not exceed a. 20 b.25 c.35 d. 50 22. What financial benefit does a small rural hospital reap by qualifying for the designation, Critical Access Hospital? a. It can receive specific federal grants for serving vulnerable populations b. It can use its beds for either acute care or long-term care as needed c. It can increase its profitabi I ity by receivi ng special payments for emergency services d. It can receive cost-plus reimbursement under Medicare Part A 23. Which hospital type is likely to emphasize holistic medicine? a. Osteopathic hospital b. General hospital c. Specialty hospital d. Rehabilitation hospital 24. According to US law, nonprofit organizations a. Can make only a limited amount of profit b. Are tax exempt c. Cannot have a governing body d. Must pay taxes only if they are profitable 25. Institutional theory predicts that a. For-profit and nonprofit organizations will imitate each other when faced with similar regu latory and legal constrai nts b. As an enterprise increases in size, its unit overhead costs would decrease c. As a hospital increases in size, its economies of scale dissipate d. In competitive markets, both for-profit and nonprofit organizations would deliver certain essential community benefits
Multiple Choice Questions (Enter your answers on the enclosed answer sheet) l. All of the following are elements of the policy cycle, except: a. Issue raising b. Policy design c. Policy implementation d. Policy evaluation 2. What was the main purpose of the Kerr-Mills program (l960)? a. Provision of federal grants to state government programs assisting the elderly b. Provision of federal grants to state government programs assisting the poor c. Provision of federal grants to state government programs assisting children d. None of the above 3. Which piece of legislation had important implications for rural hospitals? a. Rural Hospital Act of 1992 b. Omnibus Budget Reconciliation Act (OBRA) of 1986 c. Access to Ca re Act of 1988 d. Higgins-Branyan Act of 2004 4. For what is the National Health Planning and Resources Development Act of 1974 noted? a. The shift from cost containment to improvement of quality as the principal theme in federal health policy b. The shift from cost containment to improvement of access as the principal theme in federal health pol icy c. The shift from improvement of access to cost containment as the principal theme in federal health policy d. The shift from improvement of quality to cost containment as the principal theme in federal health policy 5. Which aspect of health care pol icy has received the most attention during the past several decades? a. Quality improvement b. Racial and ethnic disparities reduction c. Cost containment d. Access to car 6. What does “CON” stand for? a. Certificate of Need b. Certificate of Nursing c. Certificate of Naturopathy d. Certificate of Nationality 7. What is the mai n purpose of the Agency for Healthcare Research and Qual ity? a. To regu late hospitals b. To conduct and support research with respect to health care services and procedures c. To evaluate the effectiveness and safety of pharmaceuticals d. None of the above 8. In what way does research influence policymaking? a. Prescription b. Documentation c. Analysis d. All of the above 9. Which of the following is a health policy challenge faced by state governments? a. Protecting public health b. Subsidizing costs of caring for the uninsured c. Financing health services for the poor d. All of the above 10. All of the following were identified by the Institute of Medicine (Crossing the Quality Chasm, 2001) as areas for quality improvement, except: a. Timeliness b. Safety c. Efficacy d. Patient-centeredness 11. Which approach to national health care, if adopted, will make the most drastic changes in the US health care system? a. Laissez-faire b. Play or pay c. Single payer d. Managed competition 18. Which federal legislation has put severe constraints on the states to pass employer mandates that would require employers to pay for their employees’ health insurance? a. Health Security Act b. Trade Adjustment Assistance Act c. Employee Retirement Income Security Act d. Health Insurance Portability and Accountability Act 19. In former US Surgeon General, David Satcher’s proposal to increase investment in prevention, the ‘downstream’ level focuses on a. The individual b. The community c. The state d. The federal government 20. __ can benefit workers by furnishing them a larger set of skills. a. Diversity training b. Cross training c. Multidisciplinary teamwork d. Specialized training 21. Multi-skilled health practitioners (MHPs) are a. Particularly useful in large teaching hospitals b. Particularly useful in multidisciplinary teams c. Cross-trained d. Highly specialized 22. In a consumer-choice market, __ may be the best predictor of future success for a health care organization. a. Continuum of services b. Size c. Market share d. Client satisfaction
23. Extensive regulations imposed on health care organizations consume time and resources, which can impede a. A focus on the consumer b. Quality c. Charity d. Patient autonomy 24. Evidence-based medicine proposes to incorporate __ in medical care delivery. a. Clinical trials b. Best practices c. Experimentation d. Clinical review 25. Adherence to clinical guidelines is higher when they are based on a. Experimentation b. Clinical review c. Small area variations d. Clinical trials

Paper: White-Collar CrimeFor this assignment, we will focus on the various tools and techniques available to the security professional in order to mitigate white-collar crime.Select two of the white-collar crimes listed below.(a) Computer crimes(b) Credit card fraud(c) Embezzlement(d) Workman’s Comp fraud(e) Environmental crime(f) Securities fraud(g) Healthcare fraudAssignment help – Discuss (a) how these crimes are committed, (b) their impacts on organizations, and (c) the tools a security professional has available to reduce opportunities for such crimes to occur.Locate an example of one of your two white-collar crimes. Please make sure it is current, that is, within the past 2 years. Analyze the crime and how it was discovered, then discuss possible measures that could have deterred those found guilty.For this assignment, you are required to prepare a report of three to five pages (excluding title page and reference page), and post it in the respective Dropbox for this week.Remember to include at least two authoritative references. They must be cited within the paper as well as listed on a reference page. See the Help write my thesis – APA citation tutorial in the Course Syllabus.

HCM530 Case Study 5 Planning with Electron-Beam Computed Tomography (EBCT) The use of electron-beam computed tomography (EBCT) for screening of asymptomatic high risk cardiac population to assess for developing coronary heart disease is a new low risk alternative to the traditional invasive heart catheterization. The cardiac CT is recommended by the American College of Cardiology (ACC) as a secondary prevention test to screen prior to a myocardial infarction and death. Garcia (2005) cites that 1 in 20 emergency department (ED) patients present with chest pain and 3-5% of heart attacks have been missed by ED physicians. Another 20-40% of patients who have an invasive heart catheterization are negative. He recommends the cardiac CT as a method to solve some of these issues; however, continued validation is needed. The CT is not an answer for all patients, such as the obese, where visualization is difficult, or those with irregular heart rhythms. Hospitals and clinics across the nation are now purchasing the EBCT scanners. This case study will discuss the screening ability and healthcare planning challenges when bringing in new technology to the healthcare market. A recent purchase of an EBCT scanner was installed in a central U.S. clinic which serves a 300-bed tertiary hospital. The hospital and clinic took great care in training all staff in its use and patient preparation methods, including running a pilot on several local volunteers. Three months post pilot Case Questions: Answer the case questions, with research from your book, CDC, NIH and other quality sources to determine answers and solutions. You are to write a 2-3 page paper in Help write my thesis – APA formatting that addresses the following questions. Note: A minimum of two references should be used, which should include your textbook and the CDC, and others that support your responses in your paper. This is a paper, so your answer should not be numbered, but rather it should use titles and subtitles. 1. What are the sensitivity, specificity, and predictive values of EBCT? 2. Compare Valanis’s criteria for a good screening program with the eight criteria which the ACC/American Heart Association (AHA) panel proposed for selection of a screening procedure. 3. Provide descriptive epidemiology of this IL region to support the need to purchase a cardiac CT 4. (Health care planning) What should be done at this point to encourage use of this screening/diagnostic test for coronary heart disease?