Which program will best prepare me for my career goals? What exactly are my career goals? What are my life goals? What is the meaning of life anyway? Maybe I should just move to Aruba and become a yoga instructor…
Deciding which master’s program to attend can be a daunting decision… and one that inevitably begets a host of difficult questions. About a year ago, after indulging myself in something that vaguely resembled a quarter-life-crisis, I finally decided to make use of one of the trustiest decision-making methods that has withstood the test of time: the pros and cons table. Aside from Weill Cornell’s world-renowned faculty, practical class offerings, and advantageous location, one of the “pros” that distinguished Weill Cornell’s program from the rest was its emphasis on hands-on learning and faculty mentorship through the capstone and portfolio projects.
Upon entering the HPE program, students have the option to choose either the capstone or portfolio project. For the capstone project, a group of students work with a client, like a hospital system or physician group, to address a problem that the client is facing. Under the mentorship of a faculty member, the students create a project control plan in which they outline their strategy for solving the problem, the expected timeline, and the project deliverables. The portfolio project is similar, but instead of working in a group, it is a one-on-one project in which a student may address one of the following: (1) an issue from the student’s place of work that has not previously been addressed or (2) a draft of a personal research paper. Both options allow students to gain valuable, real-world experience under the guidance of leading industry experts and faculty members to address problems faced by our healthcare system. This has certainly been my experience in this year’s capstone project.
The client for our capstone project is NewYork Quality Care, which is the Medicare Accountable Care Organization (ACO) of NewYork-Presbyterian, Weill Cornell Medicine and ColumbiaDoctors. For those of you who are unfamiliar with ACOs, a Medicare ACO is a group of doctors and other healthcare providers who agree to work together with Medicare to improve the quality and cost of care by providing better-coordinated care to Medicare fee-for-service patients. Our project focuses on the implications of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) on NewYork Quality Care. Currently, NewYork Quality Care is a Medicare Shared Savings Program (MSSP) “track 1” ACO, which means that if the ACO meets or exceeds certain cost and quality benchmarks, they have the chance to “share” in some of the savings that go to Medicare. This is called a one-sided risk model, because they only share in savings – they do not share in financial losses if they occur. By 2018, MACRA requires that all one-sided risk ACOs must transition into a two-sided risk model in which they also share in any losses that occur. There are four different ACO “tracks” from which NewYork Quality Care may choose, and each one is unique in terms of features like the magnitude of upside/downside risk and beneficiary assignment methodologies. My capstone team is working to determine which track NewYork Quality Care should transition to in 2018.
This capstone project has been a valuable opportunity for me to apply the concepts that I am learning in class to a real-world problem faced by a large medical system. It has enhanced my understanding of how the concepts from my courses are connected and how knowledge of each concept is necessary to resolve many of the challenges facing our healthcare system. There are definitely moments in the project when my teammates and I find ourselves stuck at a roadblock. At those points, we especially appreciate being able to work under the guidance of our faculty mentor, Dr. Larry Casalino, who is one of the world’s leaders in comparative effectiveness research of the health care delivery system, and Dr. Paul Casale, who is the Executive Director of NewYork Quality Care. It is a rare opportunity to be able to work with some of the best experts in the field and it has certainly made me a better researcher. Aside from improving my understanding of the concepts taught in class and improving my skills as a researcher, the capstone project has made me a more marketable job candidate. Many employers look for real-world experience from past employment and internships, especially in cities like New York where the job market is very competitive. For students who do not have extensive experience in the field, the capstone project is a great resume-booster that can lead to more job interviews in the future.
Overall, my experience in the capstone project has exceeded my expectations and has also been personally rewarding. It is exciting to think that my groupmates and I are helping NewYork Quality Care make a decision that will improve the quality and cost-efficiency of the organization and solidify its success in providing care to thousands of patients right here in New York City. There is nothing more rewarding than making a tangible impact, especially in a health care system that so desperately needs improvement.