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Last month, a team of three Master of Healthcare Administration (MHA) students, Lais Aguilar ’23 MHA, Robin Cullen ’23 MHA, and Prateek Mansingh ’23 MHA, participated in a unique experiential learning and professional development opportunity. They attended the .

The UAB Case Competition is a highly competitive and prestigious national event, with participation by invitation only. For the first time this year, the University of New Haven’s MHA program was invited to participate in this Case Competition. Forty-two other teams representing CAHME-accredited MHA programs from top universities across the nation also participated in this Case Competition.

This year, UAB made a fundamental departure in the type of case topic they assigned to participating teams. Instead of focusing on healthcare administrative challenges faced by a single healthcare organization, this year, participating teams were challenged to create an innovative care-delivery model to provide a patient-centered full continuum of care for patients with serious illness, including hospice and palliative care, while leaving it entirely open for teams to decide on the geographic location to be served, populations to be targeted, services to be provided, technologies to be utilized, and outcome measures to be developed.

Teams were assigned their case topic on Feb. 1, and the University’s student team worked night and day over three weeks (above and beyond their daily responsibilities of work and school) to conduct the research and develop and submit their presentation and other materials prior to leaving for the event in Birmingham, Alabama on February 22. At the competition, the team presented their work before a national panel of judges.

The team’s presentation was entitled: "PALLICE CARE: Home-based integrated palliative and hospice care to provide whole person full continuum palliative care, including primary, curative, and end-of-life care."

Below is a firsthand account of the experiences of the three participating students.

Lais Aguilar ’23 MHA

As part of my final semester at the University, I had the incredible opportunity to attend the University of Alabama at Birmingham’s 17^th Annual Healthcare Administration Case Competition. This prestigious competition afforded me the most challenging academic endeavor of my collegiate career, thus far. In just three weeks, my teammates and I took a deep dive in researching the current state of palliative and hospice care in the United States, and together we came up with a business plan to address and transform the care-delivery model and payer systems for palliative care services in Mississippi.

The journey began in December 2022. I received an email from Dr. Pavani Rangachari inviting me to interview as a potential candidate to represent the University in its first invitation to participate in the UAB Case Competition. During my time at the University, I often heard of case competitions, but I had not yet participated in one. About a week after the interview, I learned that I was chosen, and Dr. Rangachari scheduled a Zoom meeting with the participants. I knew Prateek previously from our work together in the University’s chapter, and Robin and I had met in ethics class.

Dr. Rangachari had a brilliant idea that the three of us work to create a mock case using the deliverables from the UAB 2019 case. This was a challenge because we didn’t have access to all the information, but it gave us the opportunity to be creative and to start working together as a team. Even now, I believe that it was that initial work during the mock case that helped us be successful when we received the actual UAB 2023 case. We got to know how each individual operated, we helped identify each of our strengths, and we supported one another through our weaknesses.

At the end of January, we received our case, and now it was crunch time! We were Team #24, and in just three weeks, we had to define palliative care, choose a health care system anywhere in the U.S. to innovate the end-of-life care-delivery model, and we had to come up with a payer system to support our ideas. After many days and many hours of research we decided to base our plans in the state of Mississippi.

We chose the as the healthcare system with sufficient financial health to make our home health care-delivery model a reality. Mississippi has high poverty levels, low access to healthcare due to transportation issues in rural areas, and is one of just 12 states to turn down Medicaid expansion. All these social determinants of health gave us a strong reason to innovate palliative care services in Jackson, Mississippi.

"Any time I come across a hurdle, I’ll remind myself that I have what it takes to overcome the biggest of challenges, and I’m very grateful for that experience."Lais Aguilar ’23 MHA

Our team was very fortunate to have a strong support system at our home base. Our professors freely offered their time, knowledge, and experience to help guide us through this challenge. Our team worked incredibly hard until the last possible moment, and before we knew it, it was time to prepare for the trip. We flew down to Alabama early on Wednesday, February 22. I remember admiring the beautiful terrain from the airplane window. In my 23 years living in the U.S., I had never traveled to this state, and it was a treat for me to experience the food and hospitality of the people from Alabama.

The following day, we presented “Pallice Care, Bridging hope and acceptance at end-of-life” to a panel of expert judges. After concluding the 20-minute presentation, we received follow-up questions from the judges and immediate feedback on our presentation skills. I learned a lot about myself in the weeks leading up to this event.

When I interviewed with Dr. Rangachari, I was honest with her about my limitations and fears of public speaking. I also shared that coming to the University for my MHA degree was a career change for me. Everything I knew about healthcare I had learned at school, and one of my potential shortcomings was a lack of experience in the healthcare industry. Nevertheless, I told her that I was willing and dedicated to give my very best for this competition.

My goal was to help the University put its best foot forward, and to keep this door of opportunity open to more students year after year. I was blessed to have by my side a team of strong academics who helped push me to grow in knowledge every day and who challenged me to think critically. I owe many thanks to my team, Robin, Prateek, and Dr. Rangachari.

My advice for future case competition candidates is to start by forming a strong working relationship with your teammates. Come into this with an open mind and the expectation to work extremely hard. This was not an easy task, and it required an extra level of dedicated work. At times it will be very stressful and emotions run high, but if you have that mutual respect and you’re looking out for the benefit of the team, you’ll be just fine.

I look forward to coaching students in the future who participate in the UAB Case Competition. Although we did not win this time, the lessons learned will be with us for our entire careers. Any time I come across a hurdle, I’ll remind myself that I have what it takes to overcome the biggest of challenges, and I’m very grateful for that experience.

Make no mistake this was difficult, but the career building benefits are worth it. I met great people who are up and coming in healthcare administration. I networked with several Fellows and learned what it will take for me to apply for a Fellowship myself. The University of New Haven’s generosity, which allowed me to participate in the UAB Case Competition, was not taken for granted. As I prepare for graduation this coming May, I hope to have made my professors, colleagues, and the University proud.

Robin Cullen ’23 MHA

Being afforded the opportunity to marry the theoretical with the practical resulted in something very real. Much is taught during the University of New Haven's Master of Healthcare Administration (MHA) program – so much so that applying that information is crucial to its retention. That imperative was fulfilled through the 17^th Annual University of Alabama at Birmingham (UAB) Healthcare Administration Case Competition in which I was asked to compete along with my fellow team members Lais Aguilar and Prateek Mansingh. It was the best finish to the MHA program that a student could ask for.

Having a solid baseline of knowledge of healthcare organizations (HCO) and related information technology (IT), a penchant for presenting, and a joy for interacting with others, I embarked on this journey in December of 2022. At that time, we had a mock case before us that clued us in very early that we would need to employ all that we had been learning in the MHA program, from financial management to strategy and innovation – and everything in between. This journey, though, was not one in which three MHA students made their way without support, but one in which both faculty and industry advisers contributed their time and energy to our growth, all within the bounds of the UAB competition ethical agreement.

We received the actual case in late January, when the iterative three-week-sprint began, culminating in our final presentation to a panel of judges in Birmingham, Alabama. However, in order to present our proposal for an innovative, person-centered and full-continuum care-delivery model, bridging hope and acceptance in home-based palliative and hospice care – our Pallice Care plan – much work needed to be done.

Being given the choice to design a care-delivery model from the perspective of a health system, a private equity-backed HCO, or a Medicare Advantage Organization, we felt it seemed obvious given our backgrounds and desire for a person-centered product to choose the health system one.

We initially chose Saint Dominic Hospital in Jackson, Mississippi, but realizing that we would have more resources at our disposal with the payer mix of the University of Mississippi Medical Center (UMMC), we decided to change course. Our task with UMMC was in fact to expand an already existing home-based palliative and hospice care service line. Setting forth with our adopted and all-important mission (to improve the health and well-being of patients and the community) and vision (a premier academic health system, recognized nationally for high-quality clinical care) in mind, we sought to develop Pallice Care.

"It was the best finish to the MHA program that a student could ask for."Robin Cullen ’23 MHA

Personally, my main areas of opportunity for growth were centered around market analysis and financial planning, and, thus, I was eager to apply the MHA-acquired knowledge and learn from my teammates who had a better grasp of those areas. Leveraging the fruits of the UMMC Community Health Needs Assessment (CHNA) – a document required of all not-for-profit hospitals by the Affordable Care Act (ACA) – we learned much about the Mississippi healthcare market. This was followed by a PESTLE (political, economic, sociological, technological, legal and environmental) analysis to provide the context for our chosen HCO and service line.

To complement this, we employed the RACE – reach, act, convert, engage – model for marketing to engender both internal and external support for the expansion. Then, we became a Center to Advance Palliative Care (CAPC) member in order to better understand how to structure our expansion plan. We used extrapolated CAPC baseline data to ultimately devise a financial plan replete with a pro forma, which used cost-shifting analysis to describe reimbursement. UMMC would act as the hub of reimbursement with our partners as spokes in the arrangement of which the full spectrum of reimbursement models would be employed, from fee-for-service to shared savings and capitation.

Pallice Care relied heavily on IT, in particular, an electronic health record (EHR). Therefore, to breathe meaning into the statement – “knowing what level of care to provide to which patients and for how long are keys to effective and efficient advanced illness management” – we needed a system to manage bridging patients from palliative care to hospice care at the right time and at the right level with family involvement all along the care continuum from concurrent care – that is curative and palliative – to hospice care.

EHR rules-based logic – future state artificial intelligence (AI) – was used to automatically flag eligible patients through use of a population-health registry. Key to this was that the software allowed us to easily transition patients to routine care as their health improved or to continuous care if they exhibited more complex symptomology.

The final presentation to the panel of judges was not without fault, but on the whole was not only well delivered but also well received. And though we did not win, much was gained. On a personal note, I will rely on talking points in the future rather than trying to memorize a narrative. Also, I will better align that which I say with that which is seen. In the end, it was evident that much growth had been realized from the endeavor, and for that much thanks was given.

In conclusion, the opportunity to apply the theoretical with the practical did indeed result in something very real. The shared experience of both student and teacher underlined that sentiment. Many thanks to my Pallice Care teammates, Lais Aguilar and Prateek Mansingh, as well as to our faculty sponsor Dr. Pavani Rangachari.

Prateek Mansingh ’23 MHA

In December 2022, I was chosen to represent my program at the 17^th Annual University of Alabama at Birmingham (UAB) Health Administration Case Competition. This is an invite-only competition that is extended to only CAHME-accredited MHA programs in the United States.

I knew the professors had made a good call with their nominations for the team, as I knew Robin from previous classes and I had been impressed by his experience, knowledge, and emotional intelligence. I knew Lais through the Society of Healthcare Administrators, and I know her as one of the hardest-working individuals whom I have ever had the pleasure of working with.

When we were nominated, we were equally excited and nervous about this opportunity. It was an extremely prestigious opportunity, and, at the same time, we knew that we were wandering into an uncharted territory, as we had never competed at a health administration case competition before. To compensate for this lack of previous experience, we delved into the link provided by UAB that gave us access to the videos of the teams competing in previous competitions.

By watching the many videos, we came up with ideas and built up a rough framework for the case competition to address the various components that are required for a successful presentation. At the same time, we also listened to the advice of our faculty adviser, Dr. Pavani Rangachari, and we decided to work on a mock case to prep ourselves for the real deal.

We were provided with a case from 2019 by UAB. However, we did not have all the information from that case, which made tackling this mock case a bit more difficult. However, that did not deter us as we modelled a mock case using details from the System.

All the hours we poured into the mock case provided us with a solid foundation required for the 2023 UAB Health Administration Case Competition. The hours we spent researching for the mock case pointed us in the right direction and helped us know where to look when we received our actual case. At the same time, we learned about the strengths and weaknesses of the team and how to work together, while harnessing our strengths and eliminating our weaknesses and supporting each other as and when we needed it.

At the end of January, we received our actual case from UAB. We were Team #24, and in a span of just three weeks, we had to redesign palliative and hospice care to provide a full continuum of care to patients who require these services.

An interesting fact about this year’s case competition is that in the previous years, UAB provided the competing teams with a geographical location and an organization to work with, but this year, they completely left it to the teams to choose the geographical location and the organization they wanted to work with.

Our research brought us to redesign palliative and hospice services in Mississippi, which is the state with the worst accessibility to palliative and hospice services according to the Center to Advance Palliative Care (CAPC). We did not want an easy task for ourselves and wanted to do justice for our program, the case competition and ourselves, as we looked upon this case competition as an opportunity to advance ourselves personally and professionally.

"We hope that our experiences will pave the way for future teams to compete in similar case competitions..."Prateek Mansingh ’23 MHA

We spent countless hours pouring ourselves into the preparation for the case competition, working together on Zoom until 2 or 3 a.m. and meeting on the weekends. Slowly and steadily, we became more than a team – we became friends. I got to know Robin and Lais as more than just colleagues. I learned that Robin is well-versed with different cultures across the globe and is an amazing dancer, and Lais is an inherently genuine human being who gives her 110 percent to everything she does. With every day spent together, our camaraderie grew, and we became closer. (We all share a mutual love for food and tried myriad cuisines together and ended up deciding that we love Indian food the best!)

We had all the support we could imagine from all our professors. In mid-February, we presented our deliverables to a panel of our professors and healthcare executives to obtain valuable feedback from them on what to work on for our case competition. The weekend after, we worked hard to redesign our deliverables before the due date. Once we had submitted them, we presented to a class being taught by Prof. David O. Lane, who was one of our judges previously. He commended us for our work over the weekend and said that it was evident that we had not slept at all the previous weekend to ensure that we put our best foot forward with the case competition.

On the morning February 23, we presented our work to a panel of judges at UAB who gave us valuable feedback on our content and presentation styles. Although we did not win, we will carry these lessons with us for a lifetime, and they will immensely help us in our personal and professional lives.

In Birmingham, we learned how different teams presented, connected with fantastic colleagues with whom we will be working with in our futures as healthcare executives, and learned a great deal about palliative and hospice services.

This case competition gave us the opportunity to apply everything we have learned in the last three semesters and apply it to solve a real-life problem in a short span of time. Looking back, I feel that our program has equipped us with core competencies that are required of healthcare administrators, and the competition gave us a chance to polish these competencies and help us identify our weaknesses and work upon them.

However, this is not the end for Team #24! We are presenting our experience at the Graduate Student Showcase at the University on April 11, and we plan on building this culture for the students pursuing an MHA at the University by hosting an internal case competition in April. We also hope to have a bigger case competition in the fall, when we will extend the competition to other schools in Connecticut.

Last, but not the least, it has not been an easy journey, but we hope that our experiences will pave the way for future teams to compete in similar case competitions, and this will certainly make it easier for them.

Dr. Pavani Rangachari, Faculty Adviser

We want to extend a heartfelt thanks to the following individuals for supporting the preparation of our MHA student team for the UAB Healthcare Administration Case Competition over a six-week period.

Thank you to , David O. Lane, Tom Giordano, Reena Kelly, Ph.D., MHA, and Heather Ennis for attending and judging the team’s first in-person mock presentation session and for providing invaluable feedback, support, mentorship, and guidance.

Thank you to and for arranging a virtual mock presentation by our student team to colleagues in the YNHH Health-System Pharmacy Administration and Leadership Pharmacy Residency Program within the Yale New Haven Health System.

Thank you again to David O. Lane for providing our student team with an opportunity to conduct a second in-person mock presentation in his HCAD 6611 Capstone class.

A big thank you to Lewis Goodrum, FACHE, David O. Lane, Tom Giordano, Reena Kelly, Ph.D., MHA, , Bill Olmstead, and for providing our student team with invaluable guidance, support, and mentorship (on Zoom or in writing) during their early preparation period in January.

We are immensely grateful for everyone’s time, support, and mentorship of our MHA student team!

Lais Aguilar ’23 MHA, Robin Cullen ’23 MHA, and Prateek Mansingh ’23 MHA are candidates in the University’s Master of Healthcare Administration program. Pavani Rangachari, Ph.D., CPH, director of the University’s MHA program, served as their faculty adviser on this project.