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# Description Question

1-What are the goals of the athenahealth? Why?

2-Do we know what are the goals or demands of the customers?  

who to answer (Questions 1-2)? 

Brief Explanation. 2-8 sentences. List goals in bullet format.  



2.Do we know what are the goals or demands of the customers?

6.Should athenahealth create and pursue a new product? 

7.Does athenahealth have other options that it can pursue?

8.Should athenahealth enter a new market and compete against established & reputable companies?

9.How can you convince a customer to purchase and implement a new product?

10.What are the problems and obstacles both (players i.e. Athena & customers) would face?


how to answer Q 6,7,8,9,10:


Use sub-titles for each question. 

For questions 2,7,9. State brief explanations of 2-8 sentences for each one and follow with a list in bullet format.

For questions 6,8,10. Write in paragraph format.











athenahealth: Innovating in Response to a Crisis in Healthcare

I hate being like the other guys. I actually hate head-to-head competition. I was never good at it and always preferred to channel my Napoleonic energies into parallel but not quite comparable pursuits.

Jonathan Bush, president and CEO, athenahealth Inc.

On February 4, 2010, Jonathan Bush (MBA 1997), president and CEO of Watertown, Massachusetts-based athenahealth Inc. (Athena) celebrated with colleagues and friends at a restaurant in Pune, India. Barely a month into the new year, Athena already seemed to be on a roll: it had been named a "Business of the Decade" by the Boston Business Journal and was about to be announced by Fast Company as a member of the magazine's annual "Fast 50"-a list of the World's Most Innovative Companies, to be highlighted in the magazine's forthcoming issue. Athena, a publicly held provider of Internet-based business services to physician practices, was praised in the Boston Business Journal article for its II aggressive service, II and Bush was delighted to be acknowledged for the company's past ten years as an industry role model and innovator.

The dinner had gone until late in the night. Coupled with jet lag and his early morning wake-up call for a flight out of Pune (Bush was to make a long journey to Gidderbaha in rural Punjab, northern India, to visit innovative e-health facilities in action), Bush did not get much sleep. Away from the celebrations, with the very short night ahead, he had plenty to ruminate on. Despite the honor and the many awards the company he had co-founded had won for its innovative services, Bush knew Athena was a long way from being able to rest on its laurels. The company had created the industry's first Internet-based physician practice management and revenue cycle management! service and was gaining market share, but more slowly than Bush would like. Nevertheless, Bush had made additional bets on new add-on services. The first of these was a decision to introduce athenaClinicals (Clinicals), a web-based electronic health records service, even as their core offering, athenaCollector (Collector), a web-based revenue cycle management service, was growing. He wondered if Athena might have been in a different place if they had focused on Collector and not allowed the distraction involved in developing and marketing Clinicals. Indeed, Bush was troubled about the prospective launch of yet another new service, athenaCommunity (Community) even as Clinicals was beginning

1 Revenue cycle management was the collection of administrative and clinical functions that contributed to the capture, management and collection of patient service revenue.

Senior Lecturer Bhaskar Chakravorti, Senior Researcher Laura Winig, Global Research Group, and Naeem Arastu (MBA 2010) prepared this case. HBS cases are developed solely as the basis for class discussion. Cases are not intended to serve as endorsements, sources of primary data, or illustrations of effective or ineffective management.

Copyright © 2010 President and Fellows of Harvard College. To order copies or request permission to reproduce materials, call 1-800-545-7685, write Harvard Business School Publishing, Boston, MA 02163, or go to publication may not be digitized, photocopied, or otherwise reproduced, posted, or transmitted, without the permission of Harvard Business School.

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athenahealth: Innovating in Response to a Crisis in Healthcare

to catch on. If successful, Community could cement Athena's reputation as an industry innovator while dramatically growing its market share. Bush knew, however, that Community was a risky bet that on the downside could lead to cutting revenues in half without a compensating surge in sales. Yet, Bush said he was "inspired and excited by the idea of athenaCommunity" and was inclined to press on.

Despite validation of his vision for Athena by the press and his excitement about the new services, Bush had an even more basic question that, literally, kept him up at night: Why was the company's brand awareness so low, despite all the recognition and ongoing investments in innovation and sales and marketing? More importantly what could they do about this lack of awareness? He wondered: lilt just can't be as hard as we are making it, and, if in the next two years we cannot grow awareness to 50 of physician practices, I think the problem is me."

Company history

Bush had originally planned to be a doctor. He took an Emergency Medical Technician class and signed up to work on an ambulance crew in New Orleans during the summer of 1989. When his uncle, President George Herbert Walker Bush, launched Desert Storm in response to Iraq's invasion of Kuwait, Bush was a student majoring in social studies at Wesleyan University. He enlisted in the Army as a medic but did not perform combat duty; neither did he become a doctor. In 1997, Bush and Todd Park, former consultants in the managed care practice of Booz Allen Hamilton, a provider of consulting services to businesses and the government market, raised $1.6 million-comprised of their life savings and seed capital from friends and family-to buy an obstetrics practice in San Diego. The practice used a holistic approach to medicine that incorporated preventive care and education in addition to offering traditional birthing services. Park and Bush were close friends: "he's my brother from another mother," said Park.?

Apart from their exposure to the industry through their consulting assignments at Booz Allen Hamilton, Bush and Park also had additional insight into the problems in the healthcare industry through Bush's former wife, who was training to be a certified nurse midwife in the public health system in New York. Bush belonged to a well known political family-his grandfather was a senator and his uncle and first cousin had served as U.S. presidents-and Park's family were immigrants from rural South Korea. Park's father worked at Dow Chemical and, according to Park, had "more patents in Dow Chemical's history except Dr. Dow himself.Y'

The partners intended to build their obstetrics practice into a national franchise but, from the start, they were cash strapped, tied up in insurance red tape that resulted in delays in payments. II At the time, I did not get into the micro details of claims, etc. I thought revenue was cash. It isn't. It seemed like such a minor detail!" said Bush. The practice soon ran out of cash. Bush explained:

We had a revolutionary model for delivering women's healthcare. Traditionally, a lone physician screens a pregnant woman for disease throughout pregnancy and delivery and intervenes clinically when the need arises. In our model a team of nurse midwives, nutritionists and emotional-support staff engaged actively with pregnant woman to prevent the need for intervention. Physicians were only called in when patients were both pregnant

2 "HIStalk Interviews Todd Park, athenahealth Co-Founder," HIS Talk Healthcare IT News and Opinion, September 18, 2008, available /15 /histalk-interviews-todd-park-athenahealth-co-founder/ accessed March 5, 2010.

3 "HIStalk Interviews Todd Park, athenahealth Co-Founder," HIS Talk Healthcare IT News and Opinion, September 18, 2008, available /15 /histalk-interviews-todd-park-athenahealth-co-founder/ accessed March 5, 2010.


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athenahealth: Innovating in Response to a Crisis in Healthcare


and sick, actually quite a rare occurrence. Cesarean section rates dropped by half. Days spent in the newborn intensive care unit by new babies dropped 20. Meanwhile, breast feeding increased dramatically. Furthermore, our doctors became far more accomplished surgeons, since they were only treating patients who were actually sick. We had a federal study showing that births in our model were significantly less expensive, even though we spent almost five times as much time with a patient as was the case with a normal physician-centric mode of obstetric care. But it did not matter because we could not make payroll. Not because our business model did not work, but because we could not get thousands of low dollar medical claims paid in time.

The partners found that health insurance companies and Medicaid/Medicare (payers) often took weeks or months to reimburse their practice for patients' medical claims. As a result, Bush and Park were "growing broke"; revenue grew by 50, but cash flow grew by only 10.

The partners realized that they were far from alone; physician practices everywhere were struggling with the same problem. "In healthcare, the problem is that there aren't many buyers. The government has 50 market share and the top ten insurance companies have the bulk of the rest. Really there is just a handful of them and you have to serve them all and learn their rules. You have no negotiating power," said Bush.

By the end of 1998, Bush and Park knew the business-which by then had grown to 13 small clinics with 120 employees in California-was in serious trouble. While trying to raise venture capital, Bush demonstrated the company's web service, athenaNet, to a potential investor from Dallas. Bush explained:

We used athenaNet to keep track of patients as they flowed through all of our clinics. Our employees did not all have high school educations, so we used it to coach them as patients came up to our various front desks for care. Over time, we used it to access the public website of the state Medicaid plan and we would use the software to extract, or screen scrape off, our patients' insurance eligibility. Since Medicaid patients are enrolled and dis-enrolled from Medicaid based on their income levels, every month there was huge turnover, and this was the only way to determine if someone was insured at the time they came in for treatment.

The potential investor was not interested in the company, but he offered Bush $11 million for an unconditional, universal license for athenaNet. Though they turned down the offer, a few weeks later at Athena's corporate retreat, the team decided to invest in its athenaNet platform and switch the company's focus from clinical care to Internet-based medical billing. "Everyone was crying in my living room. We were exhausted. We decided to figure out how to do all the services we cared about through the Internet. We agreed that if we could not do it through the Internet, we were going to write it off," said Bush. They sold off the obstetrics clinics but were determined to fulfill their original mission and vision: to build management infrastructure to help make healthcare work the way it should. "We wanted to build a focused factory, II said Bush. "We talked ourselves into the idea that we were still on that mission, even though we were moving to billing services. We weren't an Internet company by any stretch, so that was unfamiliar ground to me. But the idea of serving all those opinionated doctors on a platform and service that was identical and inscrutable, or getting there, was like much-needed oxygen for a suffocating little Athena."

By spring 1999, the company found five physician practices willing to use athenaNet, and, within a year, they had broadened the offering to include workflow, billing and collections services (collectively referred to as revenue cycle management) and marketed Collector as a turnkey solution. Athena provided everything a physician practice needed to use its web-based service-including computer hardware. "We provided the computers, the printers, the people, a week of training and


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athenahealth: Innovating in Response to a Crisis in Healthcare

set-up-everything," said Bush. Athena charged no implementation or up-front fees for the service; instead, the company received on average 3 of each physician practice's revenue on an ongoing basis, for as long as the practice used Athena's service.

Though the company lost money through 2004, its new business model was working. "We were able to take something physician practices were doing and do it better and more cost effectively. Sure, we had a negative gross margin but all the key indicators were creeping up," said Bush. By the end of 2004, Athena had signed up 4,300 physicians and earned $36 million in annual revenues.

Athena in 2009

Healthcare information technology was a $39.5 billion industry in 2008 and was projected to grow to $54.8 billion by 2014.4 Athena estimated that the market for its services was over $27 billion in 2009 and was forecasted to grow by 5.5 annually.f In 2009, Athena generated revenues of $189 million (see Exhibits I, 2 and 3 for Athena's income statements, balance sheets and cash flow statements, respectively).

Revenue Cycle Management and athenaCollector

Growth in managed care had increased the complexity of physician practice reimbursement.

Physician practices were burdened with understanding the claim processing requirements of multiple private health insurance and government plans to be paid for services provided to patients. Health insurers offered a wide range of benefit structures, many of which were customized to particular employer groups. This resulted in a myriad of rules regarding who was eligible for healthcare services, what healthcare services were eligible for reimbursement, and who was responsible for payment. Further, health insurers continuously updated their reimbursement rules based on ongoing monitoring of consumption patterns, in response to new medical products and procedures, and to address changing employer demands. (See Exhibit 4 for revenue cycle management process flow.)

To manage billing and collections in the face of this complexity, the majority of physician practices used one of three revenue cycle management (RCM) software or service options to handle their billing and collections: locally installed software, on-demand remotely hosted software or third-party billing services.

Installed and on-demand software required internal staff to enter and manage data and follow-up on claims denials. As the complexity and number of health benefit plan payer rules (the rules that governed how, when and if a payer, such as a health benefit plan, would reimburse a physician) increased, the ability of locally or remotely installed software products to keep up with new and revised payer rules lagged behind, leading to higher levels of unpaid claims and prolonged billing cycles.

Though superior to paper-based systems, software had disadvantages. Software was updated periodically, not continuously; since payer rules changed continuously, reimbursement systems required constant updating to remain accurate. Nearly 30 of Ll.S. physicians were using an RCM

4 Bernie Monegain, "Report: Healthcare IT Spending to Grow to $39.8 Billion by 2008," Healthcare IT News, January 6, 2006, report-healthcare-it-spending-grow-395-billion-2008, accessed March 2010.

5 Athena's estimate included salary and benefits for in-house administrative staff as well as the cost of third-party practice management and electronic health record software.


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athenahealth: Innovating in Response to a Crisis in Healthcare


product that was more than five years old and 10 had a system that was more than 10 years old; only one-third of practices reported being satisfied with their current system.f

Third-party billing services, which collected billing-related information from physician practices and input the information into a software system maintained by the service, were generally small, local companies who were most familiar with health-benefit plans operating within their geographic region. Billing services typically operated discrete databases and sometimes used separate processes for each of their clients, which afforded limited advantages of scale and therefore limited cost advantages to physician practices.

Athena had the largest and most comprehensive continually updated database of payer reimbursement process rules (the key drivers of claim payments and denials) in the U.S. The company collected health-benefit-plan-specific processing information so that the medical office workflow could be tailored to the requirements of each health benefit plan. Athena used a proprietary rules engine to update its database nightly (adding approximately 100 new rules per month). The complex database included over eight years of claims data from tens of thousands of health plans, and became more accurate and efficient as it grew in scale.

Payer rules were frequently unavailable from the payers and therefore had to be learned from experience. By 2009, the company dedicated over 500 full-time service staff who researched and implemented new rules in addition to coordinating with payers to ensure that client providers were properly set up for billing; checking the eligibility of scheduled patients electronically; submitting claims to payers; receiving and processing checks and remittance information from payers and documenting the result of payers' responses; evaluating denied claims and determining the best approach to appealing and/or resubmitting claims to obtain payment; billing patients for balances that were due; and compiling and delivering management reporting about the performance of clients at both the account level and the provider level. Providing a back-office support function-which had Athena support staff participating in all key steps of a physician practice's revenue workflow-was a unique Athena offering.

All of Athena's clients simultaneously used the same version of the company's software application (although some rules were unique to particular clients), which connected them to the payer rules database and the service team. Because its service depended upon influencing client behavior using athenaNet, the company rolled out six to eight new releases of software functionality each year, all of which were free; indeed, they were a required condition of the service. "Practices were used to being angry at software vendors for 'nickel and diming them' for every single new feature available for their practice," said Bush. "With Athena, they didn't have that problem. If anything, our clients were frustrated at all the changes we pushed into their lives with our new releases, II he said. The company employed 60 software engineers in the Ll.S. and also contracted for software development services from a third-party technology development provider in Pune, India, and with 41 of its own direct employees through a wholly owned subsidiary located in Chennai, India.

Collector was designed to help clients achieve faster reimbursement from payers, reduce error rates, increase collections, lower operating costs, improve operational workflow controls, and more efficiently manage clinical and billing information. Athena measured its success using two metrics:

6 Physicians Practice Web site, accessed February 2010.


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athenahealth: Innovating in Response to a Crisis in Healthcare

average days in client accounts receivable, which had fallen from 65 days to 39 days between 2001 and 2009, and first pass resolve rate? which had gone from 75 in 2001 to 94 in 2009.

Bush and his team had invested in the infrastructure needed to serve small practices while the competition had primarily focused on large practices. "Serving the little guys requires so much more infrastructure and discipline than the big ones and the rewards come in teeny tiny packages," said Bush. "That said, the two year project to build out the online sale and implementation infrastructure which initially was unpopular with our board, has turned out to be a real boon."

Electronic Health Records and athenaClinicals

In 2007, Athena launched a new service, athenaClinicals, designed to help practices develop and maintain electronic health records (EHR) for their patients. "Good business logic would have said stay with Collector and ship the hell out of it but instead we distracted ourselves building athenaClinicals," said Bush who nonetheless modeled the service after Collector, using the software­enabled services (SeS)8, Internet-based model, rather than hurrying to market with a software-only EHR product-the existing industry model.

Clinicals was a clinical cycle management service that automated and managed medical record management-related functions for physician practices and assisted medical groups with the proper handling of physician orders and related inbound and outbound communications. The service allowed physicians to create up-to-date and accurate online patient clinical records and was designed to improve clinical administrative workflow. Clinicals provided functionality that Athena believed physician groups expected from an EHR service including: entering data about patient encounters as they happened; delivering outbound physician orders such as prescriptions and lab requisitions; and capturing, classifying, and presenting inbound documentation, such as lab results, electronically or via fax.

Athena's strong reputation within the small- and mid-size physician group market, cultivated by Collector sales, was beginning to translate into an opportunity for Athena to sell Clinicals under the same business model to those clients. Clinicals lost money for two years but eventually became profitable. By Q4 2009, Athena was serving 920 physicians and nearly 1,500 providers with Clinicals (compared to nearly 16,000 physicians and 23,366 providers for Collector in the same period).


By 2009, Collector was ranked first or second in several ambulatory and billing scheduling categories." even though many of Athena's competitors and potential competitors had significantly greater financial and technological resources. Indeed, Athena acknowledged that many of its competitors had stronger name recognition among physicians as well as more established distribution networks and relationships with healthcare providers.

7 The percentage of claims resolved (either paid or passed on to the patients) the first time they were submitted.

8 Software-enabled services was a service distribution model where a service provider used the Internet-based software to offer a range of services.

9 Rankings were issued in the "2009 Top 20 Best in KLAS Awards: Software & Professional Services" report by KLAS, a research firm that specialized in monitoring and reporting the performance of healthcare vendors. Source: company documents.


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athenahealth: Innovating in Response to a Crisis in Healthcare


Athena's primary competition was the use of locally installed software to manage revenue and clinical cycle workflow within the physician's office. Competitors included GE Healthcare, a division of General Electric with $17 billion in sales (2009); Sage Software Healthcare, Inc., a 25-year old company which provided medical software to 20 of Ll.S. physician practices; Allscripts-Misys Healthcare Solutions, Inc., an industry leader in the ambulatory market that provided software to 150,000 physicians and hospitals ($534 million 2009 revenue); Siemens Medical Solutions USA, Inc., a subsidiary of $100 billion Munich-based Siemens AG, a global electronics and engineering firm with a broad range of energy and healthcare products; and $1.7 billion Cerner Corporation. Each company competed directly with Athena (in RCM, EHR or both domains) but also offered additional software, devices, medical and related products and services to physician practices, clinics and hospitals. Smaller, "pure play" competitors included Eclipsys, a $500 million healthcare information technology firm founded in 1995, and Quality Systems, a $275 million software provider.l''

Athena had successfully carved out a niche by taking advantage of the Internet to offer proprietary web-based software. As of early 2010, Athena had no other Internet-based competitors, though some had begun introducing services where the software was centrally hosted and services were provided from central locations. Competitors such as Allscripts were beginning to explore Internet-based options, but they lacked the in-house human resources that Athena had to handle "analog" data such as faxes, phone calls and mail.

Industry Pricing

There was no industry standard for pricing. Some vendors charged flat fees, some were per-diem or per-month/year based. Software companies that competed against Athena charged an average software licensing fee of $40,000 per doctor up-front plus an additional $2,000 in annual maintenance fees. Athena's prices were 20-30 less than billing services, which averaged over 8 of a practice's revenue and could reach as high as 12, and a little less than a physician practice's internal costs (since most practices could layoff their billing staff once Athena was in place). "We're a swap on cost there," said Bush who noted that hospital-owned practices were an exception, due to their bureaucracy. "They are hard to sell to because they don't mind that they lose money," said Bush.

Athena's fees varied by type of physician practice. For most specialties the fee for Collector was based on the average size of the claim. For example, pediatric practices with generally low claim sizes might pay 7 or 8, while an orthopedic surgeon, with larger claim sizes, might pay 2. The average was 5. If clients also purchased Clinicals, it cost approximately 40 of the fee paid for Collector-an average of 2.

Bush acknowledged, however, that Athena's fees, over time, were higher. "The difference is, our competition's software does not increase practice revenue and it is 18 slower," said Bush. "Plus, they charge their fee all up front and we need nothing up front so there's a benefit at the bake-off for us. But they get 90 margin. They're selling software they wrote 10 years ago-great work if you can get it!" said Bush.

In 2009, business service fees accounted for 97 of Athena's revenues and were based on client contracts that were typically one year in length; the remaining 3 of revenue was derived from fees for implementation services, training and support.

10 All revenue figures 2008 unless otherwise noted. Data provided by Capital IQ. 2009 revenue figures from company annual reports.


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athenahealth: Innovating in Response to a Crisis in Healthcare

Sales and Marketing

Athena expected its sales to grow by over 30 annually through 2014, driven by new physicians joining the Collector platform and cross-selling Clinicals to its existing client base of over 15,000 physicians.

To reach its sales goals, Athena maintained business relationships with individuals and organizations, called channel partners, that promoted or supported its sales within specific industries or geographic regions. Channel partners generally did not make sales but instead provided Athena with leads that its 64-member sales force used to pursue new business (see Exhibit 5 for details on Athena's sales force). In 2008, channel-based leads drove approximately 50 of Athena's new business.

Athena's channel relationships included state medical societies, healthcare information technology product companies, healthcare product distribution companies, and consulting firms such as the Ohio State Medical Society, Eclipsys Corporation and PSS World Medical Shared Services, Inc. (PSS), the country's largest provider of medical supplies to the physician market with a sales force of more than 750, which sold medical supplies and equipment to 100,000 practices across the 50 states, averaging two to three doctors each.l!

In the case of PSS, which signed a sales and marketing agreement with Athena in 2007, PSS sales representatives earned up front and trailing commissions based upon the estimated contract value of orders placed for Athena's services, which were later adjusted to reflect actual revenue received by Athena from its clients. As part of this contract, PSS agree to distribute Collector as its exclusive revenue cycle solution and agreed to begin distributing Clinicals as its clinical cycle solution at a later date if certain milestones in development and certification of the service were reached. In tum, Athena agreed that it would not enter into a similar agreement with any business that had primarily distributed medical and surgical supplies to the physician ambulatory care market in the Ll.S. During the second year of the agreement, PSS urged Athena to create a dedicated team of sales representatives who would work with the PSS sales organization to generate leads. PSS subsidized the cost of this team for one year in order to demonstrate its benefits. As a result, lead volume increased substantially and by mid-2009, Athena was the sole revenue and clinical cycle solution sold by PSS. In an Athena press release, PSS's CEO remarked, "We are seeing physician practices that are going from the verge of bankruptcy to profitability just through the use of the Athena revenue cycle product. So, it is the best out there. We are very, very joined at the hip with Athena and very excited about the prospects."

Athena's relationship with its channel partners was complicated in that they had the potential to become direct competitors. For example, in late 2008 Eclipsys acquired software for small/mid size physician practices and was in the process of scaling up the billing and practice management solution to address larger-sized physician groups, which would effectively put it in direct competition with Athena. In addition, Athena's exclusive contracts with its channel partners prevented it from entering into similar arrangements with other distributors and suppliers to the ambulatory market.

Athena's direct sales force was responsible for following up on leads and, once they scheduled face-to-face meetings with prospective clients, they were charged with understanding clients' needs, developing service proposals, and negotiating contracts. "Our biggest obstacle in selling to a new practice is that it's tough to get the meeting. Doctors are bombarded by companies. The problem for

11 Physician Sales & Service website, available accessed March 2010.


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athenahealth: Innovating in Response to a Crisis in Healthcare


Athena is: we're not in there. I don't fire anyone for not getting enough sales but for not getting enough meetings. When we get meetings, we get sales," said Bush.

When physicians elected not to buy Athena, it was often because they stayed with their existing methods. "When the software companies see us coming, they make an expansion offer-perhaps an enterprise edition or special reporting packages for free, to keep doctors from de-installing them," Bush explained.

Another obstacle that Athena faced was that the practice's doctors were often not the buyers. "The people who choose the systems are not the doctors, they're the practice managers, the billing managers or the CFOs. Since Athena will replace many of the staff that report to these buyers, there is often a strong incentive not to go with us," Bush explained. Finally, some prospective clients expressed concern about patient privacy, since Athena retained all the data for its own records and use and had access to every detail of every claim.

Marketing Initiatives

Historically, Athena had focused its marketing initiatives on physician acquisition, focusing on channel partnerships and pay-per-click ads with low fixed and up front costs but high variable costs. Through 2009, the company's budgeted sales and marketing cost was 50 of its net new annual recurring revenue bookings target, which Bush considered low.

The tradeoff for the modest cost of sale, however, was low physician awareness. As a result, by 2010, Athena's marketing efforts were designed to increase awareness of the company, demonstrate the benefits of its service model and build credibility with prospective clients. The company's marketing initiatives, generally targeted towards specific segments of the physician practice market, primarily consisted of: pay-per-click search advertising and other Internet-focused awareness­building efforts, such as online videos and webinars; public relations activities aimed at generating media coverage; industry-focused trade shows; direct mail and telemarketing to physician practices; informational meetings (such as town-hall style meetings or strategic retreats with targeted potential clients at an event called the" Athena Institute"); and dinner series seminars.

In 2006, Athena mined its database to create an annual PayerView ranking report that it provided to clients. PayerView ranked payers' performance based on a myriad of categories, which combined to provide an overall ranking aimed at quantifying the ease of doing business with the payer. All data used for the rankings came from actual claims performance data of Athena's clients.

Despite these efforts, Bush considered marketing the company's biggest challenge and the most likely explanation for physician's low awareness of the company's offerings. "1 just can't figure out what the problem is. Perhaps it's just a simple numbers thing. We have fewer than 70 people in sales and our competitors have hundreds. We also have a firm rule about getting a dollar of annualized revenue for every fifty cents we spend on growth. It made a ton of sense before we were making money, but now?" Bush noted that the company had had a few false starts, including changes in marketing leadership and other setbacks that had slowed growth in market awareness. "We make things very complicated and we take a very long time to execute," said Bush. He was most concerned with the company's low level of awareness among physicians: 19 knew of Athena, up from 18 in 2008 after a year of intensive marketing efforts. "The vast majority of doctors, 80, cannot pick us out of a lineup," said Bush. "Our biggest obstacle is that they don't know who we are and they don't know that billing and medical records can be done on the Internet."

Low awareness was common in the industry generally. "Awareness and favorability for everybody is horrendous. Doctors just don't like IT vendors, but once they become customers, they


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athenahealth: Innovating in Response to a Crisis in Healthcare

love us. Most of our customers, 87, give us a top score in answer to the magic question, 'I would refer Athena to my most trusted friend or colleague,'" said Bush. "Within the next two years we need to be at 50 awareness," he added. (See Exhibit 6 for awareness among physicians.)

A significant opportunity for growth was enterprise-level deals. In 2009, Athena added two large enterprise customers, University Hospitals (450 providers) and Caritas Christi Healthcare (500 providers), to its Collector client base. University Hospital was one of the nation's largest community-based health systems and represented Athena's largest initial contract signing, while Caritas Christi Healthcare was the largest community-based health system in Massachusetts and the second largest healthcare system in New England. The Caritas Christi contract was awarded to Athena to replace GE. In June 2009 Athena announced a deal with MedNet, Maine's largest independent provider organization with over 4,000 medical provider members, and in July 2009 Athena announced a deal with Cook Children's Healthcare System (350 providers).

Performance Results

Physicians who joined Athena's network increased their collections by an average of 6.5. "We know this because the data is pooled, since everybody is on one application. None of our competitors have this data," said Bush.

Athena also built practice performance review (PPR) into its service, allowing physician practice managers to compare their performance against their peer group or against Athena's database. Once a month, Athena provided client executives and practice owners with a PPR report and recommendations and followed up with a call'? from their account manager who reviewed ten different performance measures and recommended action steps. "We have a very large benchmark set because everyone is on the same system. We can compare doctors to their own history, to the practice as a whole, to practices throughout the state, etc.," said Bush. Athena did not charge its clients for the PPR service. "If they do well, our revenue goes up, too," he noted.

The Way Forward Leveraging the HITECH Act

On February 17, 2009, President Obama signed the Health Information Technology for Economic and Clinical Health (HITECH) Act, as part of the government's economic stimulus package to improve the health of the U.S. economy. The main goal of the HITECH Act was to encourage the adoption of EHRs by providing incentive payments to physicians. The Act was comprised of two parts: $23 billion was earmarked to fund healthcare connectivity initiatives and the physician incentives, and an additional $2 billion was set aside for new entities to establish standards and certify new privacy provisions.P (See Exhibit 7 for the Congressional Budget Office's estimates of HITECH Act spending through 2019.)

12 Practices with two or more physicians received calls from account managers.

13 Ana Shrank, "HIMSS 2009 McKesson: The Right Partner for Customer Success," McKesson Corporation, undated, available, accessed March 2010.


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athenahealth: Innovating in Response to a Crisis in Healthcare


According to the Act, starting in 2011, physicians were eligible to receive up to $44,000 in total incentives from Medicare and up to $65,000 from Medicaid for the adoption and "meaningful use"14 of a certified EHR program. After Clinicals was certified by the Certification Commission for Health Information Technology (CCHIT)15 in June 2009, Athena guaranteed physicians that if they used Clinicals they would receive their Medicaid HITECH Act payment for 2011.

Bush believed that despite the established and emerging competition in EHR (more than 200 competitors were certified by CCHIT by mid-2009), the passage of the HITECH Act would significantly expand the market for everyone. "The HITECH Act is clearly an ideal opportunity for physicians who use EHRs effectively to be rewarded and to stimulate adoption for those who aren't currently using EHRs," he said.

Since the passage of the HITECH Act, stock prices of the company's two main competitors, Allscripts-Misys (25 market share) and Quality Systems, Inc. (10 market share), were up 76 and 36 respectively, while Athena had traded relatively flat, up only 16 (the S&P 500 ran up 39 during that same periodj.l"


In early 2010, Athena was contemplating the launch of a new service it planned to call athenaCommunity (Community). The offering would be a repackaging and re-pricing of Clinicals, so that labs and hospitals that received electronic orders from doctors within physician practices on the network paid for approximately 50 of the overall service. The business model would allow Athena to earn revenue from both sides of the two-sided market that it sat between. Bush believed it was a fairer business model, allowing those who reaped the benefits of the service to pay a share of the costs. "Doctors pay 100 of the cost of being on Clinicals, but receive about half of the value. The labs, hospitals and other doctors who receive electronic orders from them receive the other half," explained Bush.

Bush noted that to launch successfully, Athena would need to conduct market-dominating blitzes in each of the geographies it served. "There is a massive chicken and egg problem with the strategy," said Bush. "But if we build out the network, it's impossible for a point-to-point competitor to compete. It's a bet that competitors can't do it using a software-based approach, because they don't take responsibility for delivering orders," said Bush.

Launching Community came with many risks. "What if we find, after cutting our pricing in half, we cannot make it up either on volume or on the other side of the network? On the other hand, if we succeed, it could be a game changer," said Bush. Some analysts wondered whether it was the right time to introduce Community, speculating that perhaps Athena should wait until it had a larger installed user base that was more fully devoted to its services. Bush was not sure and wondered if

14 The rule defined a "meaningful EHR user" as a professional or hospital that demonstrated meaningful use of certified EHR technology in a form and manner consistent with certain objectives and measures presented in the regulation. These objectives and measures included use of certified EHR technology in a manner that improved quality, safety, and efficiency of healthcare delivery, reduced healthcare disparities, engaged patients and families, improved care coordination, improved population and public health, and ensured adequate privacy and security protections for personal health information.

15 CCHIT was a non-profit organization recognized by the u.s. federal government as a certifying body that ensured EHR providers meet the HITECH Act's "meaningful use" criteria.

16 February 17, 2009 through March 15, 2010.


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athenahealth: Innovating in Response to a Crisis in Healthcare

Athena should consider launching the service in small increments rather than in one fell swoop to hedge the bet.

One consideration: the rapid growth in the number of new customers strained the company's ability to support its existing customers. Athena had more than doubled the number of physicians on athenaNet between 2007 and 2009 and Bush believed the company could double the customer base again before 2012. Athena's customer satisfaction levels had been trending down and were below management's goal of 90. The declines in customer satisfaction during 2008 and the first half of 2009 had not yet impacted Athena financially and customer churn was low at 3 per year, but the trend was concerning.

Bush considered the market opportunities facing Athena and wondered how best to allocate his limited resources (see Exhibit 8 for Athena's estimated market opportunities). Should he scale up his sales and marketing efforts to support the Clinicals service? On the other hand, he could move forward aggressively to launch Community. His phone rang. It was the wake-up call from the hotel reception.


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athenahealth: Innovating in Response to a Crisis in Healthcare


Exhibit 1

Athena Income Statements, 2007 to 2009 (in $ millions)












Revenue, business services




Revenue, implementation and other




Total Revenue








Direct operating costs




Selling and marketing




Research and development




General and administrative




Depreciation and amortization




Total Expenses




Operating Income




Other income (expense):




Interest income




Interest expense




Gain (loss) on interest rate derivative








Other income (expense)




Total Other Income (expense)




Income (loss) before income tax (provision)








Income tax (provision) benefit




Net Income (loss)





Company documents.






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810-079                                                                                     athenahealth: Innovating in Response to a Crisis in Healthcare

Exhibit 2 Athena Balance Sheet, 2008 to 2009 (in $ millions)

Balance Sheet as of December 31:






Current Assets:



Cash and Equivalents



Short-Term Investments



Accounts Receivable-Net



Deferred Tax Assets



Prepaid Expenses and Other Current Assets



Total Current Assets



Property and Equipment-Net



Restricted Cash



Software and Development Costs



Purchased Intangibles-Net






Deferred Tax Assets



Other Assets



Total Assets






Current Liabilities:



Current Portion of Long-Term Debt and



Capital Lease Obligations



Accounts Payable



Accrued Compensation



Accrued Expenses



Current Portion of Deferred Revenue



Interest Rate Derivative Liability



Current Portion of Deferred Rent

1 .1


Total Current Liabilities



Deferred Rent, Net of Current Portion



Deferred Revenue, Net of Current Portion



Other Long-Term Liabilities



Debt and Capital Lease Obligations, Net of



Current Portion



Total Liabilities



Preferred Stock



Total Preferred Equity



Common Stock



Additional Paid-In Capital



Treasury Stock



Accumulated Other Comprehensive (loss)






(.1 )

Accumulated Deficit



Total Stockholder's Equity



Total Liabilities and Stockholder's Equity




Company documents.




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athenahealth: Innovating in Response to a Crisis in Healthcare


Exhibit 3

Athena Cash Flow Statements, 2007 to 2009 (in $ millions)








Net Income (Loss)




Adjustments to Reconcile Net Income (Loss) to Net




Cash Provided by Operating Activities:




Depreciation & Amortization




Accretion of Debt Discount




Amortization of Discounts on Investments




Financial Advisor Fee Paid by Investor




Provision for Uncollectable Accounts




Non-Cash Warrant Expense




(Gain) Loss on Interest Rate Derivative Contract




Deferred Income Taxes




Excess Tax Benefit from Stock-Based Awards




Stock-Based Compensation Expense




(Gain) Loss on Disposal of Property and Equipment




Changes in Operating Assets and Liabilities:




Accounts Receivable




Prepaid Expenses and Other Current Assets




Accounts Payable




Other Assets




Accrued Expenses




Deferred Revenue




Deferred Rent



(1.1 )

Net Cash from Operating Activities




Capitalized Software Development Costs

(1.1 )



Purchases of Property and Equipment




Proceeds for Sales/Disposals of Prop/Equip




Purchase in Long-Term Investment




Proceeds from Sales/Maturities of Short-Term








Purchases of Short-Term Investments




Payments for Acquisitions Net of Cash Reqd




(Increase) Decrease in Restricted Cash




Net Cash (Used in) Provided by Investing








Proceeds from Exercise of Stock Options and








Proceeds of IPO, Net of Issuance Costs




Debt Issuance Costs




Excess Tax Benefit from Stock-Based Awards




Proceeds from Long-Term Debt




Proceeds from Line of Credit




Payments on Long-Term Debt & Capital Lease Optns




Payments on Line of Credit

(13.1 )



Net Cash Provided by Financing Activities




Effect of Exchange Rate Changes on Cash and Cash








Net Increase (Decrease) in Cash and Cash









Cash/equivalents At Beginning of Year





Cash/Equivalents at End of Year





Company documents.










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810-079                                                                                       athenahealth: Innovating in Response to a Crisis in Healthcare

Exhibit 4 Revenue Cycle Management

Rules vary from payer to payer about which visits are covered

P4P revenue may depend on weight, blood pressure and other pre-exam data

Care providers will issue Rx, lab, referral and other orders based on the exam

Next steps and payment

arra ngements vary widely

Co-pays change and can vary from the card

Codes depend on exam variables (e.g. number of bodily systems examined)

P4P reimbursement often based on lab result data


Physician responsible for following up on results and orders

Source: Company documents.


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athenahealth: Innovating in Response to a Crisis in Healthcare

Exhibit 5 Athena Sales Representatives, Q3 2008 versus Q3 2009

We focused Our Go- I o-Market Approach and Expanded our Sales Force in 2009


# Reps






Ch 2009~




·1.-3 docs





~ Vi rtua I sales












~ 4+ docs




~ fie ld sates









~ 150+ docs



( Enterprise ]



~ Corp-awned



~ Biz dev as sa les



Cross-Sell &

~ Up-s.ell services.











~ Meet i ngs with





PSS reps

T ot:a~ Salles Reps-A' "Qjota-calT1ing reps i1clIJding sales lec:d~rs



Source: Company documents.

Cross-Segment Support



Channel MU1i1~C!ment

Sates & Milrkcli1ll5 Operiltions


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810-079                                                                                       athenahealth: Innovating in Response to a Crisis in Healthcare

Exhibit 6 Change in Athena's Awareness Among Physicians, 2008 to 2009

While Awareness Growth Will Take Timet Our Efforts Have Improved Favorability










































• athenaheakh








16 favo,rllbill































• •

a enaheal

(19awan~nI!5S .29 favorsbi lity)

50 0




Source: Company documents.


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athenahealth: Innovating in Response to a Crisis in Healthcare


Exhibit 7

Estimated Government Spending for Healthcare Information Technology under the


HITECH Act (in $ billions)










































Physician bonuses and




























Medicare bonuses













Medicaid bonuses



























Medicare penalties



























Hospital bonuses and




























Medicare bonuses













Medicaid bonuses



























Medicare penalties



























Savings on Medicare and













Medicaid benefits













Total spending














Adapted from "Estimated Effect on Direct Spending and Revenues of Title IV of Division B of the American


Recovery and Reinvestment Act of 2009 (Public Law 111-5): Health Information Technology," Congressional Budget


Office, available http:/ / /ftpdocs/101xx/docl0106/healthl.pdf, accessed March 2010.





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810-079                                                                                       athenahealth: Innovating in Response to a Crisis in Healthcare

Exhibit 8 Athena's Estimated Market Opportunity

Our Opportunity Remains -100X Our Size

u.s. Heallhcare Expenditures = $2.211"1'

athena health's CoUections -1  

Growth Trend - Ambulatory Care

Physician and Clinical Services:


Estimated at $86sbn by 2018'

$1 . ....u,.oM T~~~~=r-====:::;:

";!:10000~ tI

,,_, f\:~CA~G~R~~6~~It=:::=:;::j:::J:1l

";;ooooo~ f

S6(t(JJ1(10 $! ')'1(t(JJJ1)O

':!i300.ooD a- ..•...•.•.. ...,a-lHI-lI-llI-a ...•. ':!i:i! a- ..•...•.•.. ...,a-lHI-lI-llI-a ...•. $1(0)l1l0 a- ..•...•.•.. ...,a-lHI-lI-llI-a ...•.

,. ~~~~~~~~~~~

Market Opportunity

·   Revenue cycle market opportunity

·   Clinical cycle market opportunity

·   Patient cycle market opportunity

$479bn x 1-32 = - $10bn


Total = -$34bn+ )

·eMS ~~ .2007 (mtJst rec~nt dal3: ht¢tJ- f.fttWW am My "Pt1Nj"Zi2&(Heqhl:rr:weartng@ldolfQ'Q,fI9'VwpfzooSlNffl .: AssomM rste olspendifrgwitflin mNI~1 p'radk~ for 5elVices rfla.t atiw1.a/ruith offNs tm;m mJ/!;{JUMeiI basis

Source: Company documents.


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Read the case study and then answer the following questions:

Select one of the books from the Required Reading paper and read 3 chapters of your choice.

Specify the book and chapters selected and  Summarize  the content of each chapter Reflect on their meaning to you; how you relate to it; how will you use it as you move forward (provide specific examples) 

Required Reading  (3 chapters from 1 book only and 1 movie)


Book Listings:


Boyatzis, R. and McKee, A. (2005). Resonant leadership: Renewing ourself and connecting with others through mindfulness, hope, and compassion. Boston: Harvard Business School Press.


Carroll, M. (2007). The mindful leader: Awakening your natural management skills through mindfulness meditation. Boston: Trumpeter.


Carroll, M. (2004) Awake at work: 35 practical Buddhist principles for discovering clarity and balance in the midst of work’s chaos. Boston: Shambhala Publications, Inc.


Carroll, M. (2012). Fearless at work: Timeless teachings for awakening confidence, resilience, and creativity in the face of life’s demands. Boston: Shambhala Publications, Inc.


Gallo, C. (2015). Talk like TED, St. Martin Press, NY 10010


Marturano, J. (2014). Finding the space to lead: A practical guide to mindful leadership. New York: Bloomsbury Press.


Newberg A., Waldman M.R. (2012). Words can change your brain: 12 Conversation Strategies to Build Trust, Resolve Conflict, and Increase Intimacy. Penguin Group, USA







Videos/DVD (in addition to the ones in library or self selected):


Dreamkeeper (*)

Whale Rider (*)

Navajo Code Talkers (*)

Follow the River

The PathFinder

The Gods must be crazy

Around the World in 80 days

If you find a movie that deals with cultural awareness/adaptation/ challenges email the info to the prof for approval.


Available free of charge on the web:

A men called Horse:

Dances with Wolves:



Select one of the books from the Required Reading paper

Thread: Consider the heart, head, hands, and habits needed to lead like Jesus. How can we see these areas reflected in other biblical leaders from the Old or New Testaments? Reflect on leaders you have had (or those you admire in an organization today) who reflected one or more of these areas. How did their leadership impact you? What did you learn from this type of leadership?

INSTRUCTIONS:    you must post a thread of at least 500 words in response to the prompt provided.  For each thread, you must support your assertions with at least 3 scholarly citations in APA format as well as include at least 1 biblical integration.  

Topic: Practicing the Four Hs of Leadership

Lead Like Jesus

Chapter 1


1. Am I a leader?

A: Yes, I am a leader.

2. Am I willing to follow Jesus as my leadership role model?

A: Yes, I am willing to follow Jesus as my role model for servant leadership.

3. How do I lead like Jesus? (p. 4)

A: I try to give everyone respect even when may not like him or her.


Pause and Reflect

Take a moment to think about the people who have most your thinking, behavior, and life path. As you recall their names and faces, you will realize that leadership, titles, and positions of organizational authority are only part of the leadership landscape. Now think of all the relationships in which you have the opportunity to influence the thinking and behavior of others, and consider how often in any given situation you face the choice: “Am I seeking to serve or “Am I seeking to serve or to be served?”  The answer to that question will depend on whom we choose to follow. (p. 11)

A:  I seek to serve. I serve individuals even at a great expense to myself. I do not ask for anything in return just respect.



That leads to our second key question. Am I Willing to Follow Jesus As My Leadership Role Model? (p. 11)

A: Before taking classes at Liberty, I have been trying to be a better leader. I wanted to be a leader that was trustworthy, honest, helping, and going above and beyond for my suborniates.



“Does Jesus have any relevant practical knowledge or experience in dealing with the following types of leadership issues I face day to day?”  (p. 16-17)

A:  I believe Jesus face every issue and more than I can imagine He faced.



_Y__Working with or living and caring for imperfect people

_Y__Taking time to train, develop, and delegate

__Y_Under constant scrutiny and testing of commitment and integrity

Y___Required to handle rejection, criticism, and opposition

_Y__Facing fierce competition and conflicting demands from friends and foes

_Y_Tempted by instant gratification, recognition, and misuse of power

_Y__Facing serious personnel issues, including turnover and betrayal

__Y_ Required to communicate in a multicultural environment

_Y__The need to challenge the status quo and hierarchy to bring about change

_Y__The need to communicate a radically new vision of the future

_Y__The need to call attention to poor leadership at great personal risk

__Y_The need to put career or relationships on the line to serve a higher purpose






Pause and Reflect

If you are skeptical about adopting Jesus as your leadership role model, write down your reasons. What is it about Jesus that is causing you doubt? What is it about you that is causing you to hold back? (p. 19)

A:  I do not have any doubts about adopting Jesus. I just need the guidance from Him.



Pause and Reflect

List three ways you nurture trust in your leadership.

List two things you do that put trust in your leadership at risk.

Think of a time when you lost trust in a leader. How did you feel? How long did it last? You forgive him or her? (p. 26)

I do not repeat what is said to me, I am honest when asked questions, I will tell the truth no matter if it gets me into trouble.

Having others undermine me when I am doing the right thing, the stress that comes with taking in everyone’s problems.

I have lot trust in many of my current leaders. I felt betrayed. It is still on going. Yes, I have forgiven him/her.



Pause and Reflect

How do you think the people in your family would describe your leadership in the following:

  • a time of crisis
  • a time of failure
  • a time of victory
  • a time of plenty
  • a time of want

Do you like what you would hear? If not, why? (p. 28)

A: Yes, my family knows that I will do whatever it takes when the time comes.


Lead Like Jesus

Chapter 5


Professor’s Assignment: ½ Hour of solitude. What did you experience during your time of solitude and/or meditation on scripture?

A: I felt better. I have been stressed from work. I have been over loaded and have not been able to vent.


When was the last time you spent a significant amount of time in solitude (before your assignment) on purpose without a to-do, think, or pray list and sat quietly in God’s presence and listened to his “still, small voice?” If you can’t remember, you now have a clue why your life and leadership seem so hindered and unsatisfying. If you can remember and it was more than a week ago, you need to update your plans for the immediate future. (p. 159)

A: Never


One of the most revealing questions you could ask a leadership candidate is “How is your prayer life?” The answer will speak volumes about where and how the leader might lead. Here’s a question for you: “How is your prayer life?” (p. 165)

A: I think I could pray more. I do not have a set schedule as to when I pray, but I pray daily.


After each of the following explanations, evaluate where you are with your own practical application, what you plan to do to make it a habit, and when you will set as a target deadline for each one to be a Scripture habit. (p. 166)

A: I will write out on sticky notes to do for a month.


One way to apply what you hear is to ask yourself the following questions and jot down the answers. You might want to record them in your personal journal or make a form to help you remember.

What did God say to me through his message?

How does my life measure up to this Word?

What actions will I take to line up my life with this Word?

What truth do I need to study further?

What truth can I share with another person? (p. 168)

A: He spoke volumes to the good that I can do. My life, in my opioion, does not measure up as much as it should to His word. (I try to be a good person; I treat individuals as I want to be treated.) I will write down any incidents so that later I can evaluated the situation and see if God would approve of it.


Think of a time when, beyond a shadow of doubt, you experienced God’s love for you, personally, specifically, and in a way that only he and you knew its true significance in your life. How did you feel at the time? How do you feel at this moment? What do you need to say to God? (p. 179)

A: I felt warmth inside of me that I could not explain. I feel loved very much by God. I am glad He blessed me with my family.


Name the special people in your life who will love you enough to tell you what you need to hear. How are you improving that special relationship? What can you do to make sure it stays alive and well? Who needs you to hold them accountable? Do you love them enough to tell them what they need to know? (p. 186)

A: My whole family. We are honest with each other with mutual respect.


Courageous Leadership

Chapter 9


Is my calling sure? (p. 185).

A: yes


Is my vision clear? (p. 186).

A: yes


Is my passion hot? (p. 187).

A: yes


Am I developing my gifts? (p. 188).

A: yes


Is my character submitted to Christ? (p. 189).

A: yes


Is my pride subdued? (p. 190).

A: yes


Am I overcoming fear? (p. 191).

A: yes


Are interior issues undermining my leadership? (p. 192)

A: no


Is my pace sustainable? (p. 193)

A: yes


Is my love for God and people increasing? (p. 195).

A: yes


Additional thoughts and feelings during module 1:

A: I need guidance as to handle feelings when someone disrespects me.


Module 2

Greenleaf Part I


Professor’s questions:

What is your definition of management?

A: Management is the ability to motivate individuals to work for one.


Is my thinking Anachronistic? Is it provincial in the broad scheme of things (though it may up to date by modern standards)?  Is it a reflection of the times or is it based on eternal principles and absolute truths?

A: It is based in eternal principles and absolute truths


The ends do not justify the means. Do you do your best to select the correct means to your ends?

A: No, yes, I try to make sure that the means and the ends are ethical


Am I aware (as Greenleaf defines it)?

A: yes


Am I responsible (as Greenleaf defines it)?

A: yes


Greenleaf’s questions:

1. Am I contemporary? Do I have a sense of history?  Am I living in the current phase of developing history?  Do I live with open wonder at contemporary politics, philosophy, religion, economics, art, music, literature, science (both natural and social), business development? (p. 43).

A: Yes, I am. I live with wonder at everything except politics


2. Am I connected? Am I on the growing edge of the contemporary phase of history but still connected to the main body of people and events? (p. 44)

A: yes


3. Do I see evil as an aspect of good?  (p. 44).

A: no


4. Do I accept that there is no virtue that, carried to the extreme, does not become a vice, no sound idea that, overworked, does not become absurd? (p. 45)

A: no


5. Am I sure that in choosing a right aim, I have not become self-righteous?(p. 46)

A: yes


6.  Am I prepare to accept that I will never have the comfort of being ‘ideologically’ right? (p. 46)



7. “Am I willing to cultivate the ‘growing-edge” people among my contemporaries and, by so doing, except the censure of those who are far from the growing edge and don't want to look at it?” (p. 47).



8. Am I sensitive to the needs and aspirations of all who may be affected by what I think, say, and do?  And being sensitive, am I willing to say the words and take the actions that build constructive tension? (p. 47)

A: yes


9. Can I accept the that the best possible compromise is right? (p. 49).

A: yes


10. Do I have a view of myself on which progressively greater strength can be built? (p. 49).

A: yes


11. “Am I striving to make a creative act out of conformity?” (p. 50).

A: no


Strength and Journaling

“I suggested earlier that all who would be strong become journal writers. As the questions are asked and allowed to sink into the inner mental apparatus, write. Write what comes to mind. Ask the questions, reflect on them, and write something every day. Occasionally, reread what you have written an extend it. Cultivate spontaneity. Let the pen capture the fleeting insight.” (p. 51)


Capture any additional thoughts and feelings about the reading and lectures during module 2:

A: Knowing what is right by everyone is difficult, but doing nothing would be a disaster.


Module 3

Greenleaf Part II


Greenleaf sees business as the institution that will most effect society. Do you agree or disagree and why (be sure to incorporate Greenleaf’s reasons in your answer)?

A: Businesses do affect society. Whether it is a good way or a bad way is the question.


Do you believe that the new business ethic that Greenleaf describes is right? Practical?  Ethical (in terms of what the organization is supposed to do)? Discuss.

A: No, it is not practical. There is not a sense of obligation to society.


How do you feel about Greenleaf’s stance on Coercion? About the professor’s? What do you think about the use of coercion?

A:  I do not agree with either Greenleaf or the professor’s stance on Coercion. Coercion should not be used at all, but we all know that will never happen. Fear, emotions, and other things get into the way of reasoning and can lead to coercion of others.


What do you think about management as manipulation?

A: To an extent I do. A manager needs to be able to control individuals in order to meet deadlines or to get individuals to like doing what is needed.


What do you think about Greenleaf’s absolute use of persuasion?

A: Persuasion needs to be kept in checked. If it is not kept in check, it will corrupt one.


What do you think about the use of power (as Greenleaf discussed it)?

A: Power is a tool that needs to be kept in check. One should not let it go to his or her head. Power is only there for one to complete tasks at hand.


Greenleaf defines management as planning, deciding and communicating. Do you agree with his terms? Is anything missing?

A: yes, feedback, the employees, and most importantly God.


What do you think about using research to grow employees? Have you done this for employees? Has this been done to you? What was the experience like if you have?

A: Research can grow employees if he or she does the research. No, this was not done for me.


Do you consider yourself to be an operator or conceptualizer? Do you have bias against the other type?

A: No, I do not.


Have you cultivated a sense of history? If you have a deficit—what do you plan to do to rectify this?

A: Yes, I enjoy learning about other cultures and pre-modern civilization.


Have you ever been a statesman as Greenleaf defined it (even for a short term project)? In what ways were you a statesman?

A: No, I have not been a statesman.


Have you ever been distinguished? If so, when—and what happened? If not, how will you gain distinction?

A: yes, I have set very high standards for myself. I have been distinguished above my peers for the way I go above and beyond for everyone not just the individuals I like.


Additional thoughts and feelings during module 3:



Module 4

Greenleaf Part III


Are we in a leadership Crisis? Cite your reasons for or against this.

A: yes. Corruption,


What is your definition of leadership?

A: Leadership is where one gives respect to his or her subordinates and rallies them to the company’s goals.


Greenleaf offers his perspective of the challenges of leadership (when he delivered this essay in the 1960s or 1970s. What are the challenges of leadership in our society?

A: One major challenge is the “it’s not my job attitude” and “lack of respect for coworkers by throwing them under the bus”


Think back to a failed leadership experience. Have you articulated the goal?

A: I had human resource issues with my crew. I set everyone’s standards to my standards. I had to rethink the approach. I had to learn each crew members strengths and weaknesses and hold him or her to those standards.



Have you ever asked yourself “In saying what I have in mind, will I really improve on the silence?”  What do you think about this statement?

A:  It just does not make sense unless it is meant on sharing important information or experiences.


The leader must be a growing person. How are you growing?

A: yes, every day I try to learn something new. I am growing as a person.


Do you find time to regularly withdraw? How (if not, why not and what do you plan to do about it?)

A: No, I do not. I have been so busy with work, school, and family that I have not spent time to withdraw. I plan on setting at least an hour aside for me to withdraw.


Additional thoughts and feelings during module 4:



Module 5

Lead Like Jesus

Chapter 2


Pause and Reflect


In which of the following situations am I most prone to put my own agenda ahead of those I lead:


____ in my work


__X__in my home


____in my marriage


____as a volunteer


Why do you think this happens? (p. 42)

A: Because I have not learn how to listen to my children and what they want to do. My husband and I will give them a choice to choose from.


Which of the following words best describes your usual reaction to negative feedback?












______Gratitude (p. 44)

A: I want to know how to overcome it and make it better.


Do you view training your successor or the next generation as a threat, a burden, or an opportunity to extend your leadership impact beyond your season of influence? How does your successor planning impact your daily, weekly, quarterly, or yearly priorities? (P. 46)

A:  I would see it as an opportunity. It would impact my daily priorities.


Acting out of pride is like trying to blow up a balloon with a hole in it. It is lonely business requiring consistent effort with only temporary results that never satisfy or please anyone. Think of a time when your blew up a balloon and there was a hole in it, and your will have a good mental image of what happens when your put your self-esteem in your performance and the opinion of others. (p. 53)

A: I was very miserable. I did not like myself.


Think of a time when fear of rejection or failure prevented you from doing or saying something that might have helped a friend avoid and impending mistake. What excuse did you give yourself to justify letting your fears control your inaction? Was it worth it? (p. 57)

A: For a long time now, I try to speak for weak. I swallow my fear in order to make things right.


How long has it been since you have felt truly at peace?

Are you willing to make some changes in how you treat others? (p. 68)

A: I have not felt truly at peace in a while. I am always stressed and have not taken time for myself. I am  very much willing to make changes in how I treat others.


The first step to wellness is admitting you have an EGO problem beyond your control that is worth fixing. Ask yourself this: Do you Edge God Out more out of fear or out of pride? What evidence is there? Examine your inner thoughts, and evaluate how much your false pride and your fears dominate your relationships. What is your first reaction when somebody criticizes your or disagrees with your decision? Do you become defensive? What is your first reaction when you fail at something or make a mistake? Do you think about covering up because you’re worried about what people will think of you if they find out? When faced with unexpected change, is your first thought, “How is this going to affect me?” rather than, “How will this affect those who look to me for leadership?”  (p. 70)

A: I want to understand what I did wrong and how to do it right.


Imagine you were the next person to stand up at this EA meeting. How would you describe the EGO problem that has the biggest impact on how you lead people? (p. 74)

A:  I would say that the biggest problem would be how to get everyone on the same page and treat everyone with respect.


The price of forgiveness is letting go of the right to require either payment or an apology for a wrongdoing. Whom do you need to forgive in order to restore a relationship with someone who let you down? (p. 78)

A: I need to forgive my current leaders. They have failed me in many ways.


Lead Like Jesus

Chapter 3


Imagine you were being interviewed by your ten-year-old daughter, and she asked you the following question: “What are the four most important rules in our family?” What would you answer be? (p. 93)

A: Respect, honesty, trustworthy, and been good to others


Imagine what an experience that must have been for the disciples as their Lord and Teacher humbled Himself and performed such a personal and intimate service. The image of Jesus washing the feet of the disciples is powerful and humbling. What images come to mind from your own life of someone you know performing an act of humble servant leadership? For example, think about a mother with a newborn child. (p. 100)

A: It would have to be some of my teachers. They give so much to shape young minds.


As a leader, list three things that are most likely to pull you off course. What impact does changing course or direction have on the morale of the people you lead? (p. 108)

A: stress, anger, sickness. It can lead to a negative morale of the people I lead.


Think for a moment on the depth of character and the love Jesus displayed in that intense moment for His disciples, who writhing hours would abandon and deny Him. He did not give in to the temptation to despair over their slowness to grasp the essence of what He had repeatedly taught then about how they should lead. As the ultimate servant leader, Jesus demonstrated His willingness to provide what the disciples needed most to grow and develop in their ability to fulfill their mission, which was to be taught one more time. (p. 109)

A: This characteristic is patience


Think for a moment about how well you serve those around you. Do you initiate coaching? Do you help your people to pass the final exam? Do you help them to live according to the vision? Leadership is not about power. It’s not about control; it’s about helping people live according to the vision. (p. 114)

A: yes, I initiate coaching because it is important to me. I try to guide them on the vision.


Lead Like Jesus

Chapter 4


Think back to a time when you were on either side of a failure in communication on what was expected and what was delivered. Recall the frustration and wasted energy that could have been avoided by testing for understanding. (p. 123)

A: I learned this the hard way. So now I repeat back what is expected so that I do not make the same mistake.


Think of a time when you were on untrained novice just starting out to learn a new task or role. What did you need most from someone else to help you get started? Did you get it? If not, what was the result? (p. 128)

A: No, I did not get the training. I failed at what I was doing.


Think of a time when you needed someone to push you beyond a failure or an easy early success to get to a higher level of understanding and performance in a new task. Think of a time when you quit because nobody was there to take you to the next level. (p. 130.)

A: I do not quit. I will seek, seek, and seek information until I have completed my task.


Has there ever been a time when you felt underappreciated or unrecognized for a job well done because the attention was being given to the “problem children?” What would have been the effect of a leader reinforcing you with some small heartfelt sign of appreciation? (p. 133)

A: I would rather have a small heartfelt sign of appreciation verses no appreciation.


Commissioning “to go and teach others in my name” is the highest form of recognition that a teacher can give a follower. Fulfilling the commission is the highest compliment and act of gratitude the student can afford the teacher. What are you doing to pass along that which has been given to you for the next generation?

(p. 135)

A: I am going to pass along the value of respect. I want the next generation to think about ones actions and how it affects them.


Additional thoughts and feelings during module 5:



Module 6

Lead Like Jesus

Chapter 6


Soren Kirkegaard once noted, “If you don’t seek first the kingdom of God, you will never seek it, “ How do you intend to take this caution seriously as you seek to lead like Jesus?

I will seek guidance from God at every junction.


What three pieces of evidence would you rely on as your commitment to seek to lead like Jesus? Is it hard evidence or merely circumstantial? (p. 194)

A:  it is circumstantial evidence mostly, but I would rely on the Bible the most.


Think of a time when doing the loving thing instead of the popular thing, the easiest thing, the quickest thing, the most rewarding thing, or the safest thing would have restored or retained trust. Remember that moment for future reference. (p. 196)

A: I did do a loving thing instead of a popular thing.


What four words best describe what you would hope to leave as your leadership legacy? Which ones are most in need of a new focus to become a reality? (p. 208)

A: Honor, Trust, Selfless, and Spirituality….The selfless part needs some more focus on to be more of a reality.


If this isn’t the speech you would give, what parts would you change and why? When you have it right, will you deliver it – if not to a collected audience, how about moment by moment in the leadership decisions you make? (p. 213)



Lead  Like Jesus

Chapter 7


Questions of the Heart

  • Do you love Me?
  • Do you trust Me?
  • Will you serve Me by serving others?
  • Do you believe that I will always love you regardless of your performance or the opinion of others?
  • Are you willing to set aside instant gratification, recognition, and power to honor Me by doing the right thing?



Question of the Head

  • Do you see your leadership as a season of service and stewardship?
  • Do you have a compelling vision to lead your organization and a strategy to serve and help your people live according to that vision?



Questions of the Hands

  • Are you willing to seek to understand by listening and sorting what you hear with service in mind rather than self?
  • Are you willing to lead and learn from people who are different, think differently, look differently, and are older or younger than you?
  • Are you willing to honor all work honestly performed as sacred?
  • Are you ready to admit when you make a mistake in the way you treat the people you lead, and apologize?



Question of the Habits

  • Solitude- Are you ready to be with Me alone on a regular basis to keep things straight between us?
  • Prayer-How can your prayer life be different so we can communicate on a regular basis?
  • Bible study-Are you actively seeking My guidance through spending time in My Holy Word?
  • Experiencing God’s unconditional love – Do you sense God’s unconditional love for you today?
  • Supportive relationships – Do you have a small group of likeminded friends with whom you can be open and vulnerable? (p. 218)

A: yes



One way to uncover the truth about your leadership motivations is to test your response to the question “Why do I lead?” by completing the sentence as many times in succession as you need to until you uncover the root cause of why you lead.


I coach Little League so that__I can mentor young minds to work as a team with respect for each other

            So that I can improve on my servant leadership

            So that I can spread the love of God

I serve as an elder in my church so that I may mentor others in God’s name.

            So that I may be close to those in need of a shoulder for guidance.

            So that I may gain examples from the Pastor on handling different situations that  arise.



The Heart of the Servant Leader – Motivation

  • I depended on the work of the Holy Spirit in my life and relationships.


Rarely_________Once in a while_______Frequently_________Consistently_x_________



  • I actively sought and encouraged feedback on my leadership.


Rarely_________Once in a while_______Frequently_________Consistently___x_______



  • I took personal risk to support and protect others.


Rarely_________Once in a while_______Frequently___x______Consistently__________


  • I shared credit for the results of my group’s efforts.


Rarely_________Once in a while_______Frequently____x_____Consistently__________


  • I avoided letting my EGO negatively impact my leadership this week.


Rarely_________Once in a while_______Frequently___x______Consistently__________


  • The leadership motivation – related action I want to focus on for improvement during the next two weeks is:

_______Avoid letting my EGO negatively impact my leadership.________________





  • I will accomplish the following specific action goal related to my leadership motivation during the next two weeks:

_____I will take personnel risks to support and protect others. I will speak up will I see others being harmed__________________________________________________________________




The Head of the Servant Leader – Leadership Point of View


  • I aligned my leadership point of view to that which I found in the Scriptures.


Rarely_________Once in a while_______Frequently____x_____Consistently__________


  • I treated growth and development of people as being equally important as producing results.


Rarely_________Once in a while_______Frequently_________Consistently_____x_____


  • I develop, communicated, and reinforced a clear vision and set of rank-ordered operating values for my group.


Rarely_________Once in a while_______Frequently_________Consistently___x_______


  • I communicated my leadership point of view to members of my organization.


Rarely_________Once in a while_______Frequently_________Consistently___x_______


  • The leadership point of view-related action I want to focus on for improvement during the next two weeks is

_______Reading more scriptures that I can align  up my servant leadership.




  • I will accomplish the following specific action goal related to my leadership point of view during the next two weeks:

­­­­­­­­­­­­­­­­­­­____Communicate more with my group to the up coming events ahead of time. __





The Hands of the Servant Leader – Leadership Behavior

  • I practiced the “not so with you” mandate of Jesus.


Rarely_________Once in a while_______Frequently____x_____Consistently__________


  • I tested for understanding and established clear performance goals when assigning tasks within my group.


Rarely_________Once in a while_______Frequently_________Consistently____x______


  • I applied different leadership styles depending on the development level of the individuals assigned to perform specific tasks.


Rarely_________Once in a while_______Frequently_________Consistently___x_______


  • I praised progress and was actively engaged in day –to-day coaching.


Rarely_________Once in a while_______Frequently_________Consistently______x____


  • I took positive action to resist the temptations to manipulate the fears and pride of others to get things done.


Rarely_________Once in a while_______Frequently__x_______Consistently__________


  • The leadership behavior-related action I want to focus on for improvement during the next two weeks is

_The “not do with you”






  • I will accomplish the following specific action goal related to my leadership behavior during the next two weeks:

_I will not let temptations of fear and pride manipulates me or others to get things done.





The habits of the Servant Leader – Daily Recalibration

  • I called upon the Holy Spirit to guide my words, thoughts, actions, and behaviors.


Rarely_________Once in a while_______Frequently_________Consistently__x________


  • I practiced the discipline of solitude.


Rarely_________Once in a while__x____Frequently_________Consistently__________



  • I employed prayer as my first response instead of my last resort in meeting the challenges, temptations, and opportunities of the week.


Rarely_________Once in a while_______Frequently_________Consistently____x______



  • I sought God’s wisdom in the study and memorization of Scripture to stay focused on being a servant leader.


Rarely_________Once in a while_______Frequently_________Consistently____x______


  • I maintained active accountability relationships to keep making progress on my good intentions as a servant leader.


Rarely_________Once in a while_______Frequently___x______Consistently__________


  • The leadership habit I want to focus on for improvement during the next two weeks is

I will take time out every day for solitude.




  • I will accomplish the following specific action goal related to my leadership habits during the next two weeks:

_I will be more sociable since I tend to be offish and do not socialize_________________





Additional thoughts and feelings during module 6:



Module 7

Good to Great

Chapter 2


Did the level 5 leadership findings surprise you?  Why or why not?[bwe1] 

A: yes it did.


Does the level 5 leader sound like a servant leader? In what ways?

A: It does and it does not. Level 3 should be geared towards the individual and God.


Collins writes “Humility + Will = Level 5” (p. 22). Have you known any of these leaders? What were they like? What were their organizations like?

A: No, I do not know any because all most all of them do not have humility.


Why are humility and modesty such essential characteristics? (Note: incorporate thinking from the Scriptures, Greenleaf, Blanchard and Collins into this answer).

A: One needs to be humble to be able to be a servant leader.


Do you have a difficult time with the seeming contradiction between humility and unwavering resolve? Why or why not?

A: No, Humility can be practices with unwavering resolve.


Discuss the window and the mirror (use Collins’ definitions to answer this). Have you seen a leader practice this?

A: The window and the mirror is when things go well the leader is looking out the window, when things go bad the leader is looking at the mirror. I have not seen a leader practice this at any company that I worked for.


How does one cultivate level 5 leadership?

A: One will have to balance will with humility at all corners.


Good to Great

Chapter 3


What does it mean to get the right people on the bus?

A: These are the people that have the level 5 leadership. It will also have to have employees that are for the company too.


Are you on the right bus? On the right seat on the bus (use Collins’ definitions to answer this)?

A: Do you have the right individuals on the bus that will use all levels of leadership. Building the superior executive team. The right seat would be having the right individuals in those pivotal leadership positions.


Is your boss a level 5 leader, a genius with a thousand helpers, competent manager, or worse (use Collins’ definitions to answer this)? What are you?

A: My leader would be “a genius with a thousand helpers” were he sets out the vision  for where to drive the bus and the road map. This is mainly due to me being in the Military and not in the business world.


Is your organization rigorous, ruthless, incompetent or something other (use Collins’ definitions to answer this)

A: My organization is rigorous with the except of being able to fire individuals.


Additional thoughts and feelings during module 7:




 [bwe2]Brief, but good responses.


49 out of 50

Lead Like Jesus Journal Instructions

Reflective journals allow us the opportunity to integrate our thoughts regarding new knowledge, life experiences, and the work of God in our lives. Lead Like Jesus is a book that encourages such reflection, asking provocative questions that allow the reader to contemplate the material and describe how his/her personal life reflects—or fails to reflect—a servant leader perspective.

You will compose a journal by answering selections from the weekly assigned readings from the text Lead Like Jesus. Use the template provided to answer questions from various “Pause and Reflect” sections from the text. You may select which questions you desire to answer to reach the required 4–5-pages, though questions from each part (Parts I–VII) must be included in the journal. No additional formatting or references are required. This is a reflective journal; thus, first-person voice is expected. Only share reflections that you are comfortable sharing with the instructor. The journal will be graded on completeness, grammar, and evidence of reflection, not on the personal opinions and observations of the student.



Levels of Achievement

Points Earned





Quality of Information

46 to 50 points

Superior work in all areas. The student consistently exceeds minimal expectations in all areas regarding content, reflection, and writing style.

·         Content: Questions from each part are thoughtfully answered with meaningful personal and professional application.

·         Length: The 4–5-page length requirement is met.

·         Grammar: Minimal to non-existent grammatical errors.

42 to 45 points

Good work in most areas. The student demonstrates minor deficiencies in some areas regarding content, reflection, and writing style.

·         Content: Questions from each part are answered with personal and professional application.

·         Length: So long as the above criteria is achieved, length is not an issue.

·         Grammar: Minimal grammatical errors.

38 to 41 points

Fair work in most areas. The student exhibits need for improvement in areas regarding content, reflection, and/or writing style.

·         Content: 1 or more of the parts are missing, and/or questions are answered only minimally from time to time.

·         Length: Minimal answers lead to length issues.

·         Grammar: Numerous grammatical errors.

0 to 37 points

Failing. The paper reveals an inability to meet minimum standards of graduate-level work.

·         Content: 3 or more of the parts are missing, and/or questions are answered only minimally.

·         Length: Minimal answers lead to length issues.

·         Grammar: Numerous grammatical errors.




Instructor’s Comments:


BUSI 502 Servant Leadership Journal – All Questions

Thread: Consider the heart, head, hands, and habits needed to lead like Jesus. How can we see these areas reflected in other biblical leaders from the Old or New Testaments? Reflect on leaders you have had (or those you admire in an organization today) who reflected one or more of these areas. How did their leadership impact you? What did you learn from this type of leadership?


INSTRUCTIONS:    you must post a thread of at least 500 words in response to the prompt provided.  For each thread, you must support your assertions with at least 3 scholarly citations in APA format as well as include at least 1 biblical integration.  

Topic: Practicing the Four Hs of Leadership

World View Chart Assignments
Due Weeks 2 through 10 and worth 35 points each week, with a total of 315 points.  

A world view is a fundamental or basic orientation of thinking – like a mindset – which guides a culture and / or a person’s life. Like a point of view, it can be built of concepts, ideas, values, emotions, and ethics. Weltanschauung is the German word for this idea. Your goal for this course is to understand the world views of these various religions. In order to prepare you for your final assignment, you will outline the world views of various religions in the chart below, adding to it each week.

For this assignment, students will complete the weekly area of the chart, filling in the aspects of each religion as it is presented in the readings and resources. This chart, when complete, will be the starting point for the written assignment, due in Week 10.

For each weekly submission:

1.       Review the weekly lectures and supplemental materials provided, then complete the chart by elaborating on each section related to the weekly content.

2.       Identify key details and examples from the weekly resources to serve as a basis for the content being recorded in your chart.

3.       Write clearly and coherently using correct grammar, punctuation, spelling, and mechanics.


Cosmogony - Origin of the Universe

Nature of God

View of Human Nature

View of Good and Evil

View of “Salvation”

View of After Life

Practices and Rituals

Celebrations and Festivals

Week 2
Hinduism and Jainism









Week 3









Week 4
Daoism and









Week 5









Week 6









Week 7









Week 8









Week 9









Week 10
New Religious Movements









The specific course learning outcomes associated with this assignment are:

·         Analyze what is meant by religion.

·         Analyze the similarities and differences in the primary beliefs held by major religious traditions and the cultures in which these religions evolved.

·         Describe the varieties of religious experience and practice in a wide range of cultures.

·         Recognize how daily life within various religions and current affairs are influenced by religion.

·         Use technology and information resources to research issues in religion.

·         Write clearly and concisely about world religions using proper writing mechanics.

Click here to view the grading rubric for this assignment.


World View Chart Assignments
15195 I am looking for the TEAS Test 6 (Reading Section) ASAP. The one with the UFO/Social Media/Chili Recipe/Etc. TEAS 6 Test (READING PORTION)

Need TEAS reading, math, science, English.

TEAS 6 All versions (mainly retake)


CHD 204   ch 8

Read Chapter 8 and answer the following questions:

1.  What are primary-age children like?

2.  What do primary-age children like to do?

3.  Define peers, sense of industry, competence and concrete.

4.  What do primary-age children need?

5.  How do primary-age children learn best?

6.  What are some of the concerns about public education?

7.  Describe an environment for a sense of industry.

8.  What is a benefit of the learning-center approach for primary-age children?

9.  What is a planning contract?

10.  What is an advantage to providing a number of separate learning centers?

11.  What is a planning board?

12.  Define portfolio.

13.  How do teachers of primary-age children use portfolios and work samples?

14.  What are two large and important learning centers related to literacy?

15.  What should a writing center contain?

16.  List four (4) suggestions for an environment that fosters early literacy.

17.  Describe an environment that fosters math understanding.

18.  Describe a physical environment that fosters scientific awareness.

19.  Describe an environment for relationships.

20.  List five (5) suggestions for fostering peer- and teacher-child relationships.

21.  What is the problem with fragmented primary classroom schedules?

22.  On what do you base an appropriate schedule for a primary classroom?

23.  What is the problem with recess?  Why have some schools abolished recess?

24.  Define mixed-age groupings.

25.  Describe after-school childcare.

26.  What is the debate over television and video games?

27.  List nine (9) suggestions for an appropriate after-school care environment.

28.  Describe an inappropriate environment in primary classrooms.  List six (6) elements.

Read Chapter 8 and answer the following questions:

Philosophical Essay: You will write a two-part 5-6 page essay using our Library Guide for PHIL101 and our Online Library to answer one of the following question: 


 If God exists, is murder immoral?  Can those who do not believe in God be highly moral people?  Can people who practice different religions agree about how to resolve a moral disagreement?

1.      Identify at least one encyclopedia, or similar work, providing a big picture overview of key issues your topic needs to address.
2.      Identify at least one secondary source, an interpretive work, addressing your topic which was written by someone other than the philosophers identified in your topic.  This secondary source should be located through the journal article database available in the APUS Online Library, where contemporary philosophical articles pertaining to your topic, can be located.   For instance, use EBSCO’s Academic Search Elite.  This is a searchable database of scholarly articles from many academic disciplines, including philosophy.  It should be used to locate contemporary scholarly articles pertaining to epistemology, perception, Locke, etc.  It also contains the full text of many of the articles. 
3.      Identify at least one primary source, from a major philosopher identified in your topic choice. Be sure that the primary source selected pertains to the issues raised by your topic.
Provide a complete reference in MLA style for each work selected, and explain briefly (annotate) how the content of each source will assist you with your Philosophical Essay Assignment..  Attach as a correctly formatted MS Word document and submit.  Format your Philosophical Essay using MLA guidelines (see Citation and Reference Style).

 All papers should be double spaced and written in Times New Roman 12 point font. Papers should include indented paragraphs, no extra space between paragraphs, and 1 inch margins on all 4 sides. Keep quotes from sources to 2-3 lines and no more than 10-20% of the paper; this is especially relevant with regard to secondary sources. Never let your secondary sources take over or make your argument for you. For a review of how to write a thesis statement, see the following site:

Philosophical Essay: You will write a two-part 5-6 page essay using our