Healthcare Administration Degree For Rewarding Healthcare Careers

A career in healthcare has long been associated with doctors and nurses in their crisp white uniforms delivering care to patients. But there is an entire workforce that functions tirelessly, away from the glaring lights, to support these primary care givers and ensure the smooth delivery of healthcare.

Among these men and women are the healthcare administrators or managers on whose shoulders rests the responsibility of managing and running a healthcare organization.

The Department of Labor describes the day to day function of a healthcare administrator as planning, directing, coordinating, and supervising the delivery of healthcare. In other words, they are the ones who take care of the administrative and business aspects of running an organization, so the healthcare providers can do just that – provide care to the patients.

Why Healthcare?

If you are the crossroads of choosing a career, then this is as exciting a time as any to get a healthcare administration degree and enter this profession. Pages after pages have already been written about how an aging population has led to a sharp increase in the demand for healthcare professionals.

According to the Department of Labor, 10 of the 20 fastest growing occupations are related to healthcare. Now, that is a staggering figure by any measure of standards.* Healthcare administration itself is projected to grow at a faster than average pace and the employment of healthcare administrators and managers is expected to grow 16 percent by 2018.**

But excellent job opportunities and attractive compensation are not the only reasons to pursue a healthcare administration degree. The industry is also going through an exciting phase as innovate technology gets integrated with the healthcare delivery system and regulatory environment becomes more complex. The job of a healthcare administrator has become more challenging in the recent years.

Education & Training

If you thought that you need to put in six to seven years of college education to become a healthcare administrator, think again. The good news is that interested candidates can enter the profession with a bachelor’s degree in healthcare administration.

Since healthcare managers need to be familiar with management principles and practices, a bachelor in healthcare degree is designed to teach students the clinical and business aspects of managing a healthcare facility by training them in management principles, strategic planning, resource management, leadership skills, and other office procedures and medical terminology.

Graduates with a bachelor’s healthcare administration degree begin their careers as administrative assistants or assistant department heads in larger hospitals. Small hospitals or nursing facilities may hire them as department heads.

Employment Opportunities

With so many healthcare facilities springing up to provide care to an aging population, healthcare administrators may find employment in a wide range of settings. These include hospitals, clinics, office of physicians, nursing care facilities, residential care facilities, home healthcare facilities, federal healthcare facilities, community care facilities, rehabilitation centers, etc.

The Department of Labor has classified healthcare administrators as either specialists or generalists. Specialists are in charge of a specific clinical department and are called clinical managers. They are trained or experienced in the specific clinical area that they manage.

Generalists, on the other hand, manage an entire facility or a system within a facility. In large facilities, they work as assistant administrators aiding the top administrator in the running of various healthcare departments.

In smaller facilities like nursing homes or doctors’ offices, healthcare administrators are usually responsible for carrying out the day to day operations like managing personnel, handling finances, recruitment, etc.

As far as remuneration is concerned, it depends on a variety of factors such as level of responsibility and the type and size of healthcare facility. According to the Labor Department, the average annual income of a healthcare manager was $80,240 in May 2008.**

So, if you think your shoulders are strong enough to take on the responsibility of running a healthcare organization, then a career full of opportunities and personal gratification is waiting for you!

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The New Approach to Healthcare Enterprise Information Management – EHR, EMR, EIM

The lack of a healthcare specific, compliant, cost-effective approach to Enterprise Information Management (aka EIM) is the #1 reason integration, data quality, reporting and performance management initiatives fail in healthcare organizations. How can you build a house without plumbing? Conversely, the organizations that successfully deploy the same initiatives point to full Healthcare centric EIM as the Top reason they were successful (February, 2009 – AHA). The cost of EIM can be staggering – preventing many healthcare organizations from leveraging enterprise information when strategically planning for the entire system. If this is prohibitive for large and medium organizations, how are smaller organizations going to be able to leverage technology that can access vital information inside of their own company if cost prevents consideration?

The Basics –

What is Enterprise Information Management?

Enterprise Information Management means the organization has access to 100% of its data, the data can be exchanged between groups/applications/databases, information is verified and cleansed, and a master data management method is applied. Outliers to EIM are data warehouses, such as an EHR data warehouse, Business Intelligence and Performance Management. Here is a roadmap, in layman terminology, that healthcare organizations follow to determine their EIM requirements.

Fact #1: Every healthcare entity, agency, campus or non-profit knows what software it utilizes for its business operations. The applications may be in silos, not accessible by other groups or departments, sometimes within the team that is responsible for it. If information were needed from groups across the enterprise, it has to be requested, in business terminology, of the host group, who would then go to the source of information (the aforementioned software and/or database), retrieve what is needed and submit it to the requestor – hopefully, in a format the requestor can work with (i.e., excel for further analysis as opposed to a document or PDF).

Fact #2: Because business terminology can be different WITHIN an organization, there will be further “translating” required when incorporating information that is gathered from the different software packages. This can be a nightmare. The gathering of information, converting it into a different format, translating it into common business terminology and then preparing it for consumption is a lengthy, expensive process – which takes us to Fact #3.

Fact #3: Consumers of the gathered information (management, analysts, etc) have to change the type of information required – one-off report requests that are continuously revised so they can change their dimensional view (like rotating the rows of a Rubik’s cube to only get one color grouped, then deciding instead of lining up red, they would really like green to be grouped first). In many cases, this will start the gathering process all over again because the original set of information is missing needed data. It also requires the attention of those that understand this information – typically a highly valued Subject Matter Expert from each silo – time-consuming and costly distractions that impact the requestor as well as the information owner’s group.

Fact#4: While large organizations can cope with this costly method in order to gather enough information to make effective and strategic business decisions, the amount of time and money is a barrier for smaller or cash strapped institutions, freezing needed data in its silo.

Fact #5: If information were accessible (with security and access controls, preventing unauthorized and inappropriate access), time frames for analysis improve, results are timely, strategic planning is effective and costs in time and money are significantly reduced.

Integration (with cleansing the data, aka Data Quality) should not be a foreign concept to the mid and smaller organizations. Price has been the overriding factor that prevents these tiers from leveraging enterprise information. A “glass ceiling”, solely based on being limited from technology because of price tag, bars the consideration of EIM. This is the fault of technology vendors. Business Intelligence, Performance Management and Data Integration providers have unknowingly created class warfare between the Large and SMB healthcare organizations. Data Integration is the biggest culprit in this situation. The cost of integration in the typical BI deployment is usually four times the cost of the BI portion. It is easy for the BI providers to tantalize their prospects with functionality and reasonable cost. But, when integration comes into play, reluctance on price introduces itself into the scenario. No action has become the norm at this point.

What are the Financial Implications for a Healthcare Organization by maintaining the status quo?

Fraud detection is the focal point for CMS in their EHR requirements of healthcare organizations, Let’s take a deeper, more meaningful look at the impact of EHR. Integration, a prominent component of Enterprise Information Management in the New Approach, brings data from all silos of the organization, allowing a Data Quality component to verify and cleanse it. The next step would be to either send it back to its originating source in an accurate state and/or put it into a repository where it will be accessible to auditing (think CMS Sanctions Auditors), Business Intelligence solutions, and Electronic Health Records applications. With instantly accessible EHRs, hospitals and their outlying practices can verify patients with payors, retrieve medical histories for diagnosis and treatment decisions, and update/add patient related information. What impact to treatment does a review of a new patient’s history have for both patient and practice? Here are some elements to consider:

1. Diagnosis and treatments that are based on previous patient dispositions – reducing recovery time, eliminating Medicare/Medicaid/Payor denials (based on their interpretation as to fault of the practitioner in original treatment or error incurring additional treatment).

2. Instant fraud detection of patients seeking treatment for the same malady across the practices within the organization. Prescription abuse and Medicare fraud saves money not only for the payors, but the healthcare organization as well.

3. The Association of Fraud Examiners states that 9% of a Hospital’s revenue each year is actually lost to fraud.

One overlooked but common impact is in the cost of managing patient records. Thousands of file folders in storage with new instances being added each time a new patient enters into the system. Millions of pieces of paper capturing patient information, payer data, charts, billing statements, and various items such as photo copies of patient IDs, are all stored in those folders. The folders are then stored in vast filing cabinets – constantly being accessed by filing clerks, nurses, practitioners and assorted staff. Contents of the files being misplaced or filed incorrectly. Hundreds, if not thousands, of square feet being consumed for storage. The AHA projects that an enterprise leveraging Electronic Health Records will recover no less than 15,000 square feet of usable space. That space can be used for additional services, opening up new channels of revenue. The justification is easy: how much would it cost the hospital to build out 15,000 square feet for a new service? The average cost to build space utilized for Health Services is $65 per square foot, or $975,000 total. An EIM solution through the New Approach would be less than 20% of that. Not only has the EIM solution reduced dollars lost to fraud, lowered the days for payor encounters to be paid, increased cash on hand, but it will also open up new services for the patient community and revenue back to the healthcare organization.

Electronic data is costly in its own way. Bad aka “Dirty” data has enormous impact. Data can be corrupted by error in data entry, systems maintenance, database platform changes or upgrades, feeds or exchanges of data in an incompatible format, changes in front end applications and fraud, such as identity theft. The impact of bad data has a cause and effect relationship that is pervasive in the financial landscape:

1. Bad data can result in payor denials. Mismatched member identification, missing DRG codes, empty fields where data is expected are examples of immediate denials of claims. The delay lowers the amount of Cash on Hand as well as extends the cycle of submitted claim to remittance by at least 30 days.

2. Bad data masks fraud. A reversal of digits in a social security number, a claim filed as one person for the treatment of another family member, medical histories that do not reflect all diagnosis and treatments because the patient could not be identified. Fraud has the greatest impact on cost of delivering healthcare in the United States. Ultimately, the health system has to absorb this cost – reducing profitability and limiting growth.

3. Bad data results in non-compliance. CMS has already begun the architecture and deployment of Sanctions Data Exchanges. These exchanges are a network of data repositories that are used to connect to health healthcare system, retrieve CMS related data, and store it for auditing. The retrieval will only be limited to the patient encounters that show a potential for denial or fraud, so the repository will not be a store of all Medicare and Medicaid patient encounters. But, the exchange has to be able to read the data in its provider data source in order for CMS to apply certain conditions against the information it is reading. What happens when the information is incomplete or wrong? The healthcare system is held accountable for the encounters it cannot read. That means automatic and unrecoverable denials of claims PRIOR to an audit, regardless of claim legitimacy.

The Price Fix by Big Box Healthcare Technology Firms

Are the major healthcare software and technology vendors (Big Box) price gouging? Probably not. They are a victim of their own solution strategies. Through acquired and some organic growth (McKesson, Eclipsys, Cerner, etc), they find their EIM solutions lose their agnostic approach. This is bad…very bad for health systems of all sizes. With very few exceptions, the vast majority of healthcare organizations DO NOT BUY all applications and modules from a single stack player. How could they? Healthcare systems grow similarly – some organic, some through acquisition. When a hospital organization finds over the course of time, an application that is reliable, such as a billing system, there is tremendous reluctance to remove a proven solution that everyone knows how to use. Because the major technology providers in the healthcare space act as a “One Stop Shop”, they spend most of their time working on integrating in their own product suite with little to no regard to other applications. Subsequently, they find themselves trapped: they have to position all products/modules to maintain the accessibility and integrity of their data. This is problematic for the hospital that is trying to solve one problem but then must purchase additional solutions to apply to areas that are not broken, just to be able to integrate information. That is like going to the hardware store for a screwdriver and coming back with a 112 piece tool set with a rolling, 4 foot cart built for NASCAR. You will probably never use 90+% of those tools and will no longer be able to park in your own garage because the new tool box takes up too much space!

IT resources – including people – must be utilized. In today’s economy, leveraging internal IT staff to administer a solution post-deployment is a given. If those IT resources do not feel comfortable in supporting the integration plan, then status quo will be justified. This is the “anti” approach to providing solutions in the healthcare industry: the sales leaders from Big Box technology firms want their sales people in front of the business side of the organization and to stop selling to IT. While this is a common sense approach, the economy in 2010 mandates that IT has to at least validate their ability to administer new technology solutions. The prospect of long-term professional consulting engagements to follow post installation has been shrinking at the same rate as healthcare organizations profit margins

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Evolving Healthcare Trends

The model trends in the healthcare system have been changing over the period of time. The old trend gave importance to the individual patients and the emphasis was on treating illness. The goal of the hospitals was to do inpatient admissions, fill up the beds and more emphasis was given to acute inpatient care. The role of managers in the old paradigm was to run the organization and coordinate services. In the old system, all providers were essentially the same. The hospitals, physicians and health plans were separate and not integrated.

The newer trends that evolved gave importance to the population as a whole. It not only treated illness, but emphasized on promoting the wellness of the people. The goals of the healthcare system after being transformed over the years is to provide care at all levels which is continued. The role of managers in the new paradigm is more broad. They see the market and help in quality and continued improvement. They not only run the organization, but also go beyond the organizational boundaries. In the evolving system, the providers are differentiated according to their ability. The hospitals, physicians and health plans have formed an integrated delivery system.

One of the current trend in the healthcare delivery model is that continued care is emphasized. The key professionals are not only treating patients for their illness, but they are promoting and managing quality of health. For example, a patient with high cholesterol visits a doctor. He is not only given one-on-one medical treatment, but he is also offered to attend a group session where information is provided on how lifestyle and behavioral change can help. The patients learn from the clinicians and also from each other. Another current trend is to take care of the health of the defined population and not only individual patients. All the health needs of the population as a whole are identified and served. It is emphasized that the community uses the health and social services provided. Healthcare has become more population-based. Another trend that has evolved is that the hospitals, physicians and health plans have got connected and have formed an integrated delivery system. More investments are being made with a goal of providing services to the customers and retaining them.

There is a beneficial impact in the transformation of healthcare towards emphasizing continued health. The way healthcare has been viewed in the past has been changing. The shifting of care from treating acute illnesses to providing continued care is resulting in enhancement of the health of the people. The only appropriate and feasible model is to provide a continuum of care with the emphasis firmly on the family and community. The health of the population and community is considered as a whole. This is advantageous as it creates value in the healthcare delivery system. The healthcare providers work with the community as a whole and consider to improve the health of the general population. Even though this requires new kinds of ways of organizing and managing healthcare services, it helps in understanding the health needs of the target population. By studying their needs, the right health and social services could be provided to them. Examples of promoting wellness of the whole community are organizing health campaigns and providing preventive education to the people in general. Another example is providing awareness about flu vaccines and encouraging people to get the vaccination.

Integrating the healthcare delivery system has led to certain advantages to the patients. For example, they can be offered alternative sites of care depending on their convenience. It helps in meeting the needs of the customers and their preferences which is taken into account. The number of providers are expanded and the patients get to have a choice. The relationship between providers and health plans are organized in the current trend and this ensures that the right care is provided in a convenient way to the customers.

There are defined budgets and expenditure targets for the populations which implies that there is a need to be efficient and productive. The formation of strategic alliances, networks, systems and physician groups can also add value. There are capitated payments and budgets allotted to the healthcare organizations. These are used to provide care to the defined population. The organization might like to improve on the payments and budgets as the expenditures of the companies increase. This results in the management to make decisions like forming strategic alliances with other organizations and increase the total resources. The growth of such networks will help in providing better care to the customers. Financial resources greatly influence the efficiency and productivity of the organization.

The aging population is influencing the healthcare delivery. There is increased demand for primary care of people over 65 years and for chronic care of people over 75. The ethnic and cultural diversity is also influencing the healthcare delivery. This provides a challenge in meeting patient expectations on one hand and diverse workforce on the other. Biological and clinical sciences have met with technological advances and have led to new treatment modalities. This has led to open new treatment sites and manage across the organization. External forces change the supply of certain areas of health professionals like physical therapy and some areas of nursing. The management needs to compensate for such shortages and they need to develop different teams of caregivers at different work sites. Changes in education of health professionals implies that the management be more creative in offering healthcare services. With an increase in diseases like AIDS and morbidity from drugs and violence, there is more and more need to work with community agencies, form social support systems and there is a need for more chronic care management. Advances in information technology is another area where there is a need to train the healthcare employees in new advances. They also need to manage issues of confidentiality and rapid information transfer. Increasing expansion of world economy has led to more competitive management of strategic alliances, care of patients across the nations and of different cultures.

Current environmental trends impact the healthcare delivery model. Organization’s success depends on its external and internal environment. The complex environments made up of uncertainties and heterogeneity of components leads to different organizational designs. The current environmental trends influence managerial and organizational decision making. The unique challenges facing the healthcare delivery organizations should be analyzed in order to develop and implement new and effective operational processes and strategies. As an impact of current environmental trends, the healthcare delivery system needs to improve individual, team, and organizational accountability and performance. The impact of advances in medical knowledge and information technology on the process of healthcare delivery should also be examined, and it should be leveraged to improve quality of care, process and cost controls, and revenue. New strategies would need to be identified and implemented for learning and performance improvement to create a culture that supports accountability, safety, and high-quality care. Innovative models in healthcare delivery would also be required in order to develop and implement strategies that promote organizational success and competitiveness.

Due to the current environmental trends, more emphasis is given to the customers and there is more of a patient-focused care. The healthcare delivery model has been shifting to the community based care. There has been an increased modification in care processes. The traditional ways are being challenged and more experiments are being performed to fulfill the demands to improve the quality of care. Due to the shift in the environmental trends in the healthcare delivery model, more emphasis is given to quality improvement. This will help improve the performance levels of key processes in the organization. The performance levels are being measured, the defects are eliminated and new features are being added to meet the customer’s need efficiently.

There is a new emerging contemporary trend in the U.S. healthcare system. Presently, the management research and assessment have been offered increased recognition. The emerging trend seen is that this is slowly forming an integral part of managerial and organizational effectiveness. With the emerging efforts in information management, it is leading towards clinical and financial networking. The trend seen among the physicians and nurses is that they are being increasingly involved in managerial activities. The managerial trends are also changing with respect to role performance and changing values. The managers role is getting more and more recognized in managing finance and human resources. Management training, lifelong and distance learning is being offered in preparing future managers.

The healthcare executives and managers will be faced with the major responsibility and challenge in the years ahead. They will be working with other healthcare providers and will be creating a competitive future for their organizations. They will not only be managing organizations but also a network of markets, services and joint ventures. Formation of more and more strategic alliances and partnerships will lead the management to manage across boundaries. The management will change from managing a department to managing the continuum of care. The management will be following a community-based approach. Trend in management is also shifting from just coordinating services to providing improvements in quality.

As the demands in healthcare are increasing, the management is responsible for forming performance standards. The management is also challenged to maximize the productivity and quality to serve the health needs of the community. The management is looking after the demands of the external environment as well as attending to the performance of the internal environment. The management is responsible for the performance of the organization.

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