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So. You Still Want a Career in Healthcare Administration.

Laura ShueBy Laura A. Shue, MPA, CHDA, CPHIMS; Director of Data Quality, Compliance and Operations, University of Michigan Health System

I initially submitted this blog article on October 12, 2016.  After it finished the review cycle and was ready for public consumption, much of what I had written about the regulatory environment giving rise to big data was subject to be turned, exactly and precisely, on its collective head.  More importantly, I was struck with the realization that writing about how data is used in healthcare administration is not what I feel compelled to emphasize to our students at this moment.  What you need to hear now, as both future public administrators and future healthcare administrators (not to mention as consumers of healthcare), is:

  • what we can expect to stay constant,
  • what we can expect to change, and most importantly,
  • as willing and informed servants of the healthcare industry, what skills or qualities can you develop and capitalize upon to ensure resilience in the face of huge future swings of the political pendulum?

What is not going to change.

  1. Big Data.  The conditions that gave rise to big data are etched in stone from a historical context, and no amount of regulatory or policy changes will reverse that.  The horse is out of the gate. Big data is here to stay.  Having well-developed skills in data management, data analysis and critical thinking will continue to be important drivers of your success.
  2. HIPAA.  The Health Insurance Portability and Accountability Act (HIPAA) just celebrated its 20th birthday.  The HIPAA Privacy Rule and associated implications on the privacy, security and access to protected health information are a foundation upon which additional consumer access rights and protections will continue to be placed.  As such, a background and understanding of public policy analysis, implication and impact upon delivery of healthcare services remains a valuable asset to any healthcare administrator.
  3. Accountable Care.  The transformation from an industry that reimburses for volume and quantity of services provided to an industry that reimburses for value, quality and outcomes will continue to progress.
  4. Technology.  The infusion of technology into every aspect of care delivery will endure as a hallmark of the healthcare industry.  We will continue to collect, access and exchange health information digitally.  New technologies will continue to replace existing technologies and the rate of change will escalate.

What is going to change.

  1. The Affordable Care Act.  Repeal of the entire ACA is unlikely, as it would require 60 votes in the Senate, a majority that does not exist following the 2016 election.  Repeal of portions of the law could take place through the budget reconciliation process.  Those portions include the structural provisions such as the individual and employer mandates, Medicaid expansion, and the ACA taxes (medical device, “Cadillac” tax, Insurer fee).  Other portions that could not be repealed via budget reconciliation include the ban on pre-existing condition exclusions, caps on annual and lifetime limits and the ability of young adults to remain on their parents’ insurance plans until age 26.
  2. Everything.  The provisions that cannot be repealed via budget reconciliation are subject to instability if the structural provisions were repealed through budget reconciliation.  Although I do not have a crystal ball of predictions, how patients seek insurance coverage, the financing of that coverage, eligibility rules and the percentage of our population covered by insurance are up for discussion.  It is reasonable to presume that some provisions of the ACA will be revisited with renewed urgency, and that those provisions remaining will be directly impacted.
  3. Legislative Priorities.  I would hope this need no explanation, but expect to continue to see wide swings in national healthcare policy priorities whenever control over Congress and the White House changes hands, which, lately, is frequent.

In the face of this reality, what can students who want to pursue careers in healthcare administration do to ensure continued marketability and success in a career where they can expect to face constant, unrelenting change?

  1. Understand how business architecture and operating models are influenced by state and federal policy priorities.
  2. Improve your ability to learn, and then apply that learning, in cycles of rapid succession.  Never stop improving this.
  3. Possess the flexibility to completely change course, multiple times, without losing sight of your purpose.
  4. Find what you are naturally good at.  Everyone has something.  I don’t care who you are.  Do you find it easy to motivate and persuade others?  Do you sit at a keyboard and the words simply type themselves?  Do you have a knack for statistics?  Are you a policy wonk fashioned in Hillary Clinton’s own image?  Do you have a Donald Trump-esque ability at marketing?  This is what differentiates you from your peers.  This is your brand, your firepower.  Find it; nurture it; emphasize it.
  5. Cultivate the skills that will never lose value, also known as the “soft skills.”  Interpersonal relationships and the ability to connect with others will always be the foundation of healthcare.  Be technologically aware, adept and agile, but never forget that communication skills will always be focal determinants of your success.

If you are still reading, and you still want to pursue a career in healthcare administration, then go forth and pursue it with renewed passion.  We need you - and we will be waiting to pass the torch when you’re ready to join our ranks.

Laura Shue, MPA, CHDA, CPHIMS, is the Director of Data Quality, Compliance and Operations at the University of Michigan Health System. A 2011 alum of the EMU MPA program, Laura is also Director of the Michigan Health Information Management Association.

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