When we think of advances in healthcare and improved health outcomes, the initial professionals who come to mind are likely medical practitioners and their staff. But there’s a hidden side to healthcare, and one that can positively impact patient and health outcomes – that of public administration and logistics. One of the most notable of those covert healthcare professionals is the public administrator. At the end of the day, those in this influential position play an integral role in improving patient outcomes at the facility they represent.
A veritable industry lifeline, public healthcare administrators must also remain vigilant and prepare for the unexpected in light of the myriad changes to industry policies and insurance requirements within the last decade. Following a significant industry-wide overhaul in the wake of 2010’s Affordable Care Act (ACA), the healthcare industry is growing and will continue to do so. The growth is expected to occur at every level, from the financial bottom line to patient need and employment.
According to 2017 data from the Bureau of Labor and Statistics, “healthcare support occupations, and healthcare practitioners and technical occupations, are projected to be among the fastest growing occupational groups” between 2016 and 2026. Further, within that decade, just those two healthcare niches are expected to “contribute about one-fifth of all new jobs.” That’s a significant number in an industry that already provides jobs to about 16 million people nationwide. As of January 2018, the healthcare industry edged out retail and manufacturing to become the top employer in the U.S.
And while the public faces of the industry include practitioners, nurses, and surgeons, the industry would fail if it wasn’t for the professionals working behind the scenes.
One of the most notable of those covert healthcare professionals is the public administrator. At the end of the day, those in this influential administration position play an integral role in improving patient outcomes at the facility they represent. A veritable industry lifeline, public healthcare administrators must also remain vigilant and prepare for the unexpected in light of the myriad changes to industry policies and insurance requirements within the last decade.
Dissecting the ACA: Possible Changes on the Horizon
Today’s public healthcare administrators must be particularly adaptable in what has become an especially unpredictable industry. The ACA, which effectively privatized healthcare across the U.S., has seen its fair share of support as well as criticism since its implementation in 2010.
The ACA requires that every U.S. citizen, save for those who qualify for a hardship exemption, carry at least a minimal level of health insurance. Additionally, certain employers are obligated to offer coverage to their full-time employees as of 2015. Businesses with fewer than 50 employees are exempt from those insurance coverage requirements. Those “small businesses” make up about 96 percent of all employers.
Large and mid-sized employers that failed to meet the requirement were subject to a tax penalty, but that penalty has since been repealed. The change will go into effect on January 1, 2019, and healthcare professionals, including public administrators, should be aware of the change and its implications.
Also known as “Obamacare,” the ACA has been under scrutiny from the beginning, and its legal status remains under debate into 2018. Two years after the ACA was enacted, the Supreme Court upheld the act, calling its insurance requirement “a legitimate use of Congress’ taxing power.” Today, ACA opponents are picking apart that ruling in the federal district court for the Northern District of Texas.
Pre-existing conditions, including asthma, diabetes, and cancer, were protected under the ACA, but that may no longer be the reality. The fate of pre-existing conditions hinges on a pivotal court case: Texas v. U.S.
In their initial claim, filed in February 2018, 20 members of the Republican Party argued that the Affordable Care Act as a whole is unconstitutional. The group, led by Texas Attorney General Ken Paxton, further claim that the ACA has been effectively unconstitutional since the tax penalty requirement was repealed in December 2017. The GOP is asking for the entire law to be invalidated, and for pre-existing conditions protections to be eliminated.
In the interim, the plaintiffs are seeking a preliminary injunction, which asks presiding U.S. District Judge Reed O’Connor to set aside the ACA as a whole while the case is being argued. If O’Connor agrees with the GOP, it would “throw the entire system into chaos,” says California Attorney General Xavier Becerra, an outspoken opponent of the case.
Becerra’s primary reason behind the claim is the fact that the ACA didn’t only alter the individual insurance market. Employer insurance, Medicare, and Medicaid were also substantially affected, as they will be if the ACA is repealed.
Further, Becerra says that an ACA repeal, or even an injunction, could negatively affect young and vulnerable people throughout the country.
“ … We don’t believe Americans are ready to see that their children are no longer able to see a doctor or that they cannot get treated for a preexisting health condition,” Becerra told reporters.
Public healthcare administrators will face a huge learning curve if the ACA falls to the wayside, but the effect won’t be immediate. Industry insiders expect that the case will enter the appeals process if matters go south in Texas, and may perhaps even reach the U.S. Supreme Court for a second time.
The Many Hats Worn by a Public Healthcare Administrator
Whatever the ultimate decision in Texas v. U.S., it will likely affect the daily operations of healthcare facilities and organizations, and public administrators will be involved in any potential industry changes.
And for that reason, everyone in the healthcare industry, from patients and medical students to caregivers, will benefit from developing an understanding of the complex role of a public administrator. On any given day, a public healthcare administrator may interact with:
- Insurance providers
- Legislators, especially at the state level
- Medical equipment suppliers
- Patients, principally in an educational setting
- Prospective hospital employees
Ultimately, a public healthcare administrator manages the day-to-day operations of a facility. And, as the industry continues to grow and transform on both a technological and legislative level, the role of a public administrator will become increasingly complex.
The upward trend in healthcare sector employment has already begun — in January 2018, the Atlantic reported that the industry is the largest employer in the U.S. The exorbitant increase in medical spending in recent years was cited as the primary reason behind healthcare’s takeover of the top spot.
Another reason for the industry’s upward trend is the fact that, as a whole, Americans are living longer. And as we age, we typically have more healthcare needs, especially among those who remain in the workforce during their golden years. The Atlantic also predicts that, “by 2025, one-quarter of the workforce will be older than 55.”
And by 2035, the number of American adults will surpass the number of children for the first time in recorded history, according to the U.S. Census Bureau. That year, the number of people who are 65 or older is expected to hit 78 million.
In what has been dubbed “the graying of America,” the estimated median age increase mirrors that seen in a number of European countries, including France, Germany, and Spain.
In the field of public healthcare administration, an increased median lifespan opens up numerous opportunities for growth, expansion, and education, especially where prevention and wellness are concerned.
Preventative Measures and Public Administration
Thanks to their unique vantage point within a facility, bridging the gap between patient and medical professionals, public administrators can clearly see the bigger picture. This means that a public healthcare administrator can make informed decisions and implement policies that benefit patients and caregivers alike.
A public administrator also serves as the brains behind facility-wide systems and programs that focus on prevention. These may include:
- Nutrition classes
- Yearly or bi-annual wellness screenings
- Immunization clinics
As the median age of Americans increases, there will also be an increased need for vision screenings and similar services, and a public administrator may be in charge of those programs as well.
As the majority of vision impairments among otherwise healthy individuals are age-related, eyecare professionals recommend that individuals over 45 undergo an eye exam on an annual basis. Vision problems that are linked to age include cataracts, glaucoma, and macular degeneration. Additional prevention measures that may lead to improved eye health are:
- Protecting eyes from UV light
- Exercising frequently
- Consuming plenty of antioxidants
- Reporting any vision changes to a healthcare practitioner immediately
Eye exams also fall under the blanket of preventive healthcare. And prevention is an essential component of the well-being of many individuals, especially considering that around 40 percent of annual deaths from the top five causes can be prevented, according to the Centers for Disease Control and Prevention.
The leading causes of premature death in the U.S. are stroke, heart disease, chronic lower respiratory disease, cancer, and unintentional injury. For the CDC’s purposes, a “premature” death is one that occurs prior to the age of 80.
If every preventable case within the top five conditions was indeed prevented, an estimated 259,500 lives would be prolonged every year. And a public health administrator effectively serves as a life-saving liaison between patients and preventative care access.
Communication and Problem Solving in the Healthcare Industry
The ability to effectively communicate, at both a personal and digital level, is an essential trait of every successful public administrator. Those in the position should also possess copious amounts of strategic vision, attention to detail, and creativity, coupled with a strong commitment to the mission of the organization or agency.
According to the educational professionals at Ohio University, “public administrators are able to come up with creative solutions to complex problems, usually by seeing an issue from a new perspective or by innovating a new approach to the solution.”
One of those “new” approaches is the use of social media in determining patient outcome and satisfaction.
Social media and healthcare intersect in a profound way, and public administrators stand at the crux of the two. Actively monitoring social media provides a tangible way for an administrator to discover the strengths of their agency or organization, as well as any areas that need improvement.
The potential reach of social media within the healthcare field is often overlooked, but the facts are telling. While only about 26 percent of the more than 5,600 hospitals across the U.S. use a social media platform, patients are another story.
Among social media users within the U.S.:
- 32 percent say they “post about their friends and family’s health experiences.”
- 80 percent seek out general health information.
- 27 percent post status updates regarding their “health-related experiences.”
- Nearly 50 percent search for information about a particular healthcare professional or facility.
These numbers effectively illustrate how, in an educational setting, social media can play a pivotal role in reaching a large number of patients seeking advice on any number of medical issues. A public administrator may assist in educating patients on complex matters such as how to proceed after emergencies and accidents.
For example, at a public health seminar or via a social media platform, a public administrator will explain why those who have been involved in an auto accident, even a minor one, should seek a medical evaluation to ensure they aren’t injured. The evaluation should be performed prior to agreeing to anything associated with the other party’s insurance.
This is an important consideration because some types of injuries, especially head trauma, may not be immediately apparent following an accident. Public administrators in the healthcare sector can serve as a mediator of sorts, balancing their emotions while providing objective advice to accident victims during what can be an emotionally trying time.
A public healthcare administrator’s foray into the realm of laws and regulations doesn’t end there — they’re also at the forefront of legislation. And it’s a valuable role, especially when you consider the localized aspect of healthcare. After all, most patients receive care, whether on a preventive, maintenance, or emergency basis, in their own community. At its core, healthcare is a local industry.
This simple fact makes a public healthcare administrator an important figure within local communities as well as medical facilities. Thus, in Texas, where the Affordable Care Act is under fire, it’s likely that a large number of public health administrators are watching the proceedings closely. Public administrators may even be providing valuable insight and analysis to the legal professionals handling the case.
Looking to the Future of Public Health Administration
Time will tell if and how Texas v. U.S. will ultimately affect healthcare. But it’s a certainty that public healthcare administrators throughout the country will field any changes that do arise and act accordingly, channeling pertinent information to the patients and caretakers at their facility or organization. As we have seen, public administrators in the healthcare industry have a complex, multi-faceted job that may improve overall health outcomes and premature mortality rates. A savvy and passionate public health administrator holds the key to a better understanding of healthcare services in general.