Healthcare is a business and, like every business, it needs good management to keep the business running smoothly. Medical and health services managers, also referred to as healthcare executives or healthcare administrators, plan, direct, coordinate, and supervise the delivery of healthcare. These workers are either specialists in charge of a specific clinical department or generalists who manage an entire facility or system.
The structure and financing of healthcare are changing rapidly. Future medical and health services managers must be prepared to deal with the integration of healthcare delivery systems, technological innovations, an increasingly complex regulatory environment, restructuring of work, and an increased focus on preventive care. They will be called on to improve efficiency in healthcare facilities and the quality of the care provided.
Large facilities usually have several assistant administrators who aid the top administrator and handle daily decisions. Assistant administrators direct activities in clinical areas, such as nursing, surgery, therapy, medical records, and health information.
In smaller facilities, top administrators handle more of the details of daily operations. For example, many nursing home administrators manage personnel, finances, facility operations, and admissions, while also providing resident care.
Clinical managers have training or experience in a specific clinical area and, accordingly, have more specific responsibilities than do generalists. For example, directors of physical therapy are experienced physical therapists, and most health information and medical record administrators have a bachelor's degree in health information or medical record administration. Clinical managers establish and implement policies, objectives, and procedures for their departments; evaluate personnel and work quality; develop reports and budgets; and coordinate activities with other managers.
Health information managers are responsible for the maintenance and security of all patient records. Recent regulations enacted by the Federal Government require that all healthcare providers maintain electronic patient records and that these records be secure. As a result, health information managers must keep up with current computer and software technology, as well as with legislative requirements. In addition, as patient data become more frequently used for quality management and in medical research, health information managers must ensure that databases are complete, accurate, and available only to authorized personnel.
In group medical practices, managers work closely with physicians. Whereas an office manager might handle business affairs in small medical groups, leaving policy decisions to the physicians themselves, larger groups usually employ a full-time administrator to help formulate business strategies and coordinate day-to-day business.
A small group of 10 to 15 physicians might employ 1 administrator to oversee personnel matters, billing and collection, budgeting, planning, equipment outlays, and patient flow. A large practice of 40 to 50 physicians might have a chief administrator and several assistants, each responsible for a different area of expertise.
Medical and health services managers in managed care settings perform functions similar to those of their counterparts in large group practices, except that they could have larger staffs to manage. In addition, they might do more community outreach and preventive care than do managers of a group practice.
Some medical and health services managers oversee the activities of a number of facilities in health systems. Such systems might contain both inpatient and outpatient facilities and offer a wide range of patient services.
Medical and health services managers held about 429,800 jobs in 2020. The largest employers of medical and health services managers were as follows:
- Hospitals; state, local, and private - 33%
- Offices of physicians - 12%
- Nursing and residential care facilities - 10%
- Government - 9%
- Outpatient care centers - 7%
Most medical and health services managers work in offices.
Most medical and health services managers work full time. Some managers work more than 40 hours per week. Work during evenings or weekends may be required in healthcare settings that are open at all hours, such as hospitals and nursing homes. Medical and health services managers may need to be on call in case of emergencies.
Education & Training Required
Medical and health services managers must be familiar with management principles and practices. A master's degree in health services administration, long-term care administration, health sciences, public health, public administration, or business administration is the standard credential for most generalist positions in this field. However, a bachelor's degree is adequate for some entry-level positions in smaller facilities, at the departmental level within healthcare organizations, and in health information management. Physicians' offices and some other facilities hire those with on-the-job experience instead of formal education.
Bachelor's, master's, and doctoral degree programs in health administration are offered by colleges; universities; and schools of public health, medicine, allied health, public administration, and business administration. In 2008, according to the Commission on Accreditation of Healthcare Management Education, there were 72 schools that had accredited programs leading to the master’s degree in health services administration.
For people seeking to become heads of clinical departments, a degree in the appropriate field and work experience may be sufficient early in their career. However, a master's degree in health services administration or a related field might be required to advance. For example, nursing service administrators usually are chosen from among supervisory registered nurses with administrative abilities and graduate degrees in nursing or health services administration.
Health information managers require a bachelor's degree from an accredited program. In 2008, there were 48 accredited bachelor's degree programs and 5 master's degree programs in health information management, according to the Commission on Accreditation for Health Informatics and Information Management Education.
Some graduate programs seek students with undergraduate degrees in business or health administration; however, many graduate programs prefer students with a liberal arts or health profession background. Candidates with previous work experience in healthcare also may have an advantage. Competition for entry into these programs is keen, and applicants need above-average grades to gain admission. Graduate programs usually last between 2 and 3 years. They may include up to 1 year of supervised administrative experience and coursework in areas such as hospital organization and management, marketing, accounting and budgeting, human resources administration, strategic planning, law and ethics, biostatistics or epidemiology, health economics, and health information systems. Some programs allow students to specialize in one type of facility—hospitals, nursing care facilities, mental health facilities, or medical groups. Other programs encourage a generalist approach to health administration education.
All States and the District of Columbia require nursing care facility administrators to have a bachelor's degree, pass a licensing examination, complete a State-approved training program, and pursue continuing education. Some States also require licenses for administrators in assisted-living facilities. A license is not required in other areas of medical and health services management.
Other Skills Required
Medical and health services managers often are responsible for facilities and equipment worth millions of dollars, and for hundreds of employees. To make effective decisions, they need to be open to different opinions and good at analyzing contradictory information. They must understand finance and information systems and be able to interpret data. Motivating others to implement their decisions requires strong leadership abilities. Tact, diplomacy, flexibility, and communication skills are essential because medical and health services managers spend most of their time interacting with others.
Health information managers who have a bachelor's degree or post baccalaureate degree from an approved program and who pass an exam can earn certification as a Registered Health Information Administrator from the American Health Information Management Association.
How to Advance
Medical and health services managers advance by moving into more responsible and higher paying positions, such as assistant or associate administrator, department head, or chief executive officer, or by moving to larger facilities. Some experienced managers also may become consultants or professors of healthcare management.
New graduates with master's degrees in health services administration may start as department managers or as supervisory staff. The level of the starting position varies with the experience of the applicant and the size of the organization. Hospitals and other health facilities offer postgraduate residencies and fellowships, which usually are staff positions. Graduates from master's degree programs also take jobs in large medical group practices, clinics, mental health facilities, nursing care corporations, and consulting firms.
Graduates with bachelor's degrees in health administration usually begin as administrative assistants or assistant department heads in larger hospitals. They also may begin as department heads or assistant administrators in small hospitals or nursing care facilities.
Employment of medical and health services managers is projected to grow 32 percent from 2020 to 2030, much faster than the average for all occupations.
About 51,800 openings for medical and health services managers are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.
As the large baby-boom population ages and people remain active later in life, there should be increased demand for healthcare services.
This means greater needs for physicians and other healthcare workers, medical procedures, and healthcare facilities, and therefore greater needs for managers who organize and manage medical information and healthcare staff. There should also be increased demand for nursing care facility administrators as the population grows older.
Employment is projected to grow in offices of health practitioners. Many services previously provided in hospitals will shift to these settings, especially as medical technologies improve. Demand in medical group practice management is projected to grow as medical group practices become larger and more complex.
In addition, widespread use of electronic health records (EHRs) will continue to create demand for managers with knowledge of health information technology (IT) and informatics systems. Medical and health services managers will be needed to organize, manage, and integrate these records across areas of the healthcare industry.
The median annual wage for medical and health services managers was $101,340 in May 2021. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $60,780, and the highest 10 percent earned more than $205,620.
In May 2021, the median annual wages for medical and health services managers in the top industries in which they worked were as follows:
- Hospitals; state, local, and private - $119,450
- Government - $117,000
- Outpatient care centers - $99,540
- Offices of physicians - $98,230
- Nursing and residential care facilities - $83,550
Most medical and health services managers work full time. Some managers work more than 40 hours per week. Work during evenings or weekends may be required in healthcare settings such as hospitals and nursing homes, which are open at all hours. Medical and health services managers may need to be on call in case of emergencies.