A number of other roles and titles exist in both direct and non-direct care health care from directors and coordinators in performance improvement organizations to managers in home health care agencies and supervisors in public health agencies.
Today, there are numerous functional areas in which health care managers work depending on the type, size and complexity of the facility, including strategic planning, day-to-day operations, finance, business development, information services, marketing, planning, human resources and performance improvement. At one time, health care executives were for the most part generalists, with knowledge and experience in all or most of these areas. As the field and organizations became more complex in the 1960s forward, specialists in these areas and others emerged. Today, although the chief executive officer of a health care organization will have a general understanding of these functional areas, she is supported by experts with education, training and in-depth knowledge of their respective disciplines.
New health care management roles developed with the growth of managed care and health systems in the 1980s and 1990s. Managed care executives, managers of physician practices, preferred provider organizations (PPOs), physician hospital organizations, ambulatory surgery centers, imaging centers, and joint ventures appeared on the scene during this period. In response to the resulting increase in law suits and other legal issues, risk managers, in-house attorneys and insurance managers became essential. In the area of finance, revenue cycle managers and consultants responded to the complexities of government and managed-care reimbursement for services. Medicare reimbursement regulations are complicated, often requiring detailed analysis of the services a health care organization provides and the facility's expenses to ensure appropriate reimbursement. Managed care contracts are complex as well in terms of covered services, pre-authorization requirements for specific services and certain expensive services for which there may be additional reimbursement.
With the growth of government and accrediting agency regulations, government relations and regulatory affairs professionals emerged. These individuals assist health care organizations in the review and analysis of regulations and standards and monitoring compliance with these requirements. Pressure to control cost and resource consumption prompted the introduction of medical management and disease management, processes whereby hospitals and other health care providers work to provide medical care for specific conditions in an efficient and effective manner. The goal is to achieve favorable outcomes and minimize the utilization of expensive resources (expensive tests, treatments and, inpatient stays). The approach used is often based on protocols for treating specific diseases or conditions developed through medical research.
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