Photo by UC Davis Betty Irene Moore School of Nursing

Photo by UC Davis Betty Irene Moore School of Nursing

The ABCs of the ACA

Back Article Oct 1, 2011 By Stephanie Flores

As health care administrators around the country prepare to implement the Affordable Care Act, educators are also tasked with preparing the next generation of managers — for the unknown.

No one knows yet just how health care reform is going to change the daily routine for practitioners and administrators, but all agree that business decisions, from purchasing supplies to the cost of follow-up care, are going to look different.

“Because of the constitutional challenges to the health care law passed last year, it’s not clear how health care reform will manifest itself. … But it is clear that we cannot continue on the path of ever-increasing expenditures for health care. Simply put, we will need to do more with less,” says Joseph Antognini, director of peri-operative services for the UC Davis Medical Center.

Doing more with less is a common business issue in other industries, which is exactly why educators and students are turning to the private sector for case studies and guidance.

This year, the UC Davis Graduate School of Management hired Wendy Beecham to lead and explore its non-degree executive education programs, such as health care leadership. She’s still exploring how to craft an effective program in a rapidly changing industry. She expects to launch the curriculum in 2012.

“With health care reform, it’s about a customer focus,” she says. “It’s working together as teams and being conscious of business issues. … For example, we looked to Walt Disney Co. for customer service. We contracted with them, and they acted as customers.”

Sacramento State offers an executive MBA degree, but curriculum isn’t specific to health care. And Dean Sanjay Varshney says the program has attracted students from the health care field because of it.
“They’re looking for an out-of-the-box approach to problem solving,” he says.

Antognini is one such student. He completed his executive MBA at Sacramento State in spring 2010 and says he met people from several fields that he otherwise wouldn’t have met in a health care administration program.

“I learned a different way of thinking that helps me understand the implications of health care reform,” he says. For example, right now he is evaluating a new type of catheter in patients. The new one costs more money, “but we think it will decrease the long-term complications, and overall cost-savings will be significant.”

Finances were the top concern for hospital CEOs in 2010, followed by health care reform implementation, according to a survey by the American College of Healthcare Executives, a Chicago-based trade group. Specifically with reform, CEOs were worried about how to reduce operating costs and how to better align administrators and physicians.

The latter concern, aligning doctors and administration, is what’s known as a team approach in most industries and it’s not as ingrained in health care organizational charts. According to Beecham, there are two groups that must communicate better under health care reform: administrators and doctors at the management level, and nurses and doctors at the operational level.

“It’s about everyone knowing the goal and vision of the organization, communication styles and goal setting,” Beecham says. “In the past, there’s been a separation of administration versus care.”

Robert Pretzlaff, chief of pediatric critical care at UC Davis, says the communication gap is largely due to doctors serving as independent operators.

Like Antognini, Pretzlaff enrolled in Sacramento State’s MBA program to get away from traditional health care education. Chief since 2003, he wanted a firmer foundation in leadership skills.

“It has certainly improved my ability to communicate with the people I work with,” says Pretzlaff, who started the program last year. “I changed habits with regard to calling meetings. Meetings now have a firmer agenda.”

For his thesis, Pretzlaff wants to develop a business plan for a long-term acute care facility for children. “There is a real deficit for facilities like these in Northern California,” he says. If approved, Pretzlaff will have to make some predictions about reimbursements under health care reform and whether such a facility could sustain itself under the new rules.

Aside from Sacramento State and UC Davis, managers at health care facilities have some newer options for post-graduate education. Drexel University offers a Master of Public Health Executive Program at its downtown campus, and in fall 2010, the University of the Pacific’s Eberhardt School of Business added a health care management designation to its MBA offerings.

These courses aren’t just new to the region, they’re relatively new to the industry as well. In the U.S., the University of Richmond Virginia offered the first baccalaureate program in nursing leadership in 1992. Locally, the UC Davis Betty Irene Moore School of Nursing started a program last year, offering doctoral and master’s degrees in Nursing Science and Health Care Leadership.

The school recently began its second cohort. Many of these nurses are joining professional committees at their jobs, says Deborah Ward, associate dean.

“Eventually they’ll be on boards, and that’s where they’ll exercise this leadership,” Ward says.