As the nation grapples with rising healthcare costs, physician and nurse shortages, and an increased demand for services for an aging population, the need for healthcare administrative professionals steadily increases. The Bureau of Labor Statistics projects 20 percent growth in employment for healthcare administrators between 2016 and 2026, which is well above the average rate for all occupations.
(pictured at right: Elizabeth Aremu, MGPO Finance Fellow, June 2018-December 2019)
Although students have many paths to a career in healthcare administration, the road to a finance-focused administrative career is often less direct. Healthcare administrative professionals typically enter the field through general studies programs and can find fellowship opportunities through associations. However, finance-focused students usually pursue business degrees and are faced with long, unofficial apprenticeships (e.g., with an accounting or actuarial focus) before
considering a switch to health care.
(pictured at right: Neda Daneshvar, MGPO Finance Fellow, June 2016-December 2017)
Without a more formalized career path, high-performing finance students get recruited into non-healthcare industries. While some students find their way into health care later in their careers, many never discover the opportunities. As a result, healthcare organizations have fewer high-performing finance candidates from whom to choose.
Addressing the Gap
For healthcare organizations such as Massachusetts General Physicians Organization (MGPO), this gap has serious consequences. With more than 2,800 physician members practicing at Massachusetts General Hospital (MGH), MGPO is the largest multispecialty physician group in New England and one of the largest in the United States. A robust supply of high-performing candidates is critical to our operations.
To address the gap, MGPO examined programs that encourage healthcare administrative careers for college students through post-graduate administrative fellowships. These fellowships help students assess the appropriate career path for their professional goals. The fellowship programs originated more than 40 years ago, and today about 300 fellows are in more than 60 programs across the country.
(pictured at right: Larry (Hee Jun) Joo, MGPO Finance Fellow, June 2017-December 2018)
As part of its operational planning process, with support from leadership, MGPO began developing a finance-focused fellowship in 2007. The fellowship fell within the organization’s core values of teaching and education, and MGPO received valuable guidance from MGH, which has one of the oldest and best-developed administrative fellowship programs in the country.
After getting buy-in from leadership, MGPO’s Finance Department developed a curriculum that provided a balance of educational opportunity and work experience in the organization’s seven major financial areas: physician payment and analytics, compensation, professional billing, billing compliance, business intelligence, business transformation, and budgeting.
The director of each financial area created a three- to six-month rotation—with the exact duration depending on the size of the department and the tasks available—including selecting the preceptor and pertinent projects. Projects range from shadowing to fully taking on an official role within the department. The fellow also works directly with the sponsor of the program, MGPO’s CFO, on higher-level strategic initiatives.
A selection committee of staff from the seven branches of the Finance Department reviews applicants and conducts interviews. Over the past nine recruitment years, the finance fellowship has had 202 applicants, with 35 individuals attending on-site interviews.
A Comprehensive Program
Over time, the fellowship has continued to evolve and improve. The current program lasts 18 months, during which fellows, who are paid a salary for their work, gain broad exposure to a variety of financial disciplines.
In 2014, HFMA published a comprehensive list (PDF) of the knowledge and skills that are expected of a healthcare finance professional, including:
- Revenue cycle functions
- Disbursement functions
- Budgeting and forecasting
- Internal control functions
- Financial reporting
- Contract management
These skill sets were defined as “technical ‘essentials’ for a career in healthcare financial management” that would be expected of a seasoned healthcare professional. The MGPO Finance Fellowship strategically exposes participants to projects encompassing all six domains.
Fellows have the opportunity to lead teams in projects that significantly impact MGPO, including work involving the drug chargemaster, multiyear financial planning, departmental or strategic business planning, and revenue budget models. The fellows also attend departmental and leadership meetings, gaining even greater insight into the different kinds of work being done throughout the organization.
Providing guidance and mentorship to the fellows requires significant commitment from MGPO staff. During each of the seven rotations, the fellow is completely engrossed in the department and is provided a desk in the office to ensure he or she experiences all the daily activities. The staff members of each department are encouraged to offer project work and guidance. Complete buy-in and support of the fellow from the entire finance team are important to creating a successful environment for the program.
We’ve also found that a “fellow coach,” a staff member who works as a main point of contact for project work and as a liaison to human resources, is instrumental to the fellow’s success. For the last three years, two fellows have overlapped in tenure, giving the incoming fellow a peer mentor and additional source of support and the outgoing fellow the opportunity to mentor and share lessons learned.
The fellowship program benefits not only students, in the form of career opportunities and preparation for senior management, but also MGPO and its staff. Many fellows have brought insights to projects that may not have been immediately evident to staff. The fellows act as an eager resource for the completion of “dream projects” that staff otherwise would not be able to address. Additionally, staff members, including senior leaders and the CFO, learn training and coaching skills that may not come naturally. These skills, strengthened through mentoring, are invaluable in assisting in career development for all employees.
Even though the people directly involved have changed, we’ve found that the fellowship program has generated interdepartmental communication and fostered a strong sense of camaraderie and shared goals. This dynamic makes it easier to maintain the fellowship without having to rely on the “founding” individuals. There is a feeling that our Finance Department collectively owns and supports the fellowship.
The fellows have become our strongest advocates for the program. Almost every year, our fellows have added something new to the recruitment approach. For example, this year’s fellow has scheduled a few introductory webinars for interested students.
After arriving in June, a new fellow is first tasked with recruiting a replacement. The recruiting process involves contacting graduate programs, posting on job sites, hosting webinars, and attending networking events. The new fellow also arranges all phone interviews and onsite events with help from the MGH administrative fellows. The recruitment process provides each fellow with firsthand experience in the increasingly relevant human-resources function of recruiting high-performing employees.
Of the nine MGPO finance fellowship alumni, five chose to stay with the organization as administrative and billing managers. Although fellowship program staff hope to retain every strong-performing fellow, some have chosen paths outside the organization that better fit their goals. The fellowship continues to receive excellent reviews from both the fellows and staff, who have consistently demonstrated their passion for the program and their commitment to improving it each year.
Elizabeth Aremu and Larry (Hee Jun) Joo are MGPO Finance Fellows. Neda Daneshvar is a former MGPO Finance Fellow and currently a finance and analytics manager, MGH/MGPO.