Top 10 Healthcare Occupations in Demand Under Healthcare Reform

1. Registered Nurse:

One of the most in-demand careers in the entire US, registered nurses are projected to generate over 580,000 new jobs by 2016. This does not count the hundreds of thousands of jobs that will become available when older nurses retire. Those following the path toward becoming a registered nurse will find abundant job prospects and ample opportunities. Call your representatives and tell them to pass the W Visa for nurses that will provide a temporary nonimmigrant category for nurses. Also tell them to tackle legal immigration first to get the nurses in waiting in the EB-3 category moving forward, given that this is a pre-certified shortage occupation.

2. Home Health Aide:

Home health aides function as caregivers to the many people who are unable to leave their homes or live on their own. Home health aides may check vital signs, administer medicines, and help with daily tasks. The job outlook for home health aides is excellent, especially as baby boomers age and home health aides retire or advance into other careers.

* 2006 employment: 767,000
* 2016 projection: 1,156,000
* Percent growth: 50.6
* Salary range: Less than $21,220
* Education/training: On-the-job training

3. Medical Assistant:

Medical assistants perform administrative and clinical tasks in a variety of work settings. A staple of the healthcare industry, medical assistants are in demand all over the US. Employment for medical assistants is estimated to grow much faster than average, and job opportunities should be abundant for medical assistants with formal training or certification.

4. Pharmacy Technician:

Pharmacy technicians help pharmacists in providing medication and health care products to patients. Because there is currently few state, and no Federal, requirements for formal training, many employers have on-the-job training, which is appealing to individuals who want to further their education without attending multiple years of school.

* 2006 Employment: 285,000
* 2016 projection: 376,000
* Percent growth: 32
* Salary range: $21,260 – $30,560
* Job outlook: The demand for pharmacy technicians will increase along with the elderly population. Pharmacies looking to cut costs will shift more responsibilities form pharmacists to technicians

5. Medical Secretary:

Employment is expected to grow faster than average, and job opportunities should be especially good for those who are certified. Employment in hospitals and physician’s offices will continue to grow significantly.

6. Dental Assistant:

Dental assistants are the most in-demand job in the field of dentistry. Here are the stats:

* 2006 employment: 280,000
* 2016 projection: 362,000
* Percent growth: 29.2
* Salary range: $21,260 – $30,560
* Education/training: Moderate on-the-job training
* Job outlook: As dental health among older generations improves, routine preventive care is needed more than ever before. Also, younger dentists entering the field are more likely to work with assistants.

7. Healthcare Administrators:

As the backbone of healthcare systems, healthcare administrators take on the duties of overseeing vast expanses of medial personnel. As the structure and financing of the healthcare industry changes, healthcare administrators must be able to adapt to new environments. However, administrators are still in great demand despite the evolving industry.

8. Medical Records and Health Information Technicians:

Medical records and health information technicians maintain the millions of documents the healthcare industry produces. Paperwork includes x-rays, medical histories, lab tests, and treatment plans. Every patient has detailed medical records, and it is necessary that these records be kept organized and confidential. Even with the proliferation of online and electronic health records, the medical records field is expected to grow considerably.

9. Physical Therapist:

Physical therapy is a growing occupation, especially for those who was interested in pursing an advanced medical degree but do not want to be physicians. Currently, the number of physical therapy jobs is greater than practicing physical therapists because many physical therapists hold more than one job – such as having a private practice and also working part time at another healthcare facility. Call your representatives and ask them to tackle legal immigration reform first so that the backlog of PTs waiting for green-cards (a pre-certified shortage occupation along with RNs), get moving forward for foreign PTs.

* 2006 employment: 173,000
* 2016 projection: 200,000
* Percent growth: 27.1
* Salary range: $46,360 or more
* Education/training: Master’s degree
* Job outlook: The growing elderly and disabled population will push demand for physical therapy, an industry that’s constantly expanding its scope.

10. Physician Assistants:

* 2006 employment: $66,000
* 2016 projection: 83,000
* Percent growth: 27
* Salary range: $46,360 or more
* Education/training: Master’s degree
* Job outlook: As health care facilities, particularly in rural and inner-city areas, increasingly use physician’s assistants to address physician shortages and save money, job demand will grow.

Comparing the Pros and Cons of Outsourced Healthcare Coding

Deciding on whether to outsource any portion of your healthcare facility’s revenue cycle department is something that cannot be taken lightly. And facilities have different options when outsourcing the coding function. Some facilities have chosen to keep the coding in-house and only outsource the processes involved with electronic claims submissions, collections and financial reporting. However, with the increased number of audits, health care facilities are deciding to outsource all revenue cycle functions including the coding of claims.

The implication of inaccurate coding is significant. A healthcare facility should look at their available resources when determining if the coding should be outsourced. One only has to look at the two types of coding errors: “overcoding” and “undercoding.” The obvious ramification of overcoding is potential for an extended audit; repayment and possible penalties and fines. Undercoding or what providers call “defensive coding” results in millions of dollars of lost revenue.

Pros of Outsourced Coding

As mentioned, healthcare providers are seeing audits from all areas. These claims audits include RAC, MIC, MAC, CERT, PERM, MFCU, ZPIC and others. With more claims audits, the healthcare industry is seeing a higher demand for qualified coders. One benefit of outsourcing the coding tasks is that the headache of hiring an individual with coding experience is no longer an issue.

Medical coding rules can be arduous. A coder must be privy to CPT rules, Correct Coding Initiative Edits (CCI), ICD-9-CM (and soon ICD-10-CM), Local Carrier Determination (LCDs) and National Carrier Determinations (NCDs). With small practices, those individuals who are granted the task of “coding” are also given other responsibilities which affect the amount of time they have on applying, learning and keeping abreast of all of the rules. Utilizing a company who only hires qualified individuals to conduct the coding tasks, provides confidence that the claims are being submitted based on the appropriate rules and policies.

The American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA) provide various ways of obtaining the required continuing education credits. Many ways are affordable and do not require leaving your desk. However, many of these ways are not as specialty specific as you would find at regional and national conferences. With attending offsite conferences, the expenses are increased. The budgets in many health care facilities cannot accommodate the expenses associated with continuing education classes. Outsourcing the coding to a company eliminates this extra expense.

With the above benefits of outsourcing the coding, comes due diligence on the health care facility’s end. It is imperative that it is understood that these companies do provide specialty specific continuing education and that they provide their staff with the appropriate resources that spell out all of the coding rules and policies.

Cons of Outsourced Coding

So what are the cons involved in the outsourcing of the coding? For one, when mentioning the benefits of using a coding company, we are making the assumption that their employees are qualified and educated on the coding rules. Negative outcomes have been shown with physicians of certain specialties that have more difficult coding scenarios. This is often seen with Interventional Radiology and Neuro Surgery. Although the coding company may have qualified individuals, they may not be experts on these more difficult specialties. It is imperative that you find out if your designated coder is educated on your specialty. Ask for the bios and CVs of the coders who will be working on your claims. In addition, coders lose their credentials. It is easy to contact the AAPC and AHIMA to determine if the coder who is submitting your claims has allowed her credentials to lapse. Find out what type of continuing education they have received in the past; get specifics.

Unless you contract with a coding company that only deals with claims in one particular part of the country, you are taking the gamble that they are truly applying LCDs and other regional coding policies to your claims. If you are a provider in Louisiana and you are utilizing the services of a company out of Minnesota, you must get confirmation that the coding company is experienced with Medicare, Medicaid and other third-party payers in your state.

Beyond the coding tasks, there is the remainder of the revenue cycle process that can be outsourced. The process for outsourcing billing can be pretty straightforward. Typically superbills and other documents are scanned and electronically sent or mailed to the medical billing service. If the practice is using EHR software, the patient’s superbill is stored and electronically transmitted to the billing service. The medical billing service takes care of the data entry and claim submission on behalf of the provider. The company will also follow up on denied claims, work unpaid accounts (A/R management) and send out-patient statements. The mere fact that they do not have to deal with any of this is the major reason that providers choose to outsource. In this outsourcing scenario, the fee for outsourcing these revenue cycle tasks is based on a percentage of gross collections. The industry average for these fees is approximately 7 percent of gross collections.

Compare hard costs: Calculate the expense of doing it in-house (salary and overhead of your billing staff, amount of time you are spending on billing, third-party fees for claims clearinghouses, billing related supplies such as claim forms) versus the billing company fees (which are typically a percentage of collections). Many organizations provide salary surveys that can assist you with average cost of billing staff.

Compare soft costs and intangibles: This comes down to the basic hassle of dealing with daily billing issues and all issues related to human resources. Is dealing with these issues worth it?

Compare effectiveness: You must take into account the quality of the resources that you would have in-house versus assessing the potential effectiveness of a third-party. If you have done billing in-house, you can measure your collection rates; turnaround times and other points of billing to practices of the same specialty and size. This could assist you in determining how well your billing staff is doing. Another question that you could ask yourself is how often do you get reports regarding A/R, charges, and collections?

Any business decision requires acknowledgment of cost benefit, good business practice and common sense for the company. When determining whether to outsource the billing, consider these facts and apply them to your daily practices. The ultimate decision comes down to one thing and that is how can we practice medicine and maintain a business in the most efficient way.