Wednesday, May 2, 2012

How to Learn More About the Healthcare Industry

I got the following comment on the resources page and like several other questions, I thought the answer may be of interest to others as well so I decided to answer it as a post. Here’s the question:

“I would like to start by saying that I really do appreciate you taking the time to share your wealth of information and creating this reservoir of knowledge for the all of us.

I am 25 years old, just out of graduate school. I work for a firm that provides IT medical billing solutions to the medical industry and I am looking to understand the nuances/intricacies of medical billing as a whole. Reading your blog posts has been very informative to me.

I've been in the business for two and a half months now and I have gotten a head start into understanding some of the details. I was wondering though, if there was a starting point from where I could incrementally add to my understanding or if you just grasp things as you go along? I eventually do want to end up in the healthcare consulting industry. Please advise. Thank you once again for all your help.


Yash, thank you for the question and congratulations on both the new job and finishing grad school.

The healthcare industry is growing at a tremendous rate and your work in HIT (healthcare information technology) will be a huge asset in working to achieve your goal of healthcare consulting. You are absolutely right to want to learn more. Any knowledge you add to this experience will be a benefit.

Obviously, you have already visited the resources page.  Still, since this is a post, I will remind other readers that the resource page is full of great websites to help you learn more about the healthcare industry.

Yash, as you noted best way to learn anything is by hands on experience. Still, you can add to that knowledge by studying. Of course, this blog is the best place to start. If you have not done so already, go back through the archives. There is a lot of information in here!

You should also consider spending some quality time with Medicare. While there are a ton of different insurance companies around, Medicare is (as a general rule) the standard for most things. I find, that once you have a firm understanding of Medicare, other insurances policies and procedures are relatively similar.

The website  (the website for the Centers for Medicare and Medicaid Services) is a wonderful place to start. Here is a link to their education pages:

You can also take online courses in medical billing and/or coding through the AAPC. Here is a link to their educational programs:

The most important thing is to keep up on changes in the industry. There are several websites that I read frequently and I highly recommend them as sources to learn more. Check out:

Now, you will note the last one is an IT website. This is important. While there is a lot to learn in medical billing, HIT is the next big wave… be ready to ride it! You should be knowledgeable about things like EMR, Meaningful Use, health information exchanges, and new applications (apps) for healthcare.  Also, you should make an effort to learn about new business models in healthcare such as medical homes and ACOs (accountable care organizations).

Lastly, please, please do not limit yourself to billing only. I know that initially sounds counterintuitive, but hear me out. By studying other industries and various business methodologies, you can develop new ideas that apply to healthcare. A breadth of knowledge in many areas will make you far more successful than just billing alone.

For example in methodologies, Six Sigma has many ideas that apply to healthcare insofar as streamlining operations and reducing waste. Lean methodology has fabulous ideas for developing a business (product) that customers love while keeping costs in check. You should also do some study on Total Quality Management which provides metrics by which you can assess quality and implement positive and profitable changes in an organization. I cannot say any one of these methodologies is better than the other; they all have applications and benefits regardless of industry. 

In summary, read everything you can get your hands on! You will be surprised how you can apply that knowledge and what creative ideas emerge. 

I hope that you feel I have sufficiently answered your question. If you have follow up questions, please feel free to post them. I am very glad you like my blog and I promise to try to keep going with relevant, useful, and educational content. And again, thank you for the question.


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