The Role of Consultants in United States Healthcare

Complex challenges often require complex solutions. The challenge of providing affordable and effective healthcare is no different. Patients, employers, insurers, lawmakers, and industry all have a stake in achieving the triple aim of healthcare: improving patient satisfaction, improving the health of the population, and decreasing healthcare costs. Healthcare consulting is a growing industry touching each of the stakeholders involved, and these consultants are playing an increasingly significant role in the United States healthcare system.

What, exactly, is a healthcare consultant? The term encompasses a number of different job descriptions, with strategic management consulting being the most common. This job involves advising organizations on mergers and acquisitions related to accountable care organizations and expanded medical communities.

Merging services with other facilities allows hospitals to achieve cost savings through economies of scale—a key priority as hospitals face shrinking margins. The need for navigating these complex waters has enabled management consulting in the US healthcare sector to grow into a $20 billion industry. A recent article published by MHA@GW, the online MHA program from Milken Institute School of Public Health at the George Washington University, highlights other key areas of healthcare consulting. Organizations need direction on financial and operational management, technology strategy, data management, and human resources and benefits. All of these measures can be tied directly back to achieving the triple aim.

Hospitals and pharmaceutical companies leverage the largest share of healthcare consultants, respectively employing 38.4% and 28.9% of the current market. But other healthcare providers, such as outpatient labs, physicians’ offices, and outpatient centers, need strategic help implementing and maintaining electronic health records. Medical device manufacturers need consultants to drive innovation and product development while complying with government regulations. Government agencies and insurance providers rely on the expertise of healthcare consultants who can understand the opportunities and challenges of the Affordable Care Act, which as of Friday, March 24, is the “law of the land for the foreseeable future.”

Job seekers in healthcare consulting may benefit from an unprecedented population demographic shift that will keep the industry in high demand. According to the US Census, the number of Americans age 65 and older could double to more than 98 million by the year 2060. Since older Americans require more treatment, medications and long-term care than other age demographics, healthcare will continue to be a complex challenge. Healthcare organizations will need consultants to help develop complex solutions.