Health Care Management

In 2022, 509,500 health care managers were employed in the United States, according to the U.S. Department of Labor (DOL). The following sectors were the largest employers of health care managers in 2022:

• hospitals (state, local, and private): 30 percent
• offices of physicians: 12 percent
• nursing and residential care facilities: 9 percent
• government health care facilities: 7 percent
• outpatient care centers: 7 percent.

Employment for medical and health services managers is expected to grow by 28 percent from 2022 to 2032, according to the DOL, or much faster than the average for all careers. The expected growth rate for all occupations is 3 percent. The health care management industry parallels that of the overall health care industry. It consists of the following segments, all of which employ managers:

• hospitals
• nursing and personal care facilities
• physicians’ offices and clinics, dentists, and other health care practitioners
• home health care services (including hospices)
• outpatient care centers
• medical and dental laboratories.

Health care facilities are owned and operated by for-profit companies, religious and other nonprofit organizations, and government agencies at the local, state, and federal levels. Health care managers also interact with many ancillary organizations to help deliver quality health care. These organizations include insurance companies, Medicare or Medicaid, medical contractors, consulting firms, and medical supply companies. Some health care managers transition into these industries after gaining experience.

There were 6,129 registered hospitals in the United States in 2021, according to the American Hospital Association. These included 5,157 hospitals classified as community hospitals. Of these, 2,978 were non-government and not for profit; 1,235 were investor-owned, for-profit hospitals; and 944 were state and local government hospitals. According to Definitive Healthcare’s HospitalView product, the largest U.S. health systems by number of hospitals in March 2023 were:

1. HCA Healthcare: 210 hospitals
2. Universal Health Services: 180 hospitals
3. CommonSpirit Health: 164 hospitals
4. Department of Veterans Affairs: 160 hospitals
5. Encompass Health Corporation: 149
6. Ascension Health: 129 hospitals
7. Select Medical Corporation: 116 hospitals
8. Trinity Health: 105 hospitals
9. ScionHealth: 94 hospitals
10. LifePoint Health: 89 hospitals

In September 2022, there were approximately 15,151 skilled nursing facilities (SNFs) in the United States, according to the U.S. Department of Health & Human Services. These homes had nearly 1.6 million available licensed beds. Approximately 72 percent of skilled nursing homes had for-profit ownership. According to the U.S. Department of Health & Human Services, the leading SNFs in the U.S. by number of facilities in 2022 were:

1. Genesis Healthcare Corp: 234
2. The Ensign Group Inc.: 234
3. Life Care Centers of America Inc.: 210
4. HCR Manorcare (now known as ProMedica Senior Care): 155
5. Providence Group: 130
6. Consulate Health Care: 128
7. Evangelical Lutheran Good Samaritan Society: 126
8. Trilogy Health Services LLC: 124
9. Saber Healthcare Group: 112
10. Signature Healthcare LLC: 101

There are about 11,500 home health agencies in the United States, according to the CDC. These organizations provided services to 4.9 million patients. Approximately 82 percent of nursing homes had for-profit ownership. According to LexisNexis Risk Solutions, the largest home care chains in the U.S. by number of nursing homes in 2020 were:

1. Kindred at Home (now known as ScionHealth)
2. Amedisys Inc.
3. LHC Group Inc.
4. Encompass Home Health & Hospice
5. Accentcare
6. Bayada Home Health Care
7. Brookdale Senior Living Solutions
8. Elara Caring
9. Interim HealthCare
10. Trinity Health at Home

There were 6,179 Medicare-certified ambulatory surgery centers (ASCs) in the United States in August 2023—up from only about 1,000 ASCs in 1988. They performed an estimated 30 million surgeries annually. According to the healthcare transaction advisory firm VMG Health, the top ambulatory surgery center chains by number of facilities owned in 2022, were:

• United Surgical Partners International: 440 facilities
• AMSURG: 260 facilities
• SCA Health: 260 facilities
• HCA Healthcare: 150 facilities
• Surgery Partners: 145 facilities

Below are some of the better-known organizations that wield a major influence in the health care administration world:

• The American College of Healthcare Executives is an international professional society of health care executives with more than 48,000 members who lead hospitals, health care systems, and other health organizations. It offers certification, continuing education classes, publications (such as Healthcare Executive), membership for college students and professionals, and excellent job-search and networking resources and programs.
• The American Health Information Management Association is the premier association of health information management professionals. Its more than 103,000 members are dedicated to the effective management of personal health information required to deliver quality health care to the public. The association offers a variety of certifications, including the Registered Health Information Administrator designation.
• The American Hospital Association (AHA) is the national organization that represents and serves all types of hospitals, health care networks, and their patients and communities. Nearly 5,000 hospitals, health care systems, networks, and other providers of care come together to form the AHA. The AHA also offers several personal membership groups, including the American Society for Health Care Engineering, Association for the Health Care Environment, American Society for Healthcare Human Resources Administration, American Society for Health Care Risk Management, and the Society for Health Care Strategy & Market Development.
• The American Organization for Nursing Leadership (AONL) is the national organization of nurses who design, facilitate, and manage care. The organization, which has more than 11,000 members, provides leadership, professional development, advocacy, and research in order to advance nursing practice and patient care, promote nursing leadership excellence, and shape public policy for health care. The AONL offers the following certification designations: Certified in Executive Nursing Practice and Certified Nurse Manager and Leader.
• The American Public Health Association is the oldest, largest, and most diverse organization of public health professionals in the world and has been working to improve public health since 1872. It publishes the American Journal of Public Health and The Nation’s Health newspaper.
• The Healthcare Financial Management Association (HFMA) is the nation’s leading membership organization for health care financial management executives and leaders. More than 103,000 members—ranging from CFOs to controllers to accountants—consider HFMA a respected thought leader on top trends and issues facing the health care industry. HFMA members can be found in all areas of the health care system, including hospitals, managed care organizations, physician practices, accounting firms, and insurance companies.
• The Healthcare Information Management Systems Society is a “global advisor and thought leader supporting the transformation of the health ecosystem through information and technology.” It represents more than 120,000 individual members, 430 corporate members, 500 nonprofit partners, and 550 health services organizations.
• The Medical Group Management Association represents nearly 60,000 administrators and executives in 12,500 health care organizations. It offers certification, continuing education opportunities, and membership options for students and professionals.