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Strong Medicine

The Point

Winter 2012

Archish Maharaja, Ed.D., C.P.A., assistant professor of business management and MBA program director

Archish Maharaja, Ed.D., C.P.A., assistant professor of business management and MBA program director, heads the health systems management concentration available within Point Park's MBA program. He has diversified professional experience, from working at a Fortune 500 company and several smaller accounting and medical businesses to forming his own CPA and consulting firm concerned primarily with physician practices. His industry experience includes working as a manager and accountant, serving as a financial advisor on a corporate and personal level, and as a health care administrator and physician practice manager. Maharaja also provides consulting and management services to individual and multi-specialty physician practices, as well as larger health care entities. His research activities are concentrated in health care administration and management and information technology as it applies to health care. He recently talked with The Point:

The Pittsburgh-based global health enterprise UPMC has been locked in a protracted battle with Highmark, the region's largest provider of health insurance. Depending on the outcome, it's possible that many consumers may have to switch health care providers and/or turn over their medical records to another insurer. How can patients prepare for this type of situation?

Patients should be prepared for these changes by knowing how to obtain their medical records. To start the process, patients first need to call their primary care physician's office and request for a release of all their records. Due to HIPAA, before the office releases the records, the patient will first need to sign a form authorizing release of his or her medical records. After this, the patient should ask the office, "Are there any records you have not given me?" and follow up with any specialists he or she has seen, labs where blood work has bee done, etc. It is important to do this since many primary care physicians do not have complete medical records and often only a summary of what has been sent to them from labs, specialists, etc. During the transition, the two most important things a patient needs to think about are maintaining quality and continuity of care. When picking a new physician, patients can check out, although it is not 100 percent objective. I also suggest calling primary care physician offices for references and getting referrals from family and friends. In addition, I recommend patients schedule a preliminary meeting with their potential new physician.

Are there any safeguards built into the system to ensure privacy during this kind of switch, other than HIPAA?

No, HIPAA is the main privacy mandate. Everyone is doing a good job preserving privacy.

Is there a good or bad way to go about switching insurer carriers to not only ensure privacy but to make sure you are getting the best value for your dollar, as well as the best care?

Patients, especially those who have an existing health condition, need to make sure the insurer is meeting or exceeding their needs. Healthy individuals need to find out what is convenient for them and which insurer will provide the best advice and coverage in terms of maintaining their health. Make sure the premium you are paying matches what your health needs are now. Buying insurance is often a package deal and depends on what you need. Often it is based on 'you get what you pay for.' Before electing the insurance plan, read the entire contract carefully to find out what services are covered and what may be excluded.

As an expert in the use of electronic healthcare records in medical practices, can you give some examples of the good side and the bad side of the increasing use of technology in the healthcare industry?

From a personal perspective, I have experienced first hand the waste that can result from a lack of technology in doctors' offices. For example, I recently accompanied an ill family member to a hospital. She had had blood work done the week prior but the hospital couldn't locate the record so they proceeded to do the same work again. Not only is this a waste of time, it's a waste of resources and it's only one example of how medical costs are driven up when records are inaccessible among doctors and hospitals. So while a system for transferring information from hospital to physician's offices and back again in most instances will save time and resources, as consumers of medical services, individuals have to diligent about making sure that when they need to have medical records transferred from one physician to another, all their important records actually make the switch.

How would you describe the health care market in Pittsburgh?

The health care job market here is very strong. One of the region's largest employers is a health care system. In addition, the University of Pittsburgh and Carnegie Mellon University offer a lot of health care research opportunities in biotechnology. Overall, this region is always looking to hire people in management positions who are knowledgeable about business and health care.

What types of students are pursuing this concentration, and what makes Point Park's MBA program unique?

We have students already working in the health care environment such as nurses, health care administrators and managers who are looking to advance in their careers. On the other hand, we also have students who are new to the health care field and want to break into it. At Point Park, we offer a good mix of theory as well as knowledge that can be applied in the workplace. Our program combines core graduate-level business classes with the opportunity to specialize in a particular area such as health systems management or international business. Students get the theoretical basis for how businesses run and can then put their specialization on top of that. We also bring in guest speakers to our class who are experts in their field such as health care.

Why concentrate in health systems management?

Health systems management is a great career field to pursue for three main reasons. First, the health care industry has remained relatively recession proof. Second, the government's mandate for more individuals to be incorporated into the health care system will mean more consumers and more jobs. And third, the health care industry is going through a rapid integration of technology. The U.S. government is requiring all patient records be made electronic by 2014, which means that there will continue to be a demand for individuals with health care expertise who can manage these changes.

How would you describe your teaching style?

My philosophy is to encourage students in critical thinking as well as the application of the knowledge. Based on my 15-plus years working in health care management, I can provide students with real-life examples of events and circumstances I've experienced that we can use as case studies in class.

Q&A by Amanda Dabbs

Photo by Martha Rial

The Point is a magazine for alumni and friends of Point Park University.