The Reality of the First 30 Days

Here is something not mentioned in the glossy brochures: the first 30 days of an online MHA program can feel like you fell into someone else's nightmare. You're struggling in a learning management system crafted by people who likely have never used a computer. You are reading papers about healthcare policy at 11 PM while dinner begins to congeal on the counter. Your family gives you that look—the one that communicates, they were on board and supportive of this idea, but now they are not so sure. This is all completely normal. In fact, this is exactly what everyone goes through, without fail.

Building Systems for Success

As cheesy as it sounds, the difference between someone who completes the program and someone who does not is not intelligence or even prior knowledge: it's a system to build and follow. Think of your online MHA program as your second job that will pay off in future earnings—like all jobs it starts with establishing a workspace, whether that means putting up a folding table in a corner of your bedroom or finding some other place with good lighting. Or it might mean getting a calendar system that works for you, if that's color-coded Google Calendar or paper planners that function for your historical look back. And, that means figuring out a way of communicating clearly with the other people you live with about your study time and why it's worth. The person who is just figuring they will "wing it," and will complete assignments whenever the opportunity arises, is headed for a violent awakening around the sixth or seventh week of the semester when three big assignment are due simultaneously.

The Emotional Reality of Returning to School

Let's discuss a very uncommon aspect that is absent from most promotional brochures: the emotional turbulence of returning to formal schooling after several years in the workforce. You've done your jobs well enough for several years to be confident you've been competent and perhaps even exemplary. You are respected in your field. You have made decisions and taken actions that have affected other people's lives and livelihoods. Now all of a sudden you have slipped back into student mode to submit assignments for a grade, often receiving comments on your assignments that hurt, even if your professor was trying to be constructive. There is an interesting fragility in that role. You are bound to have moments—probably more than you want—where you question whether you are cut out for this. But remember those moments are data points, not truth. Everyone in your cohort is likely experiencing them too, although most of them are too proud to admit it in the discussion forum.

The Power of Your Cohort

Cohort deserves more attention than it typically gets. Cohort members will become your professional family in ways you cannot even begin to fathom. You will even know their writing styles so well you can tell who wrote something without looking at their name. You will learn that Jennifer is up early and thinks deeply and posts her thoughts around 6 AM. You will learn that Marcus is a real night owl, who writes and thinks best past midnight. You will learn that David has been in rural health for fifteen years and has stories that should be required reading. You will learn that Priya is living through the delight and distress of her hospital system and its current merger that you are following alongside the case studies. They are not just classmates, they are your future colleagues, references, sounding boards, and potentially future business partners.

Geographic Diversity as Strategic Advantage

But here's the nugget of interest: The professional network you build while a part of an online program can actually be geographically wider and have more strategic value than in a brick-and-mortar program. In a brick-and-mortar MHA, you will likely have classmates who come from the general area. An online program may have you working on a group project with someone in Seattle; another person in Atlants, and yet another, in Phoenix. Five years on, you are looking for a job, and considering a move to a new market. You will have real contacts at that market who know what is going on in healthcare. The above scenario is not just theoretical — this is how the hiring process in healthcare works at the leadership level. My contact hears of a new position before it is posted anywhere, and sends you a note.

Understanding the Curriculum

Healthcare Finance

You should think about the curriculum as more than another overview. Let's take a "standard" healthcare course that every MHA program has: Healthcare Finance. On paper, this looks boring. In reality, thou will learn why hospitals are obsessed with this thing called "days cash on hand" and why a facility can provide excellent clinical care while also going broke. You will learn what makes hospital pricing so crazy; in hospital price listing called a "chargemaster", the fees listed are often 2-3, or more, times higher than the actual prices paid. The reimbursement that a facility receives from the insurance company has little to do with the listed price. You'll understand why emergency departments are often money-losing departments that are operated by a hospital because they are often required to do so by law and serve as feeder systems to high-margin inpatient admissions. This isn't some abstract notion, but rather the financial realities that drive nearly every decision made by the administration of healthcare organizations, and appreciating the importance of this knowledge, will likely alter your view of your organization.

Healthcare Policy and Law

Or let's consider another required component, Healthcare Policy and Law, where you will read through component legislation such as the Affordable Care Act, HIPAA, the Emergency Medical Treatment and Labor Act (EMTALA), and the Anti-Kickback Statute. These are not dusty laws in pamphlet form but rather rules of the game or the laws of financial and legal engagement that dictate what your organization can do and cannot do. You will understand why a hospital organization cannot simply refuse to see uninsured patients in the emergency department, what was so cautious about physicians' practices when it comes to referral arrangements, and how payment programs like Medicare or Medicaid provide not only reimbursement but regulatory systems and rules that dictate everything from staffing levels to quality metrics. When you finish this coursework, you will walk away as the person in the room that actually understands what the compliance officer is talking about, and that is probably much more important than you realize.

Quality Improvement and Patient Safety

The quality improvement and patient safety coursework is an area where many learners find surprising rigor. In this sequence, you'll are probably pretty familiar with methodologies like Lean, Six Sigma, or Plan-Do-Study-Act cycles. However, arguably "heaviest" lift in this area is the examination of real cases of serious medical errors — some of which resulted in death — and working backwards from the event back to the systems failures that took place that lead to the error to begin with. This is generally not comfortable material.

Healthcare is the only sector where mistakes can lead to death, and you'll learn how it happens and what leaders can do to stop it. You'll be introduced to "just culture," a concept that distinguishes and differentiates human error (which should be met with support and system improvement) from reckless behavior (which deserves accountability). The best online programs incorporate guest speakers who've endured a catastrophic patient safety crisis or worked to improve a facility, and their insights can be far more interesting than a textbook.

The Writing Component

Here's one more thing that potential students are surprisingly underestimating: the writing. Because of all the writing. Discussion posts, case analysis papers, research papers, policy briefs, executive summaries, strategic plans. If you haven't crafted a formal academic paper since college, adjusting to writing level and styles can be shocking. The good news is that most programs have built-in writing support—tutoring services, writing centers, professor feedback. The even better news is that writing will make you better at your actual job. Healthcare administration requires writing all the time—memos to staff, reports to boards, proposals to executives, emails to the physicians who will scrutinize every word you write. How clearly and precisely you write in school may carry over to your professional writing.

Group Projects in the Online Space

Group projects—the perennial source of dread for students—are transformed in the online space into planning projects that can be as irritating as they were on campus: scheduling Zoom meetings across three time zones, working with the individual who ghosted for a week, or trying to navigate everyone's work style and work product standards.

However, this is representative of contemporary healthcare leadership. You should get comfortable managing teams across multiple sites, people you will not see in person often, and people you have polar opposite preferences for communicating. The group project that drives you bananas in your second semester is preparing you today for skills you will engage with every week for the balance of your career.

The Value of Residencies

And then the residencies, if you have a program that utilizes residencies, are worth mentioning. In general, residencies occur on campus or somewhat conference hotels and run from Thursday evening, arriving late afternoon or early evening, to Sunday afternoon. You will finally coordinate with the faces, or not faces, you have seen as profile pictures. I can guarantee there will be a point in the evening of that first time together, when everyone seems to be somewhat awkward and wonder if the connections made online will happen in person. They will, if anything, more acute than you expect. You will have conversations until too late about the field at the bar. You will engage in simulations, where you may be pushed into an extemporaneous discussion about a managing a PR crisis after a patient safety event, or presenting a budget request to mock board of directors. You sit in panels with leaders of healthcare in your community, and they talk about the industry in ways they would never do in a census recorded online session. Upon leaving the residency, your cohort will feel like tentative friendships, not networking spent together in your course for the last several months. You will start to engage from the bottom of your cores, if not already engaged online.

Technology Competency

Another, underrated reality is technology competency. You don't have to be a tech wizard to succeed in an online MHA, but you need to have a baseline level of comfort with digital tools. You will be using video conferencing, collaborative documents, presentation software, data analytics programs, and various other specialized platforms. If you feel anxious at the thought of learning new software, that is actually a good thing - it means you will take the process slow and deliberate. What will not work is avoiding the technology and hoping that someone else does it. You will gain one of the most valuable meta-skills you will need in a career with a healthcare administration degree—you will be prepared to learn new technology quickly and easily. That particular skill set is useful in healthcare administration in the age of electronic health records, telehealth, and data analytics.

Evaluating Programs

The Application Process

The application process is also revealing if you know what to look for. Watch how responsive the admissions team is to your questions. If it takes them a week to respond to one simple question via email, that may be a reflection of how the program operates. Consider whether the program will offer you a chance to speak with current students or alumni. Programs that are confident in their quality will help connect you. Once you talk to alumni, focus on asking direct questions. What was the area of the program that was weakest? How accessible were faculty? Did the career services help with a job search or were they simply checking boxes? Were there hidden costs beyond tuition? Alumni who give you honest, nuanced answers are worth their weight in gold experience!

Financial Planning

Financial planning requires more nuance than simply evaluating total tuition. There are technology needs—upgrade your computer or purchase software. Then there's the cost of textbooks and course materials, which could realistically add several hundred dollars per semester, even considering the proliferation of digital options. And there are always opportunity costs to consider: will you not be able to pick up extra shifts and side jobs that could produce income while earning your degree? On the other hand, some employers will promise to keep increasing tuition reimbursement should you keep a specific GPA, creating incentive structures for fairly strong performance. Some students find valuable support in creating a dedicated education savings account months before applying to programs of study, building a buffer that alleviates financial stress during the program.

Understanding the Job Market

And there are some quirks to the job market for MHA graduates that are helpful to understand. While a degree is a notable credential, it is not a guarantee. Successful graduates see value in the strategy about moving through careers. They rarely are simply ushered directly into C-Suite posts. They most often secure lateral progressions into areas providing adequate exposure (moving from a clinical department manager to a strategic planning analyst, for example; or moving from an operations coordinator to an assistant administrator position). Sure, these moves may not signify pay raises right away. They do, however, post you into the next opportunity for senior leadershnip.

The MHA program is an opportunity to open doors, but then it becomes your personal responsibility to walk through those doors and work to prove your worth on the otherside.

Regional Healthcare Differences

Regional differences in the healthcare marketplace can be more significant than most people readily acknowledge. If you are attending your MHA program in the Northeast, you will be experiencing a large academic environment and integrated delivery system environment. The Southeast has a distinct character that leans heavily to more profit-motivated hospital chains coupled with a different payer mix. The West Coast has been ahead of the curve around value-based opportunities as well as population health models. The Midwest and some rural communities face distinct challenges related to provider shortage and facility closure. An online program with a national or diversified regional student cohort offers you insights to these differences that you would not achieve purely from your local perspective. You will learn of payment models you have not experienced, and regulatory complications that don't exist in your community; you are being exposed to how healthcare actually works lean without boundaries.

Specializations: To Choose or Not to Choose

The decision to rack and gain Specializations relative to your MHA degree is contingent upon circumstance; in other words, it could be an academic advantage or a confounding consideration. If you absolutely know you are going to follow health informatics because you have been working adjacent to IT systems in hospitals for some time, then a specialization makes lots of sense. If you do not know what you want to study past or aside from the MHA, then generalist MHA track often leaves lots of options open. Students advance the decision of specialization too much and feel that it may have them pigeon-holed. The reality is, the core competencies expected to be advanced through MHA are the most important. The important competencies are related to financial management, strategic thinking, policy understanding, operations, and most importantly - leadership. Specialization is more like a cherry on top of your academic diploma, or advanced degree, and somewhat more about indicating interest to your employers than it means any promised opportunity in to work along those lines.

The Capstone Project

The dissertation or capstone project that most MHA programs utilize is often a challenge for students. The capstone is challenging when comparing it to other course work that occurs on a semester timeline. The capstone is often more ambiguous than the progress of course work because you enter into a faculty-student contract to obtain academic support on the project you identify literature around contact you go to review the prospective client organization. The capstone project has the student identify and understand a real problem facing an organization; and after identifying the challenge - the student would logically predict the solution the organization would need to implement using evidence-based practices. Some faculty students will identify or elect to work with their organizations because of the advantage of relevance the organization presents to the student providing the opportunity for learning; and typically, the faculty assigns ease to resetting the project to visit their agency and some degree of access to their data if necessary. Other MHA students will want or purposefully seek discontinuity by way of partnership; thus, these students may learn a new organizational perspective, along with the professional connections along the way to ensure they work at maximizing the associated benefits of the capstone experience.

The most successful capstones are those you are genuinely curious about the problem, not just "checking off" an academic requirement. That intrinsic motivation will carry you through the moments you are sitting in front of a blank screen and wondering why you think this is a good idea.

Work-Life-School Balance

Work-life-school balance is likely the greatest challenge of an online MHA and one that you are least prepared for. The flexibility of asynchronous learning is a huge benefit, but the drawback is that school creeps into many parts of your life. You are tempted to "squeeze in" readings at lunch, listen to recorded lectures while commuting to work, and post discussion responses while half-heartedly watching your child's soccer game. This multi-tasking or "cramming" may work for a few weeks, but over a two-year program, it will lead to burnout and resentment. The healthiest approach-simply put-is to set boundaries. Choose the times you complete coursework, and protect those times. Equally as important, choose the times when you will absolutely not be working on school. Your brain needs time to recharge. Your relationships need time to nurture. Your physical body needs time to exercise and sleep. There will always be students who want to do everything at the same time, and these students do nothing well.

Dealing with Imposter Syndrome

Imposter syndrome is rampant in graduate programs, possibly even more prevalent in online formats where you cannot see all the aothers struggling in their own way. You read a brilliant discussion post and presume your classmate must have written it in five minutes, when in reality they may have written and revised that post for two hours. You may receive a critical report from an instructor, and begin to feel, perhaps even believe, that you aren't cut out for this. That somehow everyone else around you is far more intelligent and competent than you are, and that it was a faux pas to even apply to school in the first place. It is almost astounding how ridiculous these ruminating thoughts are and yet, so convincing. Connection is the antidote. Chat with a classmate or two. Participate in your professors' virtual office hours. Utilize the mental health services that allow even for online students that almost all universities now provide. Acknowledge all of this is part of a learning experience and remember that struggling is not failing - in fact, it is clear evidence that you are being properly challenged.

Managing Your Employer Relationship

Similarly, the relationship you'll have with your employer in an MHA will need to be juggled. Some employers are unbelievably supportive, providing tuition reimbursement, some flexibility in scheduling, and some examples will allow you to link the course work with the organization to the benefit of both parties in redeeming assignments; some will be supportive in spirit but not much in practice; many assume "no change" in your performance (even when you are now committing 40 hours to MHA school), with no sense of reality. I'll stress this for you again - its so important, COMMUNICATE and DOCUMENT! Have an explicit early conversation about what the expectations are. If your employer is providing financial support, ensure you understand the implications on your performance before they offer their assistance. If your employer provides financial assistance for your education, many employers will have you sign some type of service agreement which requires you to stay with the organization for 2 years or, for the amount of assistance repay the organization. Make sure you are following up, and always get it in writing. And, be genuine with yourself - if in your position you are working 60 hours a week and being asked to respond to events on weekends and often working 1-4 hours each way from the office on weeknights, any grad program implication will not be possible. No matter how unrealistic the position you are currently in appears, it is unsustainable without adjustments.

Creating Your Study Environment

Let's talk about something that may seem trivial but isn't - a word about your studied environment. If you are working on coursework while you are half watching Netflix on your couch and no prior training to establish your studied environment, you will be inefficient and retain little. An essential aspect of your work as a healthcare administration professional is a space that signals your brain that "this is work time." You don't need anything fancy—just a desk, a comfortable chair, decent light, reliable internet, and a door you can close if you can. Some students even buy noise-canceling headphones. Others make a playlist of instrumental music to help them focus. Small changes in your environment can have disproportionate effects on your ability to focus and do good work. This is not just indulgence; this, too, is recognizing that part of the framework which helps you succeed lies outside of what is articulated in the textbook, as well as the physical environment in which you learn.

The Evolution of Your Thinking

It's also worth thinking about, or even journaling about, the evolution of your thinking through the course of the program. In your first semester, you will consider problems in healthcare largely through the lens of your current role and experiences. By the end of the program, however, you will catch yourself thinking systemically or in a way that accounts for the relationship between policy affecting reimbursement and reimbursement affecting organizational strategy affecting operational decisions affecting front line workers affecting patients. This is the entire premise for graduate education, because it is not just about learning information; it is also about learning to think about that information in a different way. You will even start reading healthcare news differently as you begin to think about the information in it for implications beyond what is being reported. You will participate in work meetings differently, as you will find yourself connecting comments from others to concepts you have been studying. This meta-awareness associated with your own professional development is tremendously satisfying.

Professional Organizations

The professional organizations associated with healthcare administration—ACHE (the American College of Healthcare Executives), MGMA (the Medical Group Management Association), HFMA (the Healthcare Financial Management Association)—may even become newly relevant to you after starting the MHA program. Many students brush these off as outdated organizations for networking old people who have drifted away from contract work. That's short sighted. There are substantial discounts associated with a student membership. The conferences will offer the best learning enhancement and opportunities to hear and engage with the executives at the top of the field. Additionally, the opportunities for credentials that come from these associations, particularly the FACHE credential from ACHE can benefit your career greatly. It is even possible that your program has incorporated some professional association engagement as a course or offered a group discount. All of this builds off of the investment you have made in your MHA.

The Hidden Curriculum

The so-called hidden curriculum with an online MHA – the learning opportunities that we engage in with one another, outside of syllabus material after a few days of working together, will I am certain offer you the same, if not more value than the curriculum portion of your experience. You will learn to influence people in whom you have little face to face contact, you will learn to detect emotion under writing, you will learn to summarize complex subjects succinctly and persuasively, you will learn when to hold your ground during group consensus and when to concede, you will learn to graciously recover from mistakes. These may not be the skills you include on your transcript, but these are the abilities that will differentiate competent administrators from inspirational leaders.

Advice for Students at Different Career Stages

Early Career Students

Students who are earlier in their careers might find the online MHA program takes a quicker path to a graduate level degree, but it may feel intimidating to enter a program with students who have 20 years of healthcare experience and diversity. Intimidating or not, you will have even more collective experience and perspectives to learn from. While you're contributing the fresh perspectives and digital fluency you bring, don't be afraid to acknowledge what you don't know. The field needs people who find common ground between traditional healthcare management and new trends. Your slightly removed point of view can provide a service to the field.

Experienced Professionals

If you are a student earlier in your career, the online MHA could seem like a way to validate and formalize something you already learned through experience. While validating is important, you should also push yourself to keep an open mind for new ways of thinking and challenge what you think you already know. Students who get the most from graduate education, irrespective of age, are learners who remain intellectually curious and challenge long held assumptions and positions around their prior knowledge. Your experience as a professional learner is a gift that adds to your contributions to the classroom, but try not to be the person who responds to every concept with "well, in my organization it's different" without engaging the fundamentals underneath the concept.

Life After the MHA

Finishing the online MHA program will be less of a finish line and more of a transition point. You will leave the program with a credential, more knowledge, and a broader professional network. The thing that can measure success will be in the months and years later, did you apply what you learned, or did it fade away in your life? Did you continue building the relationships, or did they just fade away? Did you continue to learn and grow or did you read the last chapter of the educational experience? The healthcare leaders who flourish see the MHA not as a destination but as a platform to support ongoing development. Change in healthcare happens so fast, no educational experience is going to last indefinitely. What a degree teaches you is to learn, to analyze and to lead (and, assuming you embrace those meta-skills, the content is almost secondary).

Is It Worth It?

On the question of whether it is worth it to get an online MHA, the answer is about what you do with it. The degree will not change you into a leader if you weren't going to do the work of leadership. It won't get you a promotion if you don't work in a way that builds relationships and demonstrates value at the current level. What it does get you is: legitimacy - we gave you a credential; knowledge - we gave you skills you didn't already know; skills - we gave you a way to contribute to organizational efficacy, and access - we gave you a way to have moments in relationship with decision-makers. Those factors give a lot of people in healthcare administration opportunities that did not exist before. It will be challenging. You may question if it was worth it, or if you were right to even attempt the program. But if you are reading this and nodding, observing your own ambitions and issues in these words, you have the answer. The question will be if you are ready to make the commitment to the work.