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Will Affordable Care Act Ultimately Result in Greater Contract Labor?

Posted by Tim Teague on Tue, Jun 21, 2016 @ 02:32 PM

Two of the driving tenets of the Affordable Care Act are the push for better patient outcomes and reduction of costs. Since labor spend accounts for the largest percentage of acute care expense, it is a prime target for cost cutting.

 

This presents a conundrum for the hospital. How to cut labor costs while improving the quality of care (decreased re-admission rates).  A corollary to this dilemma has been the “just-in-time” staffing models the industry has used for years.  The difference is while a manufacturer can judge work in process by the amount of incoming orders, the healthcare industry has not been able to predict the number of orders (average length of stay) in a reliable manner.

 

Peter Drucker, foremost business analyst declared just before his death in 2005 that “increasing the productivity of knowledge workers was the most important contribution management needs to make in the 21st century.” The question here is how can data be used to transform the healthcare industry to both decrease costs and improve quality?

 

The answer is equal parts simple and complex. There is enough historical data from millions of hospital admissions across the country to fine-tune a census model that provides extremely accurate daily figures for a unit-by-unit count. Several firms have been working on the analysis of these figures for years. In the same way the electronic medical records have grudgingly made their way into our healthcare system, strategic census models will soon be the norm.

 

When this data becomes granular for hospital systems, the current models for large scale census predictors will become extinct.  This new model for just-in-time staffing will finally provide a day-to-day, week-to-week picture of labor needs. Fine tuning the levels of FTE’s will become better, and non-fixed-cost labor will boom.

Tags: Affordable Care Act, Staffing Agency, Affordable Healthcare Act, Contract Labor, staffing

Don’t Let the Affordable Care Act Penalties Sneak Up on You!

Posted by Tim Teague on Wed, Nov 19, 2014 @ 06:30 AM

sneak-upAmidst the back and forth, the delays, and the political posturing surrounding the Affordable Care Act, DON’T FORGET THERE ARE SIGNIFICANT PENALTIES for employers for non-compliance.   The penalties are only for employers of 50 or more FTEs, but if your firm suddenly hits the 50 FTE threshold, penalties can accrue monthly. 

In simple terms, if you offer health insurance that covers at least 60% of costs, and the cost to the employee is not more than 9.5% of their family income, you should be safe. However, if just one employee elects to participate in an exchange, or receive a tax credit outside your company, your company will be flagged for non-compliance. Despite proof of valid coverage, you will need a paper trail that confirms compliance for every employee. This is where electronic signature technology can uncomplicate your administrative burden and provide a legal paper trail to assist in complete compliance. The penalty could be a minimum of $3,000, but for a small firm with 50 employees, it could be as much as $40,000 annually!

We have a sample document that is already loaded by our suppler, YouSignHere. This assures that each employee has been offered coverage, and what their election was.  

If you are interested in seeing that document and how to use YouSignHere for your healthcare election coverage forms please click below and we will be happy to send it to you for download.

Get my Free ACA Election Form

Tags: Affordable Healthcare Act, YouSignHere

What should the healthcare staffing industry expect from the ACA?

Posted by Doug Word on Tue, Jul 16, 2013 @ 10:04 AM

healthcare newsThe Obama administration announced earlier this month that it will allow businesses an extra year to comply with the Patient Protection and Affordable Care Act (ACA).

The law was originally slated to kick in Jan. 1, 2014 but the date for compliance has now been pushed back to Jan. 1, 2015. It will then mandate employers with 50 or more employees to offer minimum-value insurance and cover 95 percent of those workers through so-called employer shared responsibility requirements.

What should healthcare staffing agencies expect from this adjustment and from the ACA itself?

The announcement gives employers time to study whether or not complying with this facet of the law is in their best interest and plan accordingly. They will still have the option to “play,” meaning comply, or “pay” the government-mandated fine for non-compliance when the time comes.

The delay will benefit larger organizations that were prepared to remain well above the 50-employee threshold. Reporting requirements to the Internal Revenue Service (IRS) can now get pushed back a year for employers, insurers and other reporting entities without fear of penalty.

The reason behind the administration’s announcement to allow employers an extra year to prepare for implementation centered on the “complexity of the requirements and the need for more time to implement them effectively,” according to the Department of the Treasury.

Treasury also put forth two goals: (1) simplification of the new reporting requirements consistent with the law, and (2) adaptation of the health coverage and reporting systems.

Industry analysts have differing views on the influence of the act itself.

Justin Junkel, vice president of finance and analytics at Pinnacle anticipates four major developments as a result of the health care law:

  1. Companies will transition lower-skilled workers to shifts of less than 30 hours per week.
  2. Staffing firms will increase markups or bill rates to offset the costs of providing healthcare coverage and the associated administrative expenses.
  3. Health plans will adjust their costs to fall closer to the ACA minimums.
  4. The overall cost of healthcare coverage will rise over time, as companies make process changes to comply with ACA requirements.

Junkel also noted, “The ACA will result in cost increases for staffing firms, due to the requirement of providing healthcare coverage to previously uncovered employees or paying the taxes associated with not providing affordable coverage.”

Jeanne Knutzen, founder and CEO of the PACE Staffing Network, said:

“We are anticipating that the costs to become fully compliant with the law will require most staffing companies to ask for a two-to-four percent increase in client bill rates, just to break even; anywhere from 16 to 35 cents per hour.”

The ACA could help the temporary staffing industry in this way: some companies will want to remain below the 50-employee marker and turn to agencies with temporary and part-time labor.

Jay Hancock of Kaiser Health News said, “By requiring employer coverage only for those who put in at least 30 hours a week, the act appears to create an incentive for companies to do less with permanent workers and more with part-timers, which are the main focus of staffing agencies.”

Another workaround for the industry could be a regulation the IRS created last year known as the "look-back/stability period safe harbor method.” It essentially gives employers of “variable hour” labor, like staffing agencies, 12 months to determine whether or not an employee is a temporary worker or full-time worker deserving of health care benefits.

Bernard Wolfson of MEDCITY News noted, “The Affordable Care Act probably presents the biggest challenges to employers in industries that use a lot of part-time and seasonal workers. Their hours can vary dramatically from week to week or month to month, making it difficult to calculate who is eligible for benefits and who is not.”

The emerging consensus is the ACA is a complicated law that has the potential to impact companies positively or negatively once it is implemented. Companies that will be influenced now have more time to get out in front of the issues associated with the act, but understanding and implementing a strategic plan for the future is essential.


Tags: healthcare staffing industry, Affordable Care Act, Healthcare, healthcare staffing trends, Staffing Industry, Affordable Healthcare Act, ACA

Healthcare effects more than its own industry

Posted by Jennifer Kardell on Wed, Jun 19, 2013 @ 01:04 PM

healthcarelawyerSometimes in our own careers we don't stop and think about what is happening in other industries, sometimes we don't even think how our industry can effect other industries.

Think about it, in your healthcare staffing career have you stopped think about how other career fields work, how their staffing is handled, how their scheduling is completely different. I can't be the only one who hasn't stopped to think how my non-healthcare staffing friends search for jobs, hnadle their schedules or how their daily "work-life" is opposite from mine.

Now your probably, thinking "Where are you going with this?".

When studying to be in the healthcare fields, you focus on the different paths it offers such as the types of doctors, nurses and care-giver you can become. Once choosing your healthcare path you then think about the different facilities you can work in, such as hospitals, clinics or private practices.

Now here's the curve-ball, think about those studying to be a lawyer. Sure, they have some what of the same thoughts as any other career choice, choose the type of attorney you want to be and what setting you want to work in. Did you think that they have to study the basics of being a lawyer, but they also have to step in to our healthcare world.

With the new Afforadable Care Act, Lawyers are in high demand for the healthcare industry. Even companies in healthcare who have a strong, in-house law department. If someone is wanting to become a lawyer, now is the time to specialize in the healthcare world. Primary areas to specialize in include complex hospital mergers, Medicare audits and disputes over reimbursements.

Due to the ever-growing list of unknown questions it's wise for the healthcare world to keep a strong bond with their legal departments and keeping each other in the know with the changes that are about to happen to both worlds.

Does your company have it's own in-house legal department? Has your company considered amping up the need for legal services because of the new Affordable Healthcare Act? Let us know your thoughts and opinions!

Tags: healthcare recruiting and staffing software, healthcare staffing industry, Affordable Care Act, healthcare staffing trends, Staffing Industry, Affordable Healthcare Act, healthcare reform, ACA

What will Affordable Care Act actually cost through the State Exchanges?

Posted by Tim Teague on Fri, May 31, 2013 @ 02:25 PM

describe the imageAs the Affordable Care Act moves closer to full implementation, the real test is soon to begin. As state insurance exchanges prepare for open enrollment in the fall of this year, premiums for various levels of coverage are starting to take shape. Most eyes are on the State of California as it is as close as any state to publishing hard rates.  Despite the political arguments that continue on Capital Hill, there still remains much confusion over where the rates will wind up. The following articles, one from Forbes, and one from the Covered California website depict two entirely different scenarios. The Covered California article compares rates and shows that rates on average will be between 2% higher and 29% lower through the Exchange.

The next article from Forbes points out that the comparisons are not apples to oranges and that the real comparison would show an increase through the exchange of up to 146%. 

It’s amazing that even with hard numbers there doesn’t seem to be a consensus on the true cost.  In the actuarial universe, there are several factors that determine what insurance rates are required to support specified coverage.  Two of the more important factors in rate determination are average age of insured and the total size of the group covered.  As stated in a prior blog, these two issues are going to be the impetus behind a push in the second half of the year to advertise and enroll as many younger adults as possible. Although the implementation of ObamaCare has continued its march, there could still be a few legislative hurdles before full implementation. In the world of politics, expect the unexpected.

Tags: Obamacare, Obama, healthcare recruiting and staffing software, healthcare industry, healthcare staffing industry, Affordable Care Act, Healthcare, healthcare staffing and recruiting software, healthcare scheduling software, healthcare staffing software, healthcare staffing agency, healthcare staffing credentialing, healthcare staffing trends, healthcare scheduling, staffing software, healthcare recruiting, Affordable Healthcare Act, healthcare reform, healthcare staffing payroll, ACA

Will Affordable Care Act present dilemma for Unions?

Posted by Tim Teague on Fri, May 24, 2013 @ 02:30 PM

13Several million employees across the US receive health insurance benefits through what is called a “multi-employer” plan, or otherwise known as a Taft-Hartley plan.  These plans currently cover unionized workers in retail, construction, transportation and other industries with seasonal or temporary employment. These plans are typically included in the employers collective bargaining agreements, and are typically fairly expensive.

The Affordable Care Act creates problems for these plans on two fronts. First, the current multi-employer plans will have to be significantly altered to meet the minimum requirements of the ACA. These plans will have to be modified to cover dependents up to age 26, eliminate annual or lifetime coverage limits, and extend coverage to people with pre-existing conditions. These changes will cause premiums to significantly rise over what employers have typically been paying.

The second issue that could cause problems is the attractiveness of state insurance exchanges where similar benefits may be obtained by workers at the same or lessor cost due to the subsidized nature of these exchanges.

The real question for both the ACA and Taft Hartley plans is if they can co-exist in todays healthcare market.

Tags: healthcare recruiting and staffing software, healthcare industry, healthcare staffing industry, Affordable Care Act, Healthcare, healthcare staffing and recruiting software, healthcare scheduling software, healthcare staffing software, healthcare staffing agency, healthcare staffing credentialing, healthcare staffing trends, healthcare scheduling, Staffing Industry, staffing software, healthcare hiring, Affordable Healthcare Act, healthcare staffing payroll, ACA

The Travel Industry is Better than Ever

Posted by Julie Moore on Tue, May 21, 2013 @ 10:45 AM

iStock 000012050555XSmall crop380wLate Friday afternoon I received a call from one of my favorite clients, who I have known since I first started with BlueSky, and his company landed their first big travel contract. I love these types of calls because it means my customers are growing, but I also find it ironic because at the Healthcare Staffing Summit this past October we had the discussion that no matter how much you don’t want to deal with travel it’s a necessary evil if you want to grow. These conversations I have had with this client echo many other conversations I have with current and prospective clients. Travel healthcare staffing isn’t on a rebound – it has rebounded!

History Lesson of 2009

For those of you who are new to this industry and are wondering what travel healthcare staffing is rebounding from is quite simple. The travel healthcare industry took a 50% loss in revenue in 2009. This is a huge, devastating loss in any industry. The medical staffing agencies that were not diversified with Per Diem Staffing were closing their doors left and right. It was actually the same year I started with BlueSky and I was questioning myself if medical staffing software was a good career move, but I held on and so far it has been a pretty good ride.

What is driving the Recovery?

There are several reasons why travel staffing is on its way back, but in my opinion, there is one main driving factor - The Affordable Healthcare Act (AHA).

As many companies in different industries are complaining about the increased cost of health insurance, the AHA has really been doing wonders for healthcare staffing. The AHA is increasing demand for healthcare and when there is an increase in demand of a product then the cost goes up. 

As I was talking to this customer on Friday evening he made a great point: When you look at the need these hospitals have it is impossible to find all of these candidates in one city or state. You have to go elsewhere for these candidates. He nailed it on the head.  Again, demand is the main driving factor in the increase in travel healthcare staffing.

What Makes this Recovery Better?

In my opinion the travel healthcare industry has finally recovered from its 2009 downward spiral and is better than ever. Medical staffing agencies are being more cautious in how they add expenses to their agency. They are using technology to drive their business rather than adding another head. 

Many agencies who survived 2009 have learned their lesson from the previous burst and are dipping their toes in the water but not jumping in all the way.  They realize they will need to keep their per diem division alive and well as they grow the travel staffing business. Another interesting twist is that agencies also understand the value of the MSP model for a hospital but it also helps drives predictable revenue to a staffing agency which we will talk more about in a blog next week.

We want to hear more from you!

  • Are you picking up travel healthcare staffing?
  • What has your experiences been? 
  • Did you survive the crash of 2009 and are apprehensive about travel staffing?

Tags: healthcare recruiting and staffing software, healthcare industry, healthcare staffing industry, Affordable Care Act, Healthcare, healthcare staffing and recruiting software, healthcare scheduling software, healthcare staffing software, healthcare staffing agency, healthcare staffing credentialing, healthcare staffing trends, hiring for healthcare staffing agencies, healthcare scheduling, Staffing Agency, Staffing Industry, staffing software, healthcare recruiting, healthcare hiring, Affordable Healthcare Act, healthcare reform, healthcare staffing payroll, AHA

The I.R.S. and the Affordable Care Act-what role do they play?

Posted by Tim Teague on Thu, May 16, 2013 @ 12:45 PM

describe the imageRecent news cycles have been loaded with information concerning the I.R.S.’ scrutiny, or lack thereof, of applications for not-for-profit 501 C 4 status. Most of the noise concerns the ability of the institution to adequately manage parts of the largest healthcare overhaul since the introduction of Medicare. As the I.R.S. continues to be in the spotlight, it is helpful to understand what role they are playing in the delivery of the Affordable Care Act.

First, in 2014, individuals are going to be required to carry a minimum level of health insurance coverage or be subject to a penalty. The IRS will be the agency that is responsible for enforcing that penalty and collecting the amounts from the individuals. In addition, as part of the minimum coverage requirement for individuals and the minimum coverage requirement that employers be required to provide to individuals, there will be the need to determine whether or not individuals are eligible for a health insurance premium tax credit, and the IRS will have the responsibility for determining who is eligible for the health insurance premium tax credit.

Additionally, employers are now going to be required to provide coverage that is affordable to employees. If they do not provide this coverage, they will be subject to a penalty. The IRS is responsible for setting out the rules and guidance for employers in providing this coverage as well as enforcing the rule and collecting the penalty payment from the employers. 

In 2018 there will be a tax on what is called “Cadillac” plans, the high value cost coverage that can be provided to individuals, and the IRS will be responsible for enforcing that rule and collecting any penalties for coverage in excess of the “Cadillac” plan tax limit. In addition, starting in 2012, which would have been the W2 that was provided in January 2013, employers were now required to include certain information on annual W2s, specifically the value of the group health plan benefits. So beginning with that W2 that was provided in 2013, the IRS has now been tasked with recording all the values of the group health plan benefits that have been recorded on the W2s.

Based on these substantive issues related to the implementation of ObamaCare, there is probably not another agency within the Government that could monitor and account for such a large percentage of the gross national product. Unless the Act itself is defunded, or in some way repealed, the I.R.S. will continue to ramp up to manage and administer this massive program.

Tags: healthcare recruiting and staffing software, healthcare industry, healthcare staffing industry, Affordable Care Act, Healthcare, healthcare staffing and recruiting software, healthcare scheduling software, healthcare staffing software, healthcare staffing agency, healthcare staffing credentialing, healthcare staffing trends, healthcare scheduling, Staffing Agency, Staffing Industry, staffing software, healthcare recruiting, healthcare hiring, Affordable Healthcare Act, healthcare reform, healthcare staffing payroll, ACA

Common sense and The Affordable Care Act

Posted by Tim Teague on Thu, Apr 18, 2013 @ 10:45 AM

healthinsurance.022113Picture this; a not-for-profit hospital in an urban area tracks it’s cost to provide care for ONE uninsured, homeless individual for a period of between 18 months and 2 years. At the heart of this exercise lies the impetus for the creation and execution of the Patient Protection and Affordable Care Act. Making healthcare coverage available to every American. Note an important distinction, making healthcare COVERAGE available, NOT HEALTHCARE! The subtle difference in the two is about following the money. Indigent care (i.e. care for patients that cannot pay) is a line item on every acute care providers’ fiscal budget.

Now back to that one uninsured homeless individual that was tracked for nearly two years. After discovering the cost of treating the individual, the hospital pro-actively found the man a primary care physician, a neurologist, a substance abuse treatment plan, and assisted with finding a place to live.  According to the article, this was accomplished for around $6,000.  With no insurance, and no way to pay, that seems like a lot of money for the hospital to “front”, that is, until you dig deeper, and realize that for this same patient, in the prior two year period had racked up $626,143 in charges! Although it’s probably not fair to compare the $6,000 in pro-active costs to the $626,143 billable charges, it is fair to ask where these common sense solutions were prior to the passage of the Affordable Care Act.

A couple of notable articles have appeared that support some of these common sense approaches to the escalating cost of indigent care. In Camden New Jersey, Jeffrey Brenner, MD, has identified “superusers” by a process called “hotspotting” to reduce overall costs by as much as 50%.  According to this article, the sickest 5% account for more than half of U.S. healthcare costs.

This “hotspotting” technique was the premise upon which the urban hospital in Louisville KY delivered it’s results.

Tags: healthcare recruiting and staffing software, healthcare industry, healthcare staffing industry, Affordable Care Act, Healthcare, healthcare staffing and recruiting software, healthcare scheduling software, healthcare staffing software, healthcare staffing agency, healthcare staffing credentialing, healthcare staffing trends, hiring for healthcare staffing agencies, healthcare scheduling, Staffing Agency, Staffing Industry, staffing software, healthcare recruiting, healthcare hiring, health, Affordable Healthcare Act, healthcare staffing payroll, ACA

Three Tips to Automate Healthcare Staffing Credentialing

Posted by Julie Moore on Wed, Apr 10, 2013 @ 10:10 AM

Automated Healthcare Credentialing is Key to You Staffing Agency’s Success

describe the imageWe all know by now that the Affordable Healthcare Act is a game changer for healthcare and it is not any different for a healthcare staffing agency.  Healthcare credentialing is the most time consuming and costly process in staffing but also mitigates the biggest risk of non-compliance if done accurately. 

Up until a few years ago, healthcare credentialing had been mainly a paper process but the development of healthcare staffing software has replaced paper. To stay competitive healthcare staffing agencies are going to be forced to further automate and streamline their processes. 

Here are three tips that can help push your healthcare staffing credentialing to the next level.

1. Integrate Systems

The biggest time saver and area for improvement for healthcare staffing agencies, even if you have a healthcare applicant tracking system, agencies will need to integrate their current credentialing software with a healthcare applicant tracking system and healthcare staffing software. Integration is key because it is one way to mitigate human error within the credentialing process. 

Credentialing Systems that can easily integrate with BlueSky are:

Prophecy Healthcare was the groundbreaker for online clinical competency testing and checklists for the healthcare industry. They continue to lead the industry with their new behavioral and situational exams created specifically for the healthcare professional.  Using Prophecy the integration healthcare staffing agencies can request all clinical competencies out of BlueSky and then track and manage all expiration dates quickly and easily.

Universal Background Screening is a healthcare industry leader in real time web-based background check technology.   Using Universal’s secure and cutting edge technology, through integration, healthcare staffing agency’s can reduce the risk and liability of the background check process. 

You Sign Here is an electronic signature software that is fully integrated with BlueSky to where you can not only manage all of your credentials but also manage all facility contracts and healthcare provider conformation letters.  Using all of the points of integration that You Sign Here offers with BlueSky allows your credentialing staff to trust that each document is signed and completed without error.   

2. Automate Credential Notifications

Tracking expiration dates and automatically notifying your recruits about expired licenses and other credentials is extremely important.  This gives more time back to your credentialing team allowing them to be not only more through but allows them to credential more candidates – helping your bottom line! 

BlueSky has three unique features that help credentialing teams do their job quicker and better.  

  • Auto archive old documents automatically when a new document has been received.
  • See credentials in same screen as the expiration dates which reduces the risk of entering or verifying erroneous dates.
  • Use the Healthcare Professional Portal to where the candidate can see, track and upload their own credentials proactively with an agency verification process.

3. Facility Portal

Having all of your credentials stored in one central location with facility access is a great feature to offer your clients.  If Joint Commission walks in the door to your healthcare facility they can have real time access to your healthcare applicant tracking system to see only the healthcare professionals that have worked in their facility. 

Do you know what is even better? If you are the master vendor or VMS for that healthcare facility they can have all of their temporary staffs credentials managed in one central location.  Imagine how this could help revolutionize your local healthcare facility and solidify the need for your agency working in that facility.

Overall automation reduces out of compliance risk factors.  If your agency automates processes and integrate systems into a healthcare applicant tracking software ultimately your staff choose best candidate for the job.   Remember, healthcare facility’s are going to choose agencies that will help them with their bottom line and having great healthcare professionals and great technology will help achieve this goal. 

If you are interested in how BlueSky can help you automate and streamline your process click here and fill out the form one of our sales professionals will be in touch.

Tags: BlueSky Medical Staffing Software, healthcare recruiting and staffing software, healthcare industry, BlueSky, healthcare staffing industry, Affordable Care Act, Healthcare, healthcare staffing and recruiting software, healthcare scheduling software, healthcare staffing software, healthcare staffing agency, healthcare staffing credentialing, healthcare staffing trends, hiring for healthcare staffing agencies, healthcare scheduling, Staffing Agency, Staffing Industry, staffing software, healthcare recruiting, healthcare hiring, health, Affordable Healthcare Act, healthcare reform, healthcare staffing payroll, Staffing Stream, ACA, Universal Background Screening, Prophecy, YouSignHere