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Posts tagged ‘affordable care act’

The Affordable Care Act isn’t a Benefits Change – It’s a Culture Change

acaToday’s guest post is courtesy of Sharlyn Lauby, better known as the HR Bartender.  You can learn more about how the ACA and how Kronos can help you comply with its employer provisions at

One of the hot topics at this year’s KronosWorks 2013 was the Affordable Care Act (ACA). Even with the delay in the company mandate, employers are taking this time to do extra research, specifically where it applies to implementation best practices.

The sessions I attended regarding the ACA were a reminder that, while strategy is important, execution is critical. Organizations are taking the implementation of ACA very seriously. The conversation was a thoughtful and lively exchange about how to implement this very complex law while maintaining the business operation and keeping employees satisfied with their jobs. Some of the key takeaways I learned during the ACA sessions include:

The Affordable Care Act requires a culture change. The ACA isn’t considered an HR issue. It’s a law. And organizations have to develop and implement a strategy that will be used on a daily basis. Organizations are viewing the decisions they make regarding the ACA as culture decisions (versus benefits decisions).

Every department needs to be involved in the strategy and implementation of ACA. This directly reflects the first point. Business professionals agree – you cannot manage the ACA after the fact. The professionals I spoke with talked about the many departments being touched by the ACA:

Senior leadership to set the strategy.

Human resources to ensure compliance and craft the policy.

Finance to manage resources and finances associated with the Act.

Operational managers to monitor schedules and manage daily activity.

Many organizations are having to revisit their staffing models. As a result, some employees will become full-time. Instead of trying to figure out ways to keep employees part-time, many organizations acknowledge that the ACA is making them ask the question “Should this be a full-time position?” In some cases the answer is yes.

Speaking of staffing models, another topic brought up was the notion of giving hours to the best workers. We all know how this works. There’s a last minute project to be completed. Often because both skill and speed are required, we ask the fastest, most qualified employee. But what if we can’t now because the extra hours will reclassify their status? Organizations are trying to figure out how this potentially impacts the talent they currently have and skills they might need if they have to develop a contingent workforce.

Employers are concerned about losing employees who don’t want to be full-time. We often make the assumption that everyone wants to be full-time and it’s simply not the case. Employers who have created part-time positions to accommodate employees are concerned that employees will leave because the positions aren’t as flexible as they used to be.

Full-time employees who currently have benefits are impacted as well. In the past, full-time employees who wanted to cut back a few hours were fine – it didn’t jeopardize their status and another part-time employee could pick up the hours without overtime. Now, full-time workers will need to maintain their full-time schedule because those hours being passed along to a part-time employee have greater implications than just payroll.

Everyone agreed the key to managing the ACA successfully will be effective management of workforce data, reports and analytics. Debbie Baum, HRIS director at the YMCA of Metropolitan Dallas shared their plan. “We’re not changing our full-time/part-time mix of employees because of the Affordable Care Act.  We’re not going to cut hours to avoid paying healthcare.  We are going to manage the scheduled hours staff were hired to work.” Unlike the YMCA, this level of data collection and review could be new and different for some organizations. It might take some getting used to.

The Affordable Care Act’s complexity mandates that organizations dedicate time getting their strategy right on the front end. Smart organizations are using this additional time wisely, to identify their focus as a result of the ACA. Troy Jackson, employment and performance manager at Firekeepers Casino Hotel in Battle Creek, Michigan said it best – “We want to be an employer of choice. Employees who work full-time hours will get full-time benefits. It’s the right thing to do.”

The Affordable Care Act is more than a new law about health care benefits. It’s a definition of corporate culture.

Related Posts:

Talking About The Affordable Care Act With Dr. Tim Porter-O’Grady

Engaging Health Reform

Part Time Workers Confused by the Affordable Care Act

Results of the Workforce Institute Affordable Care Act Worker Survey


Engaging Health Reform

patient gurneyToday’s guest blog post is courtesy of our board member, Tim Porter-O’Grady, DM, EdD, ScD, FAAN, FACCWS.  Tim brings a deep and informed perspective to the implications of the Affordable Care Act for workers, their employers and healthcare providers.  What’s your organization doing to get ready to comply with the Act?

The Patient Protection and Affordable Care Act (PPACA) is well on its way into the fourth year of implementation. Looking past the strident political machinations, human resource leaders need to now deepen their understanding of its components and characteristics and what it actually does to improve the lives of workers and how it addresses long-standing health concerns of management. For the first time in the history of American healthcare, there is a drive to achieve real health value and ultimately to change the health status of the American population.

This focus on value economics now means that there must be increasing evidence of impact in health services.  The longstanding dependence on a tertiary care model where we wait until employees get sick and then undertake a flurry of activity to address the problem leads us to higher levels of cost and a lower capacity for a sustainable positive health outcome.  Our primary care foundations or infrastructure is not yet so well developed to a level that we can focus on preventing the conditions and circumstances that lead to our highest priced illnesses and conditions. One need only look at the overwhelming problems we are now confronting with the challenges and cost of treating an uncontrolled level of diabetes directly related to obesity and the high sugar, high fat diet in the U.S. The costs associated with treating diabetes and its co-morbidities over a lifetime far outstrip the costs associated with early addressing the practices and behaviors that lead to them.

The PPACA now emphasizes efforts that directly address health concerns and issues that can prevent the later onset of illnesses. Regular screening for high risk health issues can now be incorporated into health plans in a way that addresses both illness prevention and related costs. In addition, free preventive services are provided for potentially high risk, high cost services such as abdominal aortic aneurysm, alcohol misuse, blood pressure, cholesterol, colorectal, depression, type II diabetes, HIV screenings, diet counseling and immunizations (hepatitis, herpes, papilloma virus flu, measles, mumps, rubella, pneumonia, tetanus, diphtheria, pertussis, and varicella). In addition, free counseling is available regarding obesity, sexually-transmitted diseases, and tobacco use. Since many if not most employee related sick days are the result of these identified health problems, there is a potential for significant cost benefit for employers to assure their employees participate in these free preventive services.

Provider performance now emphasizes those activities which prevent accelerating utilization of high intensity health services and repeated admission to health services because earlier services were inadequate or ineffective. Recidivistic health care will simply not be supported or funded if it represents poor provider practices or ineffective standards of care. The PPACA now requires that providers “get it right” by assuring the application of evidence-based protocols and best practices for defined episodes of care. Besides accelerating the potential for quality care, the impact on the cost of that care of more effective provider practices will be significant.

Providers will now be incented not only by price but also by quality.  Competition between plans and providers now include measures of impact especially as it relates to comparable measures of quality of service.  Quality measures will now include clinical comparative effectiveness and user evaluation of service satisfaction. Imbedded in health reform is the intent that the system must ultimately produce a healthy population, not simply treat its ails and illnesses. In fact, the notion that admission to a hospital bed is evidence of the failure of the system to better address the health needs of the person plays out as a theme throughout the PPACA.  Beginning January 1st, 2015, physicians and other providers will begin to be paid for value not for volume. The question in this climate for the provider is not how much did I do for persons but rather did I make any difference for individuals in what together we chose to do in their best interests.  Those providers than can advance the quality of service and care at the same time as carefully managing its costs will be positioned to reap value-based rewards.

For employers and their health plans, the net aggregate value of this shift in design, delivery and outcome in the PPACA provides one of the strongest efforts to date to get at real issues of health-driven care and service. It is now time for employers who have a large stake in a healthy workforce to reinvigorate their own efforts to partner with their health plans in the pursuit of early engagement health services, primary care health interventions, and the pursuit of healthier life choices. The impact of such an effort will accrue to both healthy workers and a healthier bottom line.

 Related Posts:




Spring, Asthma, And the Affordable Care Act

I’m writing this while sitting in a parking lot waiting for a doctor appointment. Spring has finally sprung here with its fecund riot of color and accompanying plague of pollen. I love the former. The latter never bothered me until a few years ago when I suddenly became allergic to something that appears in the spring. This new allergy led quickly to asthma, another new development in my fifties. Armed with easy access to doctors, Flonase, Advair, Albuterol and the occasional visit to Prednisone land that turns me into a steroid induced superhero, my asthma is under control.

But what if I didn’t have this medical access? What if I had to procure medical services and medicines by paying 100% out of pocket? What if I wasn’t able to pay those bills? Asthma debilitates millions and kills thousands of people in the US every year – many of those deaths preventable according to experts. And asthma is only one of many chronic diseases that families have to cope with.

Which brings us to the Affordable Care Act. Lots of controversy has swirled around the 974 page act. Its driving objective is to ensure that all Americans have access to affordable health insurance and thereby to affordable healthcare. Everybody needs to comply with its provisions- individuals and employers – and therein lies much of the controversy.

If you’d like to join the conversation and tell us how you feel about the ACA, you can join Sharlyn Lauby (The HR Bartender) and me for a tweet chat on #KronosChat on 5/16 at 12pm. We’d love to hear how your organization is preparing for the full implementation of the Act in January 2014.

This week we’re reading about:
Does HR Have a Self-hate problem?
Can there really be a high-availability cloud?
Why healthcare must embrace the cloud
Puma optimizes productivity
How Obamacare will affect your business
Will Obamacare lead to millions of part-time workers?
What should you pursue if you don’t have a passion?
There’s a Little Bit of Expert In All of Us via @hrbartender
Why Stepping Back and Making It Simple Solves Everything via @TLNT_com
Connecting Work/Life Balance to Turnover via @HRExecMag
In a Big Data World, Don’t Forget Experimentation via @HarvardBiz
What a Flexible Workplace Has to Do With Trust and Creativity via @Inc

Kronites are talking about:
New Time Well Spent #Cartoon: #overtime
RT @sreeseRNMBA: It was a “fanoos”. Read about it at Time To Care #NursesDay #Nurses #nursesweek #FlorenceNightingale
RT @SmarterCafe: The #cloud makes #Kronos want to be better.
Part-time Workers Confused by the #AffordableCareAct via @WF_Institute
“Dying ain’t much of a living” via @SmarterCafe
Hockey and the Cloud (in that order…) via @SmarterCafe
@ODOT_Statewide Fast Tracks Workforce Management with #Kronos
@PUMA Optimizes Productivity via @risnewsinsights
Less Cost, Less Time, More Productivity — Take Workforce Management to the #Cloud
#Kronos Survey Shows Many Part-Time Employees Confused About #AffordableCareAct; Not Getting Much Help From Employers
Times have changed. Your #HR and #payroll processes should, too. #paycon
[INFOGRAPHIC] Are you confused about the #AffordableCareAct? You’re not alone! Join #KronosChat on 5/16 at 12pm.
Is 33% of a nurse’s time spent on administrative work too much? #NursesWeek
@sreeseRNMBA’s interview with @am800cklw on addressing nurse fatigue within healthcare institutions. #nursesweek
#KronosCloud Growing at Breathtaking Rate; Kronos Reports Outstanding Second-Quarter Results:
Webinar Reminder: Benefits one manufacturer saw with an integrated #HR & #payroll solution #paycon