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Tuesday, December 28, 2010

Major health insurers in California to resume offering individual policies for children

The companies abruptly halted the sale of individual policies for kids in September rather than comply with provisions of the nation's new healthcare law. A new state law forced them to change course. 

California's largest health insurers, fearing they'll lose new customers in the state's lucrative individual insurance market, have canceled controversial decisions last fall to stop selling policies for children.
The insurance companies abruptly halted the sale of individual policies for kids in September rather than comply with provisions of the nation's new healthcare law that required them to accept all youngsters under age 19 regardless of their medical conditions.  get a quote here

Insurers said at the time that the healthcare overhaul could saddle them with huge and unexpected costs, particularly if competitors exited the market. Their decisions prompted criticism from health activists and a spokesman for the Obama administration, who accused them of abandoning children and families.
But a new California law forced the insurers to change course. Beginning Jan. 1, it will prohibit those that abandon child-only coverage from selling new policies in the broader individual insurance market for five years — slicing into profits in a state filled with throngs of potential customers.

On Wednesday, Aetna Inc., Anthem Blue Cross, Cigna Corp., Health Net Inc. and UnitedHealth Group Inc. said they would resume sales of child-only coverage Jan. 1 for an estimated 80,000 children who are not insured through family policies or their parents' employers.

"It's good that the insurers are back in the market, even if they had to be brought back kicking and screaming," said Anthony Wright, executive director of the consumer advocacy group Health Access California. "It will make a big difference for thousands of families."

All the insurers have notified the state Department of Insurance of their intention to resume sales.
"We've let brokers know that as of the 1st, we have plans for child-only policies," said Brad Kieffer, a spokesman for Woodland Hills-based Health Net.  Cheryl Randolph, a spokeswoman for Minnesota-based UnitedHealth Group, said: "We will have child-only policies on Jan. 1.  Anthem, the largest insurer in the individual market, will work with regulators to start selling again "in the best interest of our customers in California," spokeswoman Peggy Hinz said of the Woodland Hills company.  There is plenty at stake. California's private insurance market — where individuals and small businesses buy coverage — generated $17 billion in revenue last year. The market is only expected to grow as millions of uninsured Californians buy coverage, beginning in 2014, through a new marketplace exchange set up as part of the federal healthcare law.

"California offers a significant opportunity for us and we believe we will be highly competitive in this market," Cigna spokeswoman Gwyn Dilday said in announcing the Philadelphia company's decision to resume child-only sales.  The insurers were guarded about their plans in other states. Only one, Connecticut-based Aetna, gave details, saying it would also resume sales in Kentucky, where changes in state law have required the company to rethink its approach.  "We are committed to working with states to address the issues originally raised by the change in federal law in a way that will allow us to participate in these markets," spokeswoman Anjanette Coplin said.

Regulators from the California Department of Insurance have been trying to prod insurers to start selling child-only policies once again since they announced their departure shortly before Sept. 23, when the federal healthcare law would have required them to accept all children with preexisting conditions. On Wednesday, officials sent the companies two pages of "guidance" to help them interpret the new state law.
The officials said AB 2244 requires insurers to offer children's coverage as part of all their policies, not just a select few. And they said parents must apply for the insurance during a two-month open enrollment period that runs from Jan. 1 to March 1, or in the month after their children's birthdays.

Families with sick children that apply during these periods can be charged no more than twice the standard rate. Families that apply outside the enrollment periods are not protected against higher rates.
The author of the state law said he was delighted to hear that insurers would once again offer coverage for children. "The law seems to be having just the effect we intended," said Assemblyman Mike Feuer (D-Los Angeles). "For a family there is little more important than being sure their children have access to health insurance, so I'm very pleased to see these insurers are choosing to make that insurance available."

Get a quote here

duke.helfand@latimes.com

 

Non-Discrimination Testing - Patient Protection and Affordable Care Act (PPACA)

Notice 2011-1 addresses prohibiting insured group health plans from discriminating in favor of highly compensated individuals.  The Treasury Department, IRS and the Departments of Labor and Health and Human Services have determined that compliance with these requirements should not be required until after regulations or other administrative guidance of general applicability has been issued.  The notice includes a request for public comments.

Sunday, December 26, 2010

Parents Should Be Aware of Potential Dangers of Alternative Medicine

A growing number of parents are considering complementary and alternative medicine (CAM) to treat their children’s illnesses for a variety of reasons. While some therapies may be healing and therapeutic, parents should remain aware of potential dangers of treatments, especially when they are substituted for conventional medicine.

Coordinate Complementary Medicine with Traditional Therapies for Best Outcomes

According to the National Center for Complementary and Alternative Medicine, CAM is defined as a diverse group of medical and healthcare practices that are generally not considered part of conventional or “Western” medicine. Practitioners often focus on treating the whole person and promote self-care and self-healing. CAM includes broad categories of therapies, such as natural products (ie: herbs, dietary supplements), mind-body medicine (meditation, yoga), and manipulative practices (spinal manipulation and massage).

While complementary medicine often accompanies Western medicine practices, alternative therapies are used in place of medical treatments. According to a study by the Australian Pediatric Surveillance Unit conducted between 2001 and 2003, adults are mislead to believe that CAM treatments are better for children because they are “all natural” and therefore less harmful. However, during the same timeframe, four deaths were reported in association with CAM practices because they were used in place of conventional treatments.

Read: Alternative Health Practices Gain Popularity with US Children

The researchers, who published the study in the Archives of Disease in Childhood note tha
t one death occurred in an 8-month-old child who was initially admitted with severe malnutrition and septic shock following naturopathic treatment with a rice milk diet to relieve constipation. A second case involved a 10-month-old child who was being treated with homeopathy and a restricted diet for chronic eczema.

There were also 46 instances of “negative outcomes” with seventy-seven percent experiencing a worsening of symptoms after starting a CAM therapy. Two-thirds of the cases were rated as severe, or life-threatening with symptoms that included seizures, infections, stunted growth, allergic reactions and malnutrition.

Read: Families Often Use Complementary Medicine for Children with Cancer

Forty-four percent of the parents of the children who had been harmed were warned by a pediatrician not to continue. Dr. Steven Dowshen of KidsHealth.com suggests talking with your child’s pediatrician before starting any complementary or alternative therapy to ensure that it is not dangerous and will not conflict with the traditional care your child is receiving. “By coordinating alternative and traditional care,” he says, “you don’t have to choose between them. Instead, you can get the best of both.”

Source Reference:"Adverse events associated with the use of complementary and alternative medicine in children"Alissa Lim, Noel Cranswick, Michael SouthArch Dis Child doi:10.1136/adc.2010.183152
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Wednesday, December 22, 2010

Successful Companies Gain Profits by Adding Employee Benefits

What recession?

That's how employers from Florida to Vermont to California feel after seeing their revenue double and triple in the past two years.

At a time when companies are cutting jobs, Dealer.com, a Burlington, Vt.,-based developer of websites and online marketing tools for car dealerships and manufacturers, has added more than 150 employees, bringing their roster up to 420.

CEO Mark Bonfigli believes that employee wellness and workforce productivity are directly linked, so Dealer.com has a full on-site gym and tennis court, a subsidized local/organic "Dot Calm Café" and weekly chair massages. And they're adding a yoga studio, a solarium and a rooftop vegetable garden.

Miami businessman Max Borges subscribes to the same philosophy. "When you feel good physically," the triathlete says, "you feel good mentally." So his company, which does public relations for the consumer electronics industry, also boasts employee benefits such as an on site gym, as well as fitness classes and reimbursement for athletic competition entry fees. Borges also motivates his employees by sharing his profits with them. "They don't feel like, 'Oh, I'm just getting my boss rich,'" he says. "They act more like owners. Not only do they work harder, they work smarter."

The proof, however, is in the profits. With his company's revenues up by 58% this year, MBA was selected by Inc. magazine in 2009 and 2010 as one of the fastest-growing private companies in America. Borges rewarded his 27 employees by taking them on a cruise to the Bahamas.

Across the country in San Francisco, Bibby Gignilliat gave her team a luxury weekend after seeing an 80% increase in her business, Parties that Cook, which stages hands-on cooking parties and corporate team-building events for fortune 500 companies like Apple, Google, PayPal, Wells Fargo and Facebook. Since she started rewarding her staff with equity compensation, she says, "My employees are more invested than my former partners were...This is my recipe for success."

Forget quantitative easing. These employers have figured out that the way to bring back the economy with this simple equation: profit-sharing = profit-earning. It's the perfect marriage of socialism and capitalism -- a profit not without honor.

"Most companies do it backwards," Borges says. "When you decrease their pay to increase profit, you take away their incentives." He adds, "People think, 'That will work for him, but not me,' but it will work for any situation."

Including the American economy.

And that, my friends, is The Upside.

Are you familiar with 2011 compliance topics in employment law.

Here is what HR clients had to say;

Poll of the Month


How familiar are you with the top employment law compliance topics for 2011?

1 %
Absolutely Familiar
7 %
Very Familiar
29 %
Somewhat Familiar
52 %
Barely Familar
11 %
There are employment laws?
We offer a value added program where you stay informed of HR changes and laws, get forms, handbook and posters.

The Reality of Early Retirement

Is early retirement on your "wish list?" Do you envision a relaxing lifestyle in a warmer climate or the leisurely pursuit of a personal hobby? Unfortunately, retiring later than anticipated, rather than sooner, is becoming more and more commonplace. But, some people are still managing to retire early. You may be asking yourself, "How do they do it?"
The key is to be proactive in your retirement planning. Of course, the sooner you begin planning and saving, the better your chances are for early retirement. Keep in mind that a general rule of thumb is that you may need as much as 60% to 80% of your pre-retirement income to meet your expenses and maintain your desired lifestyle in retirement.
Redefining Retirement
There are many factors that are redefining how Americans approach retirement. Due to financial necessity, or sometimes too much leisure time, some retirees are reentering the workforce. Many retired executives start their own part-time consulting businesses; others trade in their hectic seventy-hour workweek for a pseudo-retirement, in which they work less and spend more time with their families. Part-time work during retirement can be an important income supplement, especially if you plan to retire early from your full-time career.
Longer life expectances are also changing the retirement landscape. Some people spend one-third of their lives in retirement, and your chances of a longer retirement are certainly greater if you retire early. Therefore, relying solely on retirement plans and Social Security may be more difficult, as these programs were not designed to provide perpetual income. Furthermore, as longevity has increased and the use of traditional pensions has decreased, the responsibility for retirement planning has gradually shifted from employers to employees. The task of acquiring adequate retirement savings has been placed directly in the hands of the workforce, who often must take initiative to contribute to their company-sponsored retirement plans. As a result of all these factors, your retirement assets, as well as your personal savings, may have to work harder to meet your objectives, no matter when you retire.
An often overlooked aspect of retirement planning is money management once retirement has begun. To help ensure adequate retirement assets, your money may have to continue working for you throughout your retirement years. Inflation—along with the amount of income withdrawn from your retirement plan—will have a direct effect on how long you can continue to meet your expenses. Thus, personal savings will continue to be an overall part of your financial plan.
Budgetary constraints can also determine your lifestyle choices in retirement. In order to determine whether you will be able to maintain your desired lifestyle if you retire early, it can be helpful to estimate your retirement income and expenses. Unfortunately, this process may be difficult, as you will need to consider everything from greens fees at the local golf course to health insurance costs. In addition, you must factor in inflation and how your financial needs may change over time.
Finally, for those who wish to retire early, it is important to realize that certain penalties may apply for early withdrawals from retirement plans. All options need to be examined and reviewed with a qualified financial professional.
It's Your Retirement: Be Involved!
Today, early retirement remains a possibility. By planning ahead and maximizing your personal savings, you may increase your chances of reaching your retirement goals. Remaining proactive and focused is particularly important if you are contemplating, or are forced into, early

Know Your Competition

The Ins and Outs of Pricing for Profit

Set prices too high and customers may disappear; set prices too low and customers may bang your door down, but will your business be able to meet the demand? How do you go about pricing your company's goods and services in a way that benefits you and the customer?
First, you've got to know your competition. You can often find out how your competition is pricing their products or services by visiting their premises or their websites. Other resources for researching prices include industry publications, online discussion boards, trade associations, or networking groups. You may also try contacting business owners in your industry who are not direct competitors to ask them how they establish their pricing structure.

Setting the Selling Price
If you discover that prices for comparable products and services are similar in your market, arriving at a competitive price range for your own offerings may be relatively easy. However, if prices vary considerably, try to find out why. For example, a company that charges considerably more for its products may have a reputation for superior quality, a particularly attractive location, additional services, or extensive advertising. In other cases, you may find that a high-priced competitor offers no additional value to customers but has been successful in marketing its product to a willing and able clientele.

Ceiling Price vs. Base Price

One way to determine the ceiling price, or the highest price the market will bear, is to survey customers. What type of businesses and kinds of people comprise your prospective market? What are they willing to pay for particular goods and services? You may discover that the prices customers are willing to pay are, in fact, higher than current market rates.
The next step is to establish your base price, or the minimum price you must charge in order to break even. What are your outlays for supplies and materials? What are your fixed overhead costs for your building, equipment, and utilities? What is the cost of servicing loans? How much interest would otherwise accrue on investments made in the business? What are the product development costs? How much will the business spend on marketing? What financial cushion do you need to keep the business running? What are your payroll costs? When considering how much to charge, do not forget to factor in compensation for your time, labor, and personal investment in the business.
If this analysis reveals that your business is unable to price its products or services competitively while still turning a profit, try to figure out why. Are there inefficiencies in your business that could be remedied? Is it possible to lower your costs—and, consequently, your base price—through economies of scale, a change in suppliers, or outsourcing?
Once you have determined the base price, you can set the selling price. This should be substantially higher than your breakeven price; if it is not, your business and your personal wealth cannot grow.
Sometimes it is necessary to raise prices because costs have increased. You can cushion the blow of a price increase by offering new or enhanced products or services. Many businesses offer discounts to clients who buy frequently or in bulk. If your business sells multiple products or services, consider bundling them and charging a set price for the package.
Once set, reassess your prices regularly. As the marketplace changes, your prices may need to change accordingly. Small, incremental price increases are likely to be tolerated by your customers. If extreme costcutting by competitors threatens your business, try to weather the storm by maintaining realistic prices, while offering customers consistently superior quality and service.

Our Newsletters are designed to help you and your business grow.

Making Your Finances "Picture Perfect"

While most people find the notion of creating a budget about as appealing as yard work, like mowing the lawn and weeding the garden, most would agree that the work is well worth the effort once they've achieved picture-perfect surroundings.
Two financial "snapshots" you can take at any time to help view your financial landscape are a balance sheet (or net worth statement) and a cash flow statement. Along with demonstrating where you are today, these tools can also help provide a foundation for important financial comparisons in the future. Although there are software programs available to help with budgeting, it can be easy and helpful to create your own worksheets on paper.
Assessing Your Net Worth
To create a balance sheet, simply draw a line down the center of a blank piece of paper. Label one column "Assets" and the other column "Liabilities." Assets are everything you own, and liabilities are everything you owe.
You can add structure by grouping your assets into three categories: 1) cash or cash equivalents—checking and savings accounts, money market funds, and certificates of deposit (CDs); 2) investments—stocks, bonds, mutual fund accounts, and retirement accounts; and 3) personal property—your house, home furnishings, autos, boats, and other personal items.
Liabilities can be labeled as follows: 1) short-term—auto loans, most personal loans, and credit card debt; or 2) long-term—home mortgages, some home equity loans, and some educational loans.
Enter all of the relevant numbers and add up the two columns. We'll examine the outcome later.
How Fluid Is Your Cash Flow?
Next, create a cash flow statement. Draw a line down the center of a blank sheet of paper, and label one column "Cash Inflow" and the other "Cash Outflow." On the inflow side of the ledger, list monthly or yearly income from all sources, such as wages, self-employment, rental properties, and investment income (interest and dividends).
On the outflow side, list all monthly or yearly expenditures, separating fixed expenses (mortgage payments, other periodic loan payments, and insurance premiums) and variable or discretionary expenses (utilities, food, clothing, entertainment, vacations, hobbies, and personal care). You may choose to put taxes (Federal, state, FICA) in a separate category. Again, fill in the relevant numbers and total the columns.
The Results
If your balance sheet shows your assets exceeding your liabilities, you have a positive net worth, especially if your cash flow statement shows more inflow than outflow. This picture shows that you are solvent and spending within your means. The degree of your financial health depends on the amount of your surplus.
Your financial picture may look somewhat different if your balance sheet shows your liabilities exceeding your assets and/or your cash flow statement shows more outflow than inflow. This indicates that you are spending beyond your means. It may be time to assess areas in which you can decrease your liabilities.
Each year, strive to increase your net worth and keep your expenditures under control. If your financial picture is a little out of focus, taking action now to sharpen the view may help you create a more promising snapshot in the future.

For More Information: info@amsinsure.com

Monday, December 20, 2010

Cost Containment and Health Management Strategies Topped Ways Companies Weathered the Storm of Rising Health Care Costs

Dec 20, 2010 14:37 ET
IRVINE, CA--(Marketwire - December 20, 2010) -

Top 10 Health Benefits Trends of 2010

1. Healthcare Reform. The Patient Protection and Affordable Care Act of 2010 (PPACA) shook the health care world this year, causing companies to revisit their benefits strategies to determine efficient ways of becoming compliant with the reform's immediate and long-term requirements. Chief among their considerations was whether plans could be grandfathered and how to best explain the changes to an anxious workforce in light of new communication and reporting responsibilities. On the upside, companies began to explore new benefit design opportunities by becoming engaged in financial modeling and benefit strategy development as they prepared for the many changes that will go into effect from now until 2014.
2. Cost Sharing and Rewarding Healthy Lifestyles. Employee benefit contribution structures held steady over the past decade -- even during the height of the recession, when companies froze wages and cut other expenses to prevent layoffs. This year's rise in salaries, however slight, combined with premiums that jumped 12 to 15 percent, saw companies sharing health care's financial burden with employees. Covered workers contributed on average two to three percent more for single and family coverage and bore higher out-of-pocket costs for deductibles and co-pays. To keep workers at the top of their game, companies are increasingly taking advantage of carrier-sponsored wellness programs -- from weight loss and smoking cessation programs to gym memberships, virtual health coaching, nutrition classes, wellness newsletters and more. Savvy companies are pegging employee contributions to their participation in these initiatives, with financial incentives such as lower premiums and deductibles tied to the attainment of health benchmarks.
3. Plan Design. There's nothing like limited resources to inspire creative thinking. Budget-minded employers flocked to high-deductible health plans (HDHP) with health savings accounts (HSA) for cost savings and tax advantages -- namely, the elimination of the "use it or lose it" rule. Others cut costs with HMO deductible plans. Limited medical networks and increasing prescription plan deductibles provided additional avenues for saving money. Expect continued innovation in 2011, as employers focus on new ways to get the most for the money they spend on health plans.
4. Communications Game Plan. Confusion and uncertainty among employees over how they and their families will be affected by health care reform led companies to adopt proactive and innovative communication strategies to dispel misperceptions, alleviate fears and prepare workers for the changes to come. From reassuring messages and use of the company intranet to submit basic questions to HR staff to on-site education sessions hosted by brokers, smart employers brought clarity by providing critical information and timely updates. This trend will continue next year as organizations and employees across the country contend with the reality of reform as it continues to evolve. 
5. Claims Analysis. While it is important to understand the financial performance of a plan and the financial justification of premiums, employers are using claims data to take more focused directions on plan design, wellness initiatives, and communication. The data mining of claims allows employers to weigh the financial costs and member impact of any changes to their plans and helps balance disruption and cost containment. Even a review of a group's top disease states or major diagnostic categories provides focus for wellness initiatives and opportunities to avoid claims, giving employers more control of their health care costs.
6. Chronic Disease Management. Alarming rates of chronic diseases like diabetes and heart disease are taking their toll on Americans' health and on employers' bottom lines, since companies bear much of the cost associated with treatment. A remarkably positive partnership has developed between companies and employees joining forces to improve their quality of life through health management and wellness programs. These targeted approaches to specific conditions (i.e., glucose levels, blood pressure, and cholesterol) and "knowing your numbers" through health screenings and health risk assessments, help companies stay ahead of the cost curve by offering preventive care to at-risk employees and disease management that encourages healthy lifestyle behaviors in those who receive treatment. Significant future savings in the form of avoided health care costs, reduced benefit and disability premiums, and improved morale, retention and productivity -- plus an overwhelmingly positive response from employees -- mean these programs are here to stay and will likely grow more extensive in years to come.
7. Self Funding. Self-funded health care, where the employer assumes the financial risk for benefits claims payments and manages and administers the plan, was an appealing alternative to fully insured plans this year because it reduces costs while improving cash flow. Look for growing interest among all types of employers in this model in 2011. With HCR community rated requirements, employers will be considering alternative funding arrangements to capture their favorable claim costs of their plan participants vs. subsidizing others.
8. Product Bundling. Employers capitalized on premium discounts offered by carriers that combine medical plans with comprehensive specialty benefits such as dental, vision, life and disability. With just one team to administer benefits and one premium statement, employers saved money through lower administration fees. Plus, the more employees enrolled and lines of coverage bundled, the greater the savings. 
9. Going Online. Despite initial reluctance to use the Internet for benefit administration, most employers are jumping on the information superhighway, recognizing not only the willingness of employees across all demographics to use a Web interface, but also how online tools simplify processes for HR departments. Computer-based services such as online enrollment, downloading forms and documents, and access to benefit information and education are among the tech advances coming into daily use, while mobile-enacted information and services for the smartphone platform promise even greater efficiencies in the near future.
10. Executive Benefits. Executive benefits, an important tool for attracting and retaining talented staff, were a casualty of the economic downturn and new health care reform legislation, both of which put these programs under greater scrutiny than ever before. Many companies have had to weigh the competitive edge these benefits provide against the costs and risks they entail, and some faced with no choice but to set these policies aside as they struggled to stay afloat in challenging economic times.
"Perhaps the most important lesson of 2010 is that getting employees more involved in their medical decisions, expenses and overall health is a key to sustaining a financially viable, work-based benefits program," says Allison. "As for implications for the future, as the economy improves and the job market becomes vital again, companies with robust programs will have a significant advantage in terms of their ability to meet productivity goals and attract and retain desirable employees while they make significant inroads into improving the health of American workers and their families."

Sunday, December 19, 2010

The Benefits Of California Labor Law Posters And How It Helps Employer and Employee

A labor law poster helps an employee to identify his rights in an organization. There are many benefits that an employee can identify and utilize the facilities provided by the company. The labor law posters are a mediator between the employer and employee, to create a friendly atmosphere in the organization with harmony and trust. These posters are designed to motivate the employee and make them comfortable in the work place.

The California labor law posters are a great significance to the residents of California, the employer need to post these law posters in their premises for all the employees to read and understand these laws. The employees can identify their minimum wages though these law posters do not allow the employer to exploit them. The employers also need to indicate about the date of payment and the place of payment, so that the employees are aware about the date of payment.
The employer also should display the emergency telephone numbers in the work site, so that employees can access these numbers in case of any emergency situation. In some company smoking is banned, the employer also should mention about the rules of the non smoking zones to the employees. The labor law posters should contain all the compensation rules which are applicable to each and every employee.

The employer should display the languages in multi lingual language so that the employees who do not understand English can read it in their own language. This is very crucial for immigrant workers. The California labor law posters also has law related to the welfare of women in the organization, a women who wants to go on a maternity leave, are granted leave with pay.
The employer should make this awareness in the organization with the help of labor law posters. The California labor law posters also state about the safety posters which are displayed in the premises of the organization to create a awareness about employees safety and protection of health. These are the main core points discussed in the California labor law posters.

Friday, December 17, 2010

Getting to the bottom of your health care costs

Did you know: 10-year study indicates spending for prescription drug use in America is on the rise?

U.S. spending for prescription drugs more than doubled to $234.1 billion over the 10 years covered by a study released by the Centers for Disease Control in September 2010 as part of its National Center for Health Statistics data brief. Among those ages 60 or older, 37% used five or more prescriptions per month.


Contact us on how to lower your Rx costs and click on the link above for more Rx info.  info@amsinsure.com

Employer responsibility and automatic enrollment available

The health care reform law requires employers with 50 or more full-time employees to offer minimum essential coverage starting in 2014. Employers who don't meet this requirement will be subject to penalties. In addition, employers with more than 200 full-time employees must start automatically enrolling full-time employees in 2014.  

Contact us for additional information; info@amsinsure.com

Thursday, December 09, 2010

Senate Unanimously Approves Medicare "Doc Fix."

The AP (12/9, Alonso-Zaldivar) reports, "The Senate approved a measure Wednesday to avoid a steep cut in Medicare pay for doctors by shifting some money from President Barack Obama's health care overhaul law." This "deal by Senate leaders of both parties was approved by a voice vote and appeared headed for passage by the House, which would send the measure to Obama for his signature." Notably, the "president had urged lawmakers to move quickly," saying, "This agreement is an important step forward to stabilize Medicare."

Wednesday, December 08, 2010

Study: Private Plans May Trump Medicare At Controlling Costs.

Study: Private Plans May Trump Medicare At Controlling Costs.


The Hill (12/8, Millman) reports, "Private insurance plans might be better at controlling healthcare costs than Medicare, according to a Health Affairs study released Tuesday morning." Notably, the "study followed up on an influential 2009 New Yorker article that found Medicare spending on the elderly population is significantly higher in McAllen, Texas, than it is in El Paso, Texas. Using medical and expense data for patients in those towns who are privately insured by Blue Cross and Blue Shield, researchers found private insurers were cheaper and had a more consistent cost structure."
        CQ HealthBeat (12/8, Adams, subscription required) reports, "The new study cannot explain definitively why differences in health care spending are lower under private coverage, but the authors suggest that mechanisms for utilization review and management used by private insurers could play a big role." They also "said the most probable explanation is based on which payers are better at controlling costs in areas where legitimate medical judgments can vary. Medicare exercises very little utilization management, but private insurers can be much more aggressive about controlling services."
        Modern Healthcare (12/8, Vesely, subscription required) reports that according to lead study author Luisa Franzini, "For a number of reasons, insurers generally are reluctant to intrude on medical decision-making. ... But the fact that these utilization management mechanisms exist may prompt some physicians who might otherwise overuse certain services to exercise more restraint."
        NPR (12/8, Rau) notes in its Shots blog, "The new study analyzed claims from 65,701 Blue Cross members in McAllen's Hildago County and 66,657 members in El Paso. Blue Cross spent $2,266 on the average McAllen enrollee, compared to $2,428 on the average El Paso enrollee." In "contrast, Medicare spent an average of $14,817 per patient in McAllen -- 86 percent above the $7,947 it spent on an average El Paso enrollee, according to the study." The Washington D.C. Examiner

Wednesday, December 01, 2010

Expert Analysis of 2010's Leading Trends in Human Resources and How Smart Companies Turned Uncertainty to Their Advantage in an Uncertain Economy

1. Stretching the Compensation Dollar. Although 2010 showed some signs of recovery, HR managed workforces that were considerably smaller than just a few years ago. HR's role in managing productivity through ancillary projects while maintaining employee morale and well-being was challenged by the parallel expectation that workers be twice as productive. Innovative HR professionals instituted creative programs such as gift card giveaways and lottery prizes to boost employee enthusiasm in lieu of raises and bonuses.
2. Embracing Social Media. Social networking's undeniable impact hit the big screen in 2010, and it hit workplaces in a number of ways as well. Managers learned to be on the lookout for lost productivity as employees grew increasingly concerned with checking in with their favorite social networking sites. On the upside, savvy HR pros saw a shift in the landscape as hiring and firing trends played out online. Posts cost some careless employees their jobs as HR monitored Facebook, Twitter and LinkedIn accounts. Smart employees landed new gigs by harnessing the power of social networking to market themselves and share information about job openings. Policies were developed to communicate clear boundaries and expectations and to attract top talent with the latest tools -- with some even canceling subscriptions to Monster.com and shifting to social media recruiting.
3. Keeping the Communication Lines Open -- Especially Amid Health Care Reform Anxiety. Maintaining employees' trust in the company and its business decisions through the ups and downs of health care reform was a must. Smart senior management kept communication lines open to demonstrate accessibility and willingness to answer questions and address concerns as they arose. That applied not only to top-down communication, but to lateral lines as well. Human resources professionals were charged with bringing functional departments together; communications, legal, payroll, and IT departments -- everyone had to communicate a unified message to maintain employee trust.
4. Retaining Top Talent. When soaring unemployment numbers left many top performers handling increasing workloads for the same old salary, human resources departments had to focus on retaining company stars. Some of these high performers got antsy as compensation froze and expectations rose. Many continued to struggle with the lingering losses they've felt after company layoffs. This delicate situation required that HR pros soothe sore nerves and keep these folks from looking for greener pastures with creative incentives and sincere appreciation.
5. Managing Three Generations of Work Styles. As young Millennials entered the workforce, companies had their hands full integrating three distinct generations: Millennials, Gen Xers and Baby Boomers. The aging Boomers believe strongly in security and loyalty. They don't always see eye to eye with hard-working Gen Xers who have more of an independent streak. The Millennials shook things up with the attitude that if they don't like what's happening at work, they'll go home to Mom and Dad. This generational juggling was best handled with management training that stressed the characteristics of these disparate groups and how to motivate and inspire the most productivity from them. Succession planning also came into play as firms prepared for the replacement of retiring Boomers with less motivation to stick around now that they're feeling overworked and underpaid. 
6. Sharing an Ounce of Prevention. Healthcare reform drew the spotlight to employee wellness issues in 2010, shifting more emphasis to preventive programs like smoking cessation and obesity reduction. Ben Franklin's proverbial "ounce of prevention" may finally see its day in the sun in 2011 workplaces, as employers continue the 2010 trend of encouraging employee participation in wellness programs in order to increase productivity, reduce absenteeism and boost the health of their staffs. For some, it's also a long-term strategy to avoid higher health coverage costs for increasingly overweight and unhealthy American employees.
7. Clearing Up Confusion. Another obvious consequence of healthcare reform's starring role in 2010 was employee confusion and uncertainty about health benefits. It became an imperative for human resources staffers to communicate benefit changes in advance, whenever possible, and explain changes in terms of how they would affect individual employees and their families. A crucial piece of that puzzle was often dispelling the misperceptions that dominated the public conversation -- from dire cuts to death panels. Few changes have occurred yet, so this trend will persist in 2011 and beyond, compelling HR teams to closely monitor things like free flu shots, effective dates and the details of grandfathered health plans -- and of course, clearly communicating these details to employees in a timely manner. The smartest pros will keep arming themselves with concise answers to difficult questions that will continue to arise as changes are implemented and look for new ways to reach employees with relevant information.
8. Managing the Virtual Workplace. Tech advances continued to lure employees into new territory, especially when it came to virtual work and telecommuting. The trend came with pluses and minuses. Some companies slid into this trend with ease, as exempt Gen Xers with no defined hours blended work and personal responsibilities into an organic off-site workday. Other companies struggled with non-exempt workers. Meticulous time tracking was required to ensure proper payment of overtime and the like. Most of the latter companies discovered the concept was detrimental to business. It's a lifestyle management issue that will continue to show up on HR radar screens in 2011 and could be further impacted by additional tech developments.
9. Working Together. Leaner, more streamlined companies must share information laterally to get the most from scarce resources. HR teams took a leadership role in reaching out to other departments and "sharing the sandbox." More than ever, employees in every department have a sense of facing adversity together. Strategic-minded businesses used the momentum to support strong teamwork and innovative solutions that crossed department lines for everyone's benefit.
10. Riding Out the Recession. As much as circumstances have improved, the recession we battled against throughout 2010 continues to impact companies and individuals -- a trend that will likely continue beyond 2011. HR departments and executives need to tune into their resources and prioritize more than ever before. True innovation is the best way to establish solid initiatives without a solid budget. Successful firms will continue to prioritize wisely, focusing on the most effective tools to enhance business strategy and achievements and develop new business.
"Uncertainty breeds fear in everyone from employees to executives," says Fenster. "Perhaps the most important take-away from the major shifts we saw in 2010 is that the best HR professionals are those who are best at managing uncertainty and allaying fears. That means always reaching out for new information and reliable answers and communicating that information clearly. It also means creating new ways of helping managers and employees move forward, even when the future remains uncertain. Great change requires great innovation, so I think we're going to see some exciting programs and strategies come out of this adversity."

IRVINE, CA--(Marketwire - December 1, 2010) - This tumultuous year in business has transformed human resources strategies in organizations of all sizes. From its vantage point at the forefront of these HR trends, CanopyHR Solutions, an innovative human resources group based in Orange County, California, offers up its insights on 2010's trends and how some will continue to reshape the way successful businesses operate in 2011.

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