Health Care Reform Will Lead to Stricter Workplace Wellness Programs and Harsher Penalties

The Obama administration recently announced the final rules on employee wellness programs under the Affordable Care Act (ACA). The U.S. Department of Health and Human Services issued the regulations, which were enacted under the ACA on May 29. The program allows employers to increase the incentives they give workers to get them into a wellness program or other means of promoting healthier choices and behavior. It supports workplace health encouragement and deterrence as a way to decrease chronic sickness, better health, and regulate growth of health care costs while making sure workers are safe from unfair underwriting methods that could lessen benefits based on health status.

Employers also get clarity on applying penalties for unhealthy employees. Under the new regulations, employers have greater flexibility to charge higher premiums to workers who do not meet certain health goals.

According to a recent survey by the Midwest Business Group on Health, more than 80% of the country’s biggest employers are looking to implement a penalty and reward system to encourage their workers to get healthy.

The rules support “participatory wellness programs,” which are typically accessible no matter the individual’s health status. Included are programs that compensate employees for the cost of membership to a gym or fitness center, rewards for those who attend a free monthly health education meeting or who undergo a health risk assessment.

The final rules protect users by demanding that health-contingent wellness programs be logically planned, equally available to all similarly situated people, and that they accommodate suggestions made at any time by an individual’s doctor founded on medical appropriateness.

Due partially to the ACA, 82% of almost 100 global and national businesses are lowering premiums and offering gift cards for healthy living or charging higher co-payments and fees for poor health choices like smoking. The final rules will go into effect starting on or after Jan. 1, 2014

Read the official news release from the U.S. Department of Health & Human Services here: http://www.hhs.gov/news/press/2013pres/05/20130529a.html

Employers Cut Back on Generous Health Plans

According to a recent New York Times article, companies that offer high-end health plans are scaling back benefits to employees. This is because of a so-called Cadillac tax, which penalizes companies that offer these sorts of plans. The purpose of the tax is to discourage employers from plans that shield employees from the high costs of healthcare and can lead to excessive and unnecessary medical procedures. The tax is highly controversial, but intended for employers to consider long-term healthcare cost control.

Companies that are scaling back their health plans are going to be looking to control their business costs in other ways as well. One way to do that is through invoice factoring, which is the sale of unpaid invoices for cash advances. Proper cash flow is a step in the right direction for companies struggling to meet healthcare reform requirements, and could be a blessing amidst the current uncertainty.

The Myths about Obamacare and Small Business

The opposition to the Patient Protection and Affordable Care Act (PPACA) often falls back on the argument that says health care reform will hurt small businesses. However, according to a CNN Money article, new research indicates that this argument is overblown and only a tiny fraction of businesses will be affected by the 2014 provisions.

Out of 5.9 million small businesses, defined as businesses below 500 employees, 97% have below fifty full-time employees; therefore, healthcare reform only affects 3% of small business, or 200,000 companies. Out of those 200,000 companies, 97% already offer insurance. Although detractors claim that their insurance policies could still be penalized, new research from the University of Chicago says that more than 99% of the existing insurance policies will be acceptable under the PPACA.

All told, that leaves a tiny fraction of small businesses that will have to change their policies under health care reform. So while it may be tricky for these few companies, to say that Obamacare will harm small business is a stretch.

The Future of Medical Transcription Under Obamacare

In 2010, the U.S. Department of Health and Human Services (HHS) introduced measures that lay a groundwork for the widespread adoption of electronic medical records (EMR) within medical institutions. Electronic medical records are a digital files containing health information about patients that are typically filled out by doctors.

With these electronic medical records now mandated by Obamacare, does that leave any room for flesh and blood medical transcriptionists? Medical transcription is the process of converting voice-recorded reports dictated by healthcare professionals into text format. The transcription industry has faced threats before, such as outsourcing and voice recognition software, but the mandated EMRs are likely to reshape the whole transcription industry.

Almost everyone agrees that completely electronic records will never eradicate the need for medical transcription. Instead, experts say that future transcriptionists will simply need to augment their existing skill set with new EMR structure knowledge. The job will evolve with technology, just like every other industry must.  Accurate health documentation is a must, and the human touch is still needed when it comes to doing so.

For more information, see How EMR is Going to Affect Medical Transcription Industry

Size of Staff Now Matters to 2014 Obamacare

While the Affordable Care Act doesn’t go into full effect until 2014, business owners should be aware that the size of their staff this year determines whether they are hit by penalties.

Most SBOs know by now that any company with over 50 full-time equivalent employees will be required to provide healthcare for their employees in 2014 or face fines. However, some aren’t aware that the government will be using staff data from 2013 to determine whether a company falls under the provision. According to the WSJ article Insurance Rule Will Go By Size Of 2013 Staff, this could change some SBO’s plans to change their staff next year. Rather than wait, they should make the changes this year while there is still time. A misunderstanding of the provision’s rules will have some companies blindsided with penalties in 2014.

Once business owners get wise to the rules, staffing in these companies may be rearranged and reorganized. Change often brings opportunity, and industries like temporary staffing will probably be the most affected.

What Does Obamacare Mean for Small Business?

While the brunt of the Affordable Care Act doesn’t come into effect until next January, now is the time for small businesses to get informed and make plans for the future. Although companies with fewer than 50 full-time equivalent employees will not be penalized for not offering healthcare, there are several things that they must keep in mind.

Disclosure: At the very least, small businesses are required to inform their employees in writing about the new law and health exchanges. The deadline to do so was originally March 1st, but now information about exchanges should be avaialble to employerts starting in October. If they do offer healthcare, then they also must make sure it complies with the ACA.

Exchanges: Starting in 2014, state health insurance exchanges will be established that allow small businesses to shop for affordable coverage. Businesses with 100 or fewer employees are eligible for the Small Business Health Options Program (SHOP), although some states may opt to lower the requirement to 50 employees or less until 2016. Companies can also choose to shop on the traditional insurance market, and private third party exchanges will be set up as well.

Costs: The question on small business owners’ minds is what healthcare reform is going to cost their business. According to an Urban Institute analysis last year, small business costs might actually be reduced by the new law. Costs per person would only be higher for mid-sized businesses, and large business costs will likely stay the same.

Now is the time to get informed about what Obamacare means for small business, while there is still time to prepare. Know the requirements now so you don’t get blindsided by unforeseen costs in the future.

For the full article, see Obamacare 101

Marketing Directly to Consumers of Private Duty Health Home Care

October 12, 2012
A recent article in the Private Duty Today newsletter addresses an issue that home healthcare providers often face: how to effectively market their services without breaking the bank.  After conducting market research, the author of the article put together a breakdown of the most effective marketing methods for this important field. The top four of the top results are displayed below, along with the percentage of responders who found the technique highly effective:

  1. Website (62.5%)
    You must have a functioning website that ranks high on search engines.
  2. Health Fairs (45.2%)
    Take advantage of opportunities for networking with other health care providers and getting that referral when the time comes.
  3. Sponsorship of Community Events (34.3%)
    A banner ad isn’t enough; you have to be actively involved with the event you sponsor (such as an Alzheimer’s Association or Parksinson’s disease fundraiser)
  4. Writing for Local Magazines and Newspapers (25.8%)
    A great way to build your brand is to write a column or an “Ask the Experts” in the local newspaper dealing with aging issues .

See the original article, Marketing Directly to Consumers of Private Duty Health Home Care.

Hospitals for Profit or for Help?

Did anyone see the article A Giant Hospital Chain is Blazing a Profit Trail in the NYTimes earlier this week?

The article talks about HCA’s revamped billing procedures and revised patient screenings that have led them to be extremely profitable health care industry giant during a time when so many of America’s hospitals have been struggling to stay out of the red.

According to the article, “Among the secrets to HCA’s success: It figured out how to get more revenue from private insurance companies, patients and Medicare by billing much more aggressively for its services than ever before; it found ways to reduce emergency room overcrowding and expenses; and it experimented with new ways to reduce the costs of its medical staff, a move that sometimes led to conflicts with doctors and nurses over concerns about patient care.”

What are your thoughts on this article?

Supreme Court Stuns Nation with Obamacare Decision

The outcome appeared uncertain, but in a 5-4 decision, the Supreme Court ruled the Patient Protection and Affordable Care Act to be constitutional in accordance with U.S. tax laws.

Chief Justice John Roberts opined that the individual mandate, the clause compelling all Americans to own some sort of health insurance, was unconstitutional if the penalty took the form of a fine. Instead, if

Americans decided not to follow the individual mandate, they would be taxed in accordance with the burden that any potential uninsured illnesses might pose to taxpayers.

Though, prior to signing the bill into law in March 2010, the president had vehemently denied the bill to be a tax, his wording was corrected by the court on Thursday June 28, 2012.

Beyond compelling Americans to purchase policies from healthcare insurance companies, the bill also limits insurance companies’ rights to severability. The PPACA holds that no insurance company can terminate coverage because of a person’s pre-existing condition.

Limitations upon the rights of private sector insurance firms are subsequently countered by the bill’s expansion of Medicaid. The federal government has offered to fund the expansion in every state, to the tune of 100% of the cost.

The act, pejoratively known as Obamacare, has a host of pros and cons that will be sure to affect the well-being of each and every American. It is unforeseeable how our small business, healthcare factoring clientele will be affected, but we will keep you posted as new information becomes available.

The Future and Foundations of Medical Transcription

There was an interesting article in For The Record Magazine last month that the medical transcription factoring specialists at PRN Funding wanted to share with our medical transcription readers–Utterly Essential. Keep reading for a brief overview of the article:

Could it be that the old way of doing things is more effective than the new? When it comes to medical transcription, many doctors still stress the benefits of dictation for providing patient care that is at once more personal, nuanced and efficient.

In his 2007 article in Family Practice Management, David E. Trachtenbarg, MD shared that “clicking or typing text multiple times is generally slower than dictating…Using discrete data, it took me 95 seconds to complete 17 clicks for yes-or-no questions, five text boxes that required typing and two drop-down lists. In contrast, it took me 41 seconds to document the same history using dictation.”

Furthermore, Jason Mitchell, MD, was quoted in Utterly Essential as saying that dictation can “capture nuances and subtleties that cannot be communicated strictly through EHR fields.”

While dictation certainly makes relationships between individual patients and doctors more personal, meaningful, and effective; in the grand scheme of data collection, the tape recorder certainly has its shortcomings. Even with burgeoning vocal-recognition technology like Apple’s “Siri,” harvesting, codifying and putting dictated notes to good use is a process that presents many challenges to the health information industry.

After all, EHR has many benefits. Though it has been criticized for turning highly-paid doctors into data-entry clerks, medical practices are experimenting with cost-effective methods of implementing the process.

One method-which is rapidly becoming dated-involves a scribe whose job is to communicate with the physician and record the finer points of the patient’s case. This allows the doctor more time to see more patients.

Though it would seem to make sense to have nurses act as scribes, Jason Mitchell, MD, argues otherwise. Mitchell, who acts as the assistant director of the American Academy of Family Physicians’ Center for Health IT, believes it to be “more cost-effective to bring someone in on a lower pay scale.”

According to For the Record, Mitchell goes on to assert that “as software becomes more developed… the scribe’s role will eventually become obsolete.”

What does this mean for our medical transcription factoring clientele? It means that the future of EHR has to incorporate, in some meaningful way, the efficient, interpersonal process of dictation. Software must be developed that can enter dictation into EHR, codify it for future diagnostic purposes, and save it for the physician’s use.

By improving the process of extracting discrete data from patients’ narratives, the combined forces of dictation and EHR could save lives in both the present and the future, using all of the methods and information from the healthcare industry’s past.

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