Providing workers with healthcare coverage still makes economic sense for large employers.  However, there are fewer incentives for smaller employers to offer coverage in the new era of healthcare reform.  That was the key message in a new national study for the nonpartisan National Institute for Health Care Reform.

The study, led by University of Minnesota researcher Jean Abraham, who worked with the Center for Studying Health System Change, calculated the economic incentives for employers offering coverage to active workers before and after health reform implementation in 2014.   The analysis used data from the 2008-2010 Medical Expenditure Panel Survey.

“The findings indicate that the economic incentives to offer coverage will remain strong under health reform for many businesses, especially larger, higher-wage firms,” Abraham said. “But they will weaken for small and low-wage employers – the very establishments that already were most likely to drop coverage because of rising costs.”

For the nation’s healthcare providers, the study points to the importance of regular verification of current insurance coverage, particularly for patients working for smaller businesses that might decide to drop this benefit. If so, there could well be a significant time lag before the patient purchases coverage from another source.

The institute’s study found that pre-reform, all businesses had an economic incentive to offer health insurance because the U.S. government gave preferential tax treatment for both employer and employee premium contributions.  Post-reform, employer premium contributions remain tax exempt.  In addition, two new policies take effect in 2014: a penalty on larger employers that do not offer affordable health insurance, and premium tax credits for lower-income people to purchase insurance in new state exchanges if they lack access to affordable employer coverage.

In the pre-reform period, the economic incentives of employers to offer health insurance were all positive and increased with firm size.  After reform implementation in 2014, the largest firms with 500 or more workers will continue to have a strong economic incentive, with an average incentive of $2,503 per employee, according to the analysis.  However, the smallest firms with fewer than 50 workers will face lower economic incentives – an average of $990  – in the post-reform period, in large part because these smaller employers will be exempt from the penalty.

With President Obama returning for a second term, the debate in Washington over the merits (or demerits) of the Affordable Care Act (ACA) is finished.  Now, physicians, hospitals, payers and other healthcare organizations can focus on how the ACA will be changing the landscape over the next few years.

First, the Obama administration will soon start releasing the regulations needed to implement the ACA, whose major provisions are scheduled to take effect on January 1, 2014.  That will give healthcare organizations about a year prepare for the new rule, although it’s possible that the implementation of some ACA provisions will be delayed until later in 2014.

In the past few months, much of the public debate over the ACA has been centered on employer-related issues, such as who should be covered, what coverage is needed and what penalties apply for failing to provide that coverage.  Those employer-employee provisions will also affect U.S. hospitals, health systems and major physician groups.

For most providers, an even more important issues is how the ACA will increase demand for care.  The impact will vary across the country, since each state will decide whether to expand Medicaid and set up a subsidized health insurance exchange for individuals to obtain coverage.  However, the ACA is already increasing coverage, as a recent U.S. Census Bureau report found that the number of uninsured Americans decreased in 2011 for the first time in four years.

Therefore, physicians, hospitals and other providers should try to estimate the number of uninsured residents in their markets to estimate the potential growth in demand in 2013 and beyond.

Initially, the growth in coverage is likely to spur demand for primary care services, with a “trickle up” impact on specialty care through referrals.  However, providers of all sizes and types should begin making plans for their staffing patterns in the coming year to ensure that they can continue to deliver quality patient care.  In many cases, temporary staffing can provide a flexible solution to finding the right professionals needed to meet the increased demand for services.

A recent decision by the U.S. Department of Health and Human Services to promote enrollment in high-quality Medicare Advantage signals a renewed focus on consumer preferences and patient outcomes.  That trend toward quality will continue to be a key driver in the changing healthcare landscape, affecting both plans and providers in the future.

HHS Secretary Kathleen Sebelius recently announced that Medicare is doing more to promote enrollment in high quality plans.  Now, persons enrolled in consistently low performing plans (those receiving less than 3 of 5 stars for at least the past three years) will be notified about how they can change to a higher quality plan.  In addition, 5-star plans are rewarded by being allowed to continuously market and enroll beneficiaries throughout the year.

“In 2013, people with Medicare will have access to a wide range of plan choices than ever before,” Sebelius said, noting there are now 127 four- or five-star Medicare Advantage plans that serve 37 percent of enrollees.  In 2012, there were only 106 four- or five-star plans, serving only 28 percent of enrollees.  People with Medicare will also have access to 26 four- or five-star prescription drug plans, which currently serve 18 percent of enrollees.

The Affordable Care Act also added new benefits to Medicare, such as phasing out the Medicare prescription drug coverage gap also known as the “donut hole.”   In 2013, people with Medicare who reach the “donut hole” will receive approximately 53 percent off the cost of brand name drugs and 21 percent off the cost of generic drugs.  Medicare beneficiaries will also continue to benefit from Medicare-covered preventive services at zero cost-sharing, including a yearly wellness visit.  At the same time, premiums in the Medicare Advantage program are remaining steady, Sebelius said.   From 2010 through 2013, Medicare Advantage premiums have fallen by 10 percent and enrollment has increased by 28 percent.

That’s a winning combination for people enrolled in Medicare plans, and a trend that providers should continue to follow closely.

If you are seeking a career in the healthcare sector, taking a temporary position makes a great deal of sense.  Perhaps you are a physician, nurse, laboratory technician, administrator or support person who already has at least some experience in your chosen line of work.  Accepting a temporary employment position allows you to get a first-hand impression of the workplace, the patients or clients, and the roles and personalities of the current staffers.  It’s an ideal way to find out if a hospital, physician’s office, laboratory or other setting is the right one for you on a long-term basis. It certainly lowers the risk of making a bad choice – both for you and the healthcare organization.

A temporary staffing position can be even more valuable if you are making a career change into healthcare. Let’s say you recently earned your nursing degree or lab tech credentials. In that case, a temporary position allows you to get your foot in the door with a potential long-term employer.  It lets you develop and use your skills and training, so that you have practical on-the-job experience to go with your degree or credentials. That gives you more material for your resume and a potential reference from the temporary employer if you decide to continue your career search elsewhere.

In both situations, you can be on the job, building your confidence, earning money, and putting your skills to work helping others – without necessarily making a permanent commitment. Instead, you have flexibility in regard to scheduling and in the length of a temporary assignment – an important consideration if you have young children or are planning to start a family.  That flexibility is also important if you may need to relocate in the not-too-distant future.  If you are interested in temporary employment in the healthcare and  insurance sectors, All Medical Personnel can help you achieve your goals!

Having a strong social media presence is an important aspect of a healthcare job search strategy for administrators, physicians, nurses, lab techs, therapists and other professionals.  Recruiters today regularly visit LinkedIn, Facebook, Twitter and YouTube to take a closer look at a potential job candidate.  Therefore, your information on those sites needs to be accurate and up-to-date, while highlighting your skills and experience.  Here are several suggestions for developing an effective strategy.

• Make a list of all your social media sites (including older ones like Friendster or MySpace) and see what your profile looks like.  You could do a quick online search for your name to be sure you have all the sites, and uncover any potential surprises. Remember that a recruiter can also do a quick search on your name.
•  Update your profiles to reflect your current position, skills and accomplishments.  Make sure to highlight information that will support your job search, such as “15 years of hospital nursing experience,” or “strong financial skills including A/R management.”
• Be sure you have appropriate privacy settings for Facebook, particularly if you have uploaded personal photos or comments that you don’t want a potential employer to see.  Do the same thing for your Twitter account.
• Consider uploading a YouTube video where you discuss your accomplishments and career goals.  This gives a recruiter a chance to “meet you” prior to a face-to-face interview.  Include a link to your video in your job search emails or other social media accounts.
• Join relevant social media groups, including business, alumni and civic organizations.  It gives you a chance to network online, and make new professional contacts. It won’t get you a job, but it might open the door to your next interview!