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.

In a step that will affect healthcare organizations throughout the country, the U.S. Department of Health and Human Services (HHS) recently issued a final rule implementing five key consumer protections from the Affordable Care Act. Under the rule, all individuals and employers have the right to purchase health insurance coverage regardless of health status.  In addition, insurers are prevented from charging discriminatory rates to individuals and small employers based on factors such as health status or gender, and young adults have additional affordable coverage options under catastrophic plans.

For providers, the HHS rule is expected to increase demand for healthcare services from the more than 30 million Americans who are currently uninsured for one reason or another.  Now, the HHS is mandating that most health plans include the following key provisions by 2014:

• Guaranteed availability. Nearly all health insurance companies offering coverage to individuals and employers will be required to sell health insurance policies to all consumers. No one can be denied health insurance because of current or prior illness.
• Fair health insurance premiums. Health insurance companies offering coverage to individuals and small employers will only be allowed to vary premiums based on age, tobacco use, family size, and geography.  Basing premiums on other factors will be illegal.  The factors that are no longer permitted in 2014 include health status, past insurance claims, gender, occupation, how long an individual has held a policy, or size of the small employer.
• Guaranteed renewability. Health insurers can no longer refuse to renew coverage because an individual or an employee has become sick.  Consumers have the option to renew coverage.
• Single risk pool. Health insurers will no longer be able to charge higher premiums to higher cost enrollees by moving them into separate risk pools.  Insurers are required to maintain a single statewide risk pool for the individual market and single statewide risk pool for the small group market.
• Catastrophic plans. Consumers will have access to a catastrophic plan in the individual market.  Catastrophic plans generally have lower premiums, protect against high out-of-pocket costs, and cover recommended preventive services without cost sharing.

With these rules slated to go into effect in 2014, hospitals, physician groups and other providers should begin planning how to address the likely increase in patient volume in the new state and national healthcare climate.

It is that wonderful time of year when everyone is making travel plans!  Spring Break is just around the corner and soon it will be Summer. Locums are in-season. Physician coverage is in demand. And we are receiving tons of new Job Orders each day! Have you thought about where you want to travel this Summer? Why not make a little money while you’re there? Locum Tenens work, whether it be at a clinic or hospital facility, rural or city, long- or short-term, almost always includes covered travel and lodging expenses. So do a little work during the day and enjoy the city at night.

Many states even offer a Locum Tenens License. Instead of waiting the typical 2-12 months to obtain a permanent license in that state, they offer a speedier option whereby you can obtain a temporary or locums permit in 2-8 weeks. The fees are less and the wait times are shorter. It’s a win-win. The third piece of that is that the client receives the coverage they need much more quickly. Win-win-win!

States such as Alaska, Arizona, Arkansas, Delaware, Georgia, Idaho, Indiana, Kansas, Kentucky, Maine, Massachusetts, New Hampshire, Oklahoma, South Carolina, Texas, Utah, Wyoming and others will grant temporary licenses. New Hampshire, Maine, Indiana, Texas and others even have an expedited protocol on top of that to get Locums Physicians in quickly. All Medical’s experienced administrative staff can provide paperwork assistance to help make the licensing process as quick and painless as possible.

Not a Physician? Nurse Practitioners are also in demand. Many facilities are now using certified Advanced Practice Nurses to fill in as well. And with the Nurse Licensure Compact (NLC), it makes obtaining an APRN license in a compact state for a practitioner who already has a multistate nursing license a much quicker process. The compact states are Arizona, Arkansas, Colorado, Delaware, Idaho, Iowa, Kentucky, Maine, Maryland, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia and Wisconsin. 24 states and counting!

If you are interested in Locums opportunities in the coming months, please give us a call. Our team of seasoned recruiters would love to speak with you and start your Customized Locums Search today. Or if you’re more of a ‘stay-cation’ kind of person, we can find you something local instead. We have a lot of non-travel work available too.

One of the foundations of the national Affordable Care Act (ACA) is the concept of a state-level health insurance exchange or marketplace. The goal is to make it an easy and affordable for consumers and small businesses to purchase health coverage through private health plans. It’s a particularly important step for millions of individuals who do not get insurance from their employers.

Hospitals, physician groups and other healthcare providers should pay attention to the progress toward creating these two marketplaces – one for individuals and one for small businesses – in their states. After all, having insurance coverage makes it much more likely that individuals, couples and families will access primary care and specialty services.

As of mid February, 20 states and the District of Columbia have been conditionally approved to partially or fully run a marketplace, according to the Department of Health and Human Services (HHS). The most recent state was Illinois, which plans to be ready for open enrollment in October 2013. “We are forging ahead to make the promise of the Affordable Care Act a reality,” said Illinois Governor Pat Quinn on Feb. 13. “We are going to be working very hard between now and October 1st to educate the people of our state about the health care coverage options they will have through the marketplace.”

Quinn’s remarks reflect the two key challenges that states will face in setting up these new health insurance entities. First of all, each state will need to establish policies, rules and regulations for insurance companies that desire to participate in the marketplaces, as well as reviewing their rate structures and coverage options.  That’s a daunting task in itself.  But state officials will also need to educate the consumers about these new options – a process that may well require telephone or face-to-face discussions with individuals and families.  Since educating consumers is vital to the success of the state marketplaces, healthcare providers may want to become involved in the process, such as holding health fairs that include insurance representatives or posting information, such as FAQs, on their websites.  While getting ready for the full implementation of the ACA next January is a major challenge for the healthcare industry, the reform effort is also creating new opportunities as well.

It always seems like the month of December sneaks up on everyone.  Suddenly, it’s time for holiday parties, client luncheons, charitable activities and other seasonal events.  At the same time, many healthcare staffers realize they have unused vacation time and decide to take off for a week or two before the end of the year.

As a result, physician groups, hospitals, laboratories and other healthcare organizations often find it difficult to stay fully staffed during the late December – early January season.  Many organizations already have temporary staffing plans in place to fill those gaps in the schedule, while others find themselves looking for help at the last minute.

Since December staffing issues are a highly predictable occurrence, All Medical Personnel urges healthcare organizations to take a proactive approach.  That might involve reviewing last year’s employee schedules to determine how many people took vacation or personal days during the month.  That can help in projecting staffing needs for this December.  Planning ahead for staffing coverage is also important when arranging a holiday party or charitable event.

If everyone in the office is volunteering a half-day to serve meals to the homeless, deliver gifts to needy children or contribute in another way, then be sure to have temporary staffers in place to “hold down the fort” in the meantime.  It may seem obvious, but it’s surprising how temporary staffing issues are often left to the last minute amid the busy activities of the month.  With the biggest holidays of the year just ahead, All Medical Personnel recommends taking a careful look at your December staffing plans to be sure you can continue to provide seamless care to patients and clients during the 2012 holiday season.

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.

Three major national conferences are coming in October, and All Medical Personnel’s locum tenens team will be present at each one:

• American College of Emergency Physicians (ACEP) Scientific Assembly on Oct. 8-11 in Denver, CO (www.acep.org/sa)
• American Academy of Family Physicians (AAFP) Scientific Assembly on Oct 18-20 in Philadelphia, PA (www.aafp.org)
• Medical Group Management Association (MGMA) Annual Conference on Oct 20-23 in San Antonio, TX (www.mgma.com/mgma12)

For physicians, these conferences provide an ideal opportunity to connect with other subspecialists, build your professional network, and explore locum tenens opportunities. Healthcare administrators at the MGMA event can learn more about the importance of having a robust locum tenens program in place for providing coverage on a temporary basis or handling a surge in patients.

Long ago, the Romans coined the term locum tenens, which in Latin means “placeholder,” someone who fills in for another person.  Today the word locum tenens covers a much broader range of career options, from daily “fill-in” assignments to  longer-term engagements that could be related to the opening of a new office, clinic or hospital, the launch of a new medical service or a “ramping up” of staffing to meet higher demand.  These temporary or long-term placements offer significant benefits for physicians and other healthcare professionals, including:

• Flexibility.  You can choose a schedule that meets your needs.  That might mean working for several weeks at a different organization in a nearby community or spending the summer at a popular seasonal destination.
• Work-family balance.  A locum tenens assignment can help you find a healthy balance between work and family responsibilities.  That’s particularly important to parents of young children or caregivers for aging parents.
• New experiences.  You can gain experience in different clinical settings, handling different types of cases and working with new patient populations.

If you plan to attend one of these October conferences, we invite you to talk with All Medical Personnel’s locum tenens team and learn more about these exciting opportunities.

As the U.S. healthcare system moves into a new era, the question of transparency is likely to become an increasingly important issue for providers and health plans.  Under the Affordable Care Act (ACA), patients will have greater access to insurance plans and more coverage options to consider.  But to make well-informed decisions, patients will need to be able to access information relating to cost, price and quality, such as:

• How much will choosing a higher deductible reduce my premiums?
• How much is my co-pay or my out-of-pocket cost for various procedures or treatments?
• How large is the plan’s network of providers?
• What is the quality of care delivered by a provider (and how is quality measured)?
• What is the average cost of a certain procedure or treatment in my area?
• Is plan A or plan B a better choice for me and my family?

These types of questions will become even more important when state health exchanges become operational in 2014.  Both the exchanges and employer-sponsored plans will include cost-sharing provisions.  That’s a positive step for the overall system, since patients today usually have little knowledge about the cost of services they are purchasing from their providers.  In fact, the key financial figures – provider’s cost, insurance reimbursement and patient’s out-of-pocket payments – bear little relation to each other in the minds of most patients.

In addition, patients have little opportunity to compare the cost and the quality of care offered by different providers in their communities.  Instead, patients choose physicians and hospitals based on factors like personal recommendations, convenience and provider websites.  Hopefully, implementation of the ACA will eventually bring more transparency to the complicated issues of cost and quality of U.S. healthcare.

With the U.S. Supreme Court’s historic June 28 decision upholding the 2010 Affordable Care Act (ACA), healthcare organizations across the country can expect to see an increase in patient volume over the next few years.  Now, hospitals, physicians and other providers have clear guidance from Washington to guide their strategic planning for the next few years.  While it’s possible that the act could be repealed by a Republican-controlled Congress after the November election, healthcare organizations should ramp up their preparations for the law’s impact.

Certainly, the ACA will make it easier for millions of Americans to access the healthcare system.  It requires individuals to have health insurance – the so-called individual mandate – either through an employer or a state-sponsored exchange.  It also prevents insurers from denying coverage to people with pre-existing medical conditions, and requires them to cover preventative care without additional costs.

So, the big question is what will happen when all those newly insured Americans arrive at a hospital, clinic or physician office.  Will there be enough physicians, PAs, nurses and other professionals to provide quality care?  How can healthcare organizations minimize waiting times and provide cost-effective diagnostic and treatment services?

To cope with the increased demand, healthcare providers will need to review their staffing arrangements and operational procedures.  That could mean expanding the facility to include more examination rooms, or it might mean extending office hours to accommodate more patients in the existing space.  Providers should also consider their staffing options, including temporary, part-time or full-time employees. As the healthcare landscape evolves, All Medical Personnel’s staffing services can provide a valuable resource in this strategic planning process.

Physicians are among some of the busiest professionals, and the time involved for credentialing can be overwhelming. The headaches and paper work to apply with locum tenens companies, obtain hospital privileges and keep up with renewing medical, DEA and controlled substance licenses can be stressful and time consuming. All Medical is here to help.

For providers and clients, All Medical-Locum Tenens has a dedicated staff of experienced administrative professionals ready to assist you. Providers: simply provide an updated CV and we will complete your application for locums work, including hospitals and other medical facilities, licenses and DEA renewals, etc.  Clients: we are here to help you with privileging paperwork, billing enrollment and supervision guidelines for midlevel providers.

At All Medical, we are experts in the field and know how to avoid mistakes and pitfalls that may cost you time and money. Once an application is submitted, our staff will stay on top of it by continually checking the status, making follow up calls and ensuring the application is handled in a timely manner. This will enable you to do what you do best - provide patient care.

Call us today and let us work for you. We’d love to find you the perfect fit, whether a locums job or the coverage your facility needs to keep you on track.