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Will Affordable Care Act Ultimately Result in Greater Contract Labor?

Posted by Tim Teague on Tue, Jun 21, 2016 @ 02:32 PM

Two of the driving tenets of the Affordable Care Act are the push for better patient outcomes and reduction of costs. Since labor spend accounts for the largest percentage of acute care expense, it is a prime target for cost cutting.

 

This presents a conundrum for the hospital. How to cut labor costs while improving the quality of care (decreased re-admission rates).  A corollary to this dilemma has been the “just-in-time” staffing models the industry has used for years.  The difference is while a manufacturer can judge work in process by the amount of incoming orders, the healthcare industry has not been able to predict the number of orders (average length of stay) in a reliable manner.

 

Peter Drucker, foremost business analyst declared just before his death in 2005 that “increasing the productivity of knowledge workers was the most important contribution management needs to make in the 21st century.” The question here is how can data be used to transform the healthcare industry to both decrease costs and improve quality?

 

The answer is equal parts simple and complex. There is enough historical data from millions of hospital admissions across the country to fine-tune a census model that provides extremely accurate daily figures for a unit-by-unit count. Several firms have been working on the analysis of these figures for years. In the same way the electronic medical records have grudgingly made their way into our healthcare system, strategic census models will soon be the norm.

 

When this data becomes granular for hospital systems, the current models for large scale census predictors will become extinct.  This new model for just-in-time staffing will finally provide a day-to-day, week-to-week picture of labor needs. Fine tuning the levels of FTE’s will become better, and non-fixed-cost labor will boom.

Tags: Affordable Care Act, Affordable Healthcare Act, Contract Labor, staffing, Staffing Agency

Donald Trump and Affordable Care

Posted by Tim Teague on Fri, Jun 03, 2016 @ 03:37 PM

Donald Trump and Affordable Care Act

 

As Donald Trump moves closer to becoming the Republican’s presidential candidate in the general election, there are new ramblings of what he would do to Obamacare if elected. Many arguments have been made against the continuance of this growing governmental entity, but odds are the ACA has already “left the station”, never to be diminished or ended. The last battles are likely to be held in state legislatures where expansion of Medicaid and State sponsored exchanges are still in flux. A particularly interesting outcome will be the Commonwealth of Kentucky where a recently elected Republican governor has vowed to dismantle and discontinue a well-entrenched statewide exchange that had been operating for years.

 

If history is to be repeated, the Affordable Care Act is here to stay, and massive changes to its structure are very doubtful. Let’s take a quick look at what was said in the 60’s when Medicare, a similarly tagged national health plan was proposed.

 

Ronald Reagan: “[I]f you don’t [stop Medicare] and I don’t do it, one of these days you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.” [1961]

George H.W. Bush: Described Medicare in 1964 as “socialized medicine.” [1964]

Barry Goldwater: “Having given our pensioners their medical care in kind, why not food baskets, why not public housing accommodations, why not vacation resorts, why not a ration of cigarettes for those who smoke and of beer for those who drink.” [1964]

Bob Dole: In 1996, while running for the Presidency, Dole openly bragged that he was one of 12 House members who voted against creating Medicare in 1965. “I was there, fighting the fight, voting against Medicare . . . because we knew it wouldn’t work in 1965.” [1965]

 

If these arguments sound familiar, so will the likely outcome of the more recent protests against the ACA. In a period when both major parties are struggling to figure out who their constituencies really are, odds are the Affordable Care Act will just keep lumbering along.

 

Good news for those seeing increased healthcare dollars expanding their business, but not necessarily for those desiring less government intervention.

What are you writing about today?

Tags: Affordable Care Act, Healthcare, health

Supreme Court Health Care Ruling: What businesses need to know

Posted by Tim Teague on Fri, Jun 26, 2015 @ 09:25 AM

King v. Burwell: Follow the money to Healthcare Staffing AgenciesSupreme_Court_Health_Care

The historic ruling concerning Obamacare this week has left constitutional scholars scratching their collective heads.  A mentor of mine was told me; “you can study the roots…or you can enjoy the fruits” take your pick! 

Despite the interest in the reasoning behind the ruling (the roots), today I would rather look at the outcome (fruits). 

To summarize, the complaint was that states should not be required to accept the insured that were being subsidized via the minimum standards set forth under the Affordable Care Act. The ruling effectively forces states to comply with the availability standards to all state residents. Striking down this portion of the law would have negated insurance benefits for millions. Upholding the law promises that these individuals, and those that follow will have coverage, and will be subsidized if they meet the criterion, no matter what state they reside in. 

The immediate impact is that individuals that would have been denied coverage will now be insured, providing additional reimbursements for the healthcare providers. For those that carefully watch the markets, nearly every publicly traded healthcare company’s stock surged. (i.e. Aetna, United Health Group, Cigna, Corp., Humana, Anthem, HCA, Community Health, etc. …….) 

In short, there will be more reimbursed dollars in the healthcare system, greater capacity for profitable census growth, and continued increased demand for healthcare workers. The future looks good for the healthcare staffing industry. 

Tags: Obamacare, Affordable Care Act, ACA

Upward Drivers in Healthcare Temporary Staffing

Posted by Tim Teague on Mon, Jun 15, 2015 @ 08:42 AM

Despite the debate that still simmers regarding the Affordable Care Act, a couple of factors will escalate the need for temporary healthcare workers over the next decade.

An enormous driver of healthcare expenditures is the aging population. As the graphic below shows, the over-65 population is exploding with no abatement for years to come. Seasonal trends in census behaviors will continue to be erratic with a definite upward moving trend line. Despite the growth in geriatric outpatient options, the admissions will still continue to grow.

US Bureau of Census

Another driver are the Value Based Purchasing Programs. These programs will reward quality outcomes from hospitals, and penalize those that are doing poorly. These programs will have a dramatic impact on the true cost of patient care as staffing ratios will be more closely monitored. The following programs are already in effect.

http://www.medicare.gov/hospitalcompare/readmission-reduction-program.html
http://www.medicare.gov/hospitalcompare/readmission-reduction-program.html
http://www.medicare.gov/hospitalcompare/HAC-reduction-program.html

Tags: healthcare industry, Affordable Care Act, Health Care Staffing, Medicare

The latest challenge to the Affordable Care Act

Posted by Tim Teague on Fri, Jan 16, 2015 @ 02:21 PM

Silly Photos-3Late last year the Supreme Court decided to hear the latest legal challenge to the Affordable Care Act. One item at issue is the Act’s provision to pay health insurance companies subsidies to help offset the cost of out-of-pocket expenses for low income policyholders that purchase insurance through a government exchange.

In short, the suit claims that paying these subsidies out of an account that has not been appropriated by Congress is a breach of the separation of powers, and by passes Congress’ authority to hold the purse strings.

The anti-ACA activists see this as a means to dismantle the Act in piecemeal fashion, whereas the supporters believe it nothing more than a partisan move to curry favor with a certain segment of the population.

From an objective view, the likely outcome of the suit will create some language changes in how the law is executed, but will have minimal impact on the intended delivery of service.  The Supreme Court has already facilitated continuance of the law despite similar challenges, and it is unlikely to render a decision that would cripple the program. Love it or hate it, it’s here to stay.

Tags: Affordable Care Act

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