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Dear ASHHRA Member:

Happy New Year! I am beginning my new tenure as ASHHRA president with the gratitude of knowing I am supported by a phenomenal Board of Directors. Our job, first and foremost, is to listen to you – our members – and to respond to your professional needs.

Choosing a career in healthcare HR makes you a special and unique individual. Whether you support a hospital, clinic, nursing or retirement facility, or any other healthcare organization, you are in a profession unlike any other. And ASHHRA wants to be your primary resource for your unique professional needs.

Recently, ASHHRA conducted a study in which many of you participated, and I want to thank you for taking the time to contribute to that conversation. You told us that you value ASHHRA because ASHHRA is dedicated solely to healthcare HR. However, you also told us that we need to be “more” and “better.” We need to give you more resources, such as white papers, online resources and professional tools. We also need to get better at telling what we have to offer and making those things more accessible to you, such as our online tools, logging on to the “members only” section, and participating in the online community.

In 2008, our goal is to give you more and make it easier for you get the wonderful resources we have for you. We plan to add more white papers and best practices to our Web site, and we will launch a new online community giving you the ability to dialogue with other healthcare professionals.

You also told us that you would like to see some kind of healthcare credential or certification program, supported by the AHA. Such a program would be a tremendous boost to your career development and succession planning. In 2008, the board will explore the feasibility of this type of program, and we will update you as the year progresses.

We also heard from you through the 2007 conference feedback survey, giving us great information for planning the conference this year in Austin. Look for many new features, such as learning tracks, programs and sessions aimed at specific groups of healthcare HR professions – executive leaders, new-to-the-profession practitioners, and HR professionals working for healthcare organizations other than hospitals.

This year is going to be better than ever for you as ASHHRA members and healthcare HR professionals. I look forward to serving you and being a part of your career journey.

Best regards,
Jeanene Martin
ASHHRA 2008 President


Headlines

ASHHRA News
Regional Consultant Election Results
ASHHRA Advocacy Update

Legal
"U.S. Ruling Backs Benefit Cut at 65 in Retiree Plans"
"California, The Bellwether"
"Employers Tell Workers to Get Healthy or Pay Up"

Workforce
"Norovirus Sweeps 2 Boston Hospitals"
"Nurse Residency Program Implementation"

Compensation
"Give It Back"

General HR
"Superior Scheduling"
"Do Your Employees Consider Your Corporate Policies Racist?"
"Hospital Chemicals Threaten Nurses' Health, Report Says"

Benefits
"Corporate Wellness: Implementing a Program With Strong ROI and Improved Health Outcomes"
"Retirement Debit Cards Sound Like a Nightmare, but Have Some Benefits"

Physicians
"Creating a Sustainable Physician Strategy"

Management and Leadership
"Boards Increase Oversight of Human Capital Issues"
"What Every Leader Needs to Know About Followers"
"How to Lead Different Generations in the Workplace"


ASHHRA News

Regional Consultant Election Results

Lisa Schott, PHR, chair of the Regional, Chapter, & Member Services Committee, this week announced election results for regional consultants in Regions 1, 3, 5, 7, and 9, as well as Region 2, a mid-term replacement for Joe Miccuci, who accepted a position on the ASHHRA 2008 Board of Directors.

Regional consultants serve a two-year term. They are the voice of membership in their respective regions and key participants in fulfilling the ASHHRA strategic goals.

Please be sure you connect with your regional consultant at some point throughout the year. Share your ideas, and let them know how ASHHRA can better serve you.

Congratulations to the following regional consultants:

REGION 1, Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
Judith West
Vice President, HR
Maine Medical Center
Portland, Maine

REGION 2, New Jersey, New York, Pennsylvania
Fran Keane
Vice President, HR
Centrastate Healthcare System
Freehold, N.J.

REGION 3, Delaware, District of Columbia, Kentucky, Maryland, North Carolina, Virginia, W. Virginia
Grace Moffitt, VH, HR/Sup Svc
Annie Penn Hospital
618 South Main Street
Reidsville, N.C.

REGION 5, Canada, Illinois, Indiana, Michigan, Ohio, Wisconsin
(re-elected) Carol J. Bank, VP, HR
Divine Savior Healthcare
PO Box 387
Portage, Wisc.

REGION 7, Arkansas, Louisiana, Oklahoma, Texas
(re-elected) Felicia Miller, Regional Director, HR
Texas Health Resources / Presbyterian Healthcare System
Plano, Texas

REGION 9, Alaska, California, Hawaii, Nevada, Oregon, Washington
(re-elected) Lisa McDaniel, SPHR
Human Resources Administrator
Kittitas Valley Community Hospital
Ellensburg, Wash.

For a complete list of the Regional, Chapter, & Member Services Committee, click here. Return to Headlines

ASHHRA Advocacy Update

When Congress left Washington last month, it left unresolved much legislative business of interest to ASHHRA. But human resource advocates made headway on a number of key issues before Congress took its final roll call votes for 2007. Throughout the year, ASHHRA advocacy efforts yielded positive results on a few issues and also warded off legislation that would have adversely affected human resource professionals. Here’s a recap of issues that ASHHRA followed during the first session of the 110th Congress:

Card Check – One of the first bills Congress considered in 2007, and one that was high on labor unions’ “must pass” list, was H.R. 800/S. 1041, also known as the “Card Check” bill. ASHHRA, through its coalition activities, Alerts, and congressional education efforts, helped defeat this onerous bill in the U.S. Senate. The bill would have amended the National Labor Relations Act (NLRA) by eliminating the right to a federally supervised private ballot election during union organizing drives. It also would have forced employers and workers into federal binding arbitration – binding for 2 years on both parties -- if a collective bargaining agreement could not be reached within 90 days. The ASHHRA Advocacy committee, during their Washington visit, focused on educating members of Congress on the adverse impact that this measure would have on hospitals and health care providers.

Nurse Education/Workforce funding – On Dec. 26, President Bush signed into law the omnibus spending bill which provides funding for 11 government agencies for Fiscal Year (FY) 2008, including the Departments of Labor, Health and Human Resources, and Education. Because of critical shortages of health care professionals, ASHHRA strongly lobbied for increased funding for programs aimed at increasing and retaining health care professionals, particularly nurses. Our efforts paid off when the conference committee approved funding for $156 million for nursing programs, an increase of $6.4 million over FY 2007. The additional funding is aimed at increasing nurse faculty, retaining nurses in the workforce, and bolstering scholarships and loan repayment programs for nursing students and faculty.

Immigration -- Comprehensive immigration legislation was introduced in the Senate that would have seriously impeded the ability of U.S. hospitals to recruit well-qualified health care professionals from abroad. The bill, S. 1348, would have eliminated the employer’s role in hiring health care professionals from abroad and instead replace it with a point-based systems where the foreign health care professional would be granted a visa without employer screening or sponsorship. ASHHRA, along with AHA and other employers, urged Congress to reject such an approach. The bill was ultimately defeated.

As we enter the second session of the 110th Congress, much remains to be done. Legislative challenges facing ASHHRA and human resource professionals include:

NLRB Definition of “Supervisor” -- H.R. 1644, the Re-Empowerment of Skilled and Professional Employees and Construction and Traderworkers (RESPECT) Act is expected to be voted on by the House in the early months of the second session. This labor-backed bill, introduced by Reps. Rob Andrews (D-NJ) and Rosa DeLauro (D-CT) was approved by the House Education and Labor Committee on a straight party line vote. A similar measure has been introduced in the Senate by Sens. Dick Durbin (D-IL), Ted Kennedy (D-MA) and Chris Dodd (D-CT). This bill would amend the definition of “supervisor” under the NLRA by eliminating two duties of the supervisor: that of “responsibly directing” and “assigning” other staff. It would also require that a majority of the supervisor’s time must be spent performing other duties that remain in the definition: hiring; firing; laying off; suspending; recalling; promoting; discharging; rewarding; or imposing disciplinary actions. The bill would reverse long-standing NLRB guidance on when a charge nurse is considered a supervisor.

FMLA changes -- Numerous bills have been introduced to expand the reach of the FMLA and these measures are expected to be considered in 2008. A provision which would give FMLA protected leave to workers to care for wounded soldiers and also to family members of those called to active duty was included in H.R. 1585, the Defense Authorization bill. However, the bill was vetoed by the President over an issue unrelated to the FMLA expansion. One of the first items on Congress’ agenda when they return will be to address the President’s concern (which related to a liability issue) and re-pass the bill. If the FMLA provision remains intact, it will represent the first expansion of FMLA since 1993.

Worker Verification – Prior to Congress’ adjournment, legislation was introduced that would require employers to use a Department of Homeland Security (DHS) verification system to ensure that their workers are authorized to work in the U.S. H.R. 4088/S. 2368, the Secure America through Verification and Enforcement Act would phase in the use of the DHS “E-Verify electronic verification system to all employers. The bill is designed to decrease illegal immigration by increasing border and interior enforcement and providing employers with tools to verify worker eligibility.

Mandatory Staffing Ratios – One of labor’s top issues is the imposition of mandatory nurse staffing ratios in health care institutions. Two bills remain pending on this issue: The Registered Nurse Safe Staffing Act of 2007 (S. 73), introduced by Sens. Harry Reid (D-NV) and Dan Inouye (D-HI); and H.R. 2132 by Rep. Jan Schakowsky (D-IL). While no hearings have yet been scheduled, it is anticipated that consideration may arise early in the second session.

Restrictions on Unavoidable Overtime – The Safe Nursing and Patient Care Act of 2007 (S. 1842) and it’s House companion bill, H.R. 2122, would prohibit health care providers from requiring a nurse to work more than the scheduled work shift – 12 hours in a 24-hour period, or 80 hours in a consecutive 14-day period. The bills also establish civil money penalties for health care institutions that violate the act. They further prohibit health care institutions from retaliating against any nurse who complains or reports violations. There are no hearings scheduled for consideration of these bills, but they remain a top union priority.

Ergonomics – The Nurse and Patient Safety and Protection Act of 2007 (H.R. 378) is intended to protect the health and safety of patients, nurses and other caregivers by eliminating manual lifting of all patients except during a declared state of emergency. No hearings are scheduled however there has been increased pressure by unions to move the bill.

The early weeks of the Congress will be devoted to the President’s budget proposal. And with the election looming in the fall, Congress will have to work at a steady pace in order to accomplish everything on their plate before their final adjournment. During the year, ASHHRA will strive hard to accomplish our goals on “the Hill” and continue to keep our members abreast of significant legislative developments.
Return to Headlines


Legal

"U.S. Ruling Backs Benefit Cut at 65 in Retiree Plans"
New York Times (12/27/07) Pear, Robert

With the population continuing to age and health insurance costs on the rise, employers are struggling to offer health insurance benefits to retired workers. The Kaiser Family Foundation indicates health insurance costs rose 6.1 percent in 2007 and 78 percent since 2001. The U.S. Equal Employment Opportunity Commission (EEOC) recently ruled that while employers can offer healthcare benefits to retirees voluntarily, they are not required to do so under federal law. While the latest regulation from the EEOC does not intend to encourage employers to drop retiree benefits altogether, AARP and other advocates for seniors are concerned the rule will do just that. The rule will allow employers to offer more robust benefits to retirees under age 65 than to those over 65 who are eligible for Medicare, thus providing employers with anti-discrimination law exemptions. It also will permit employers to adjust retiree benefits at a later date, which could lead to reductions in benefits for spouses or dependents. Critics contend the new regulation violates the Age Discrimination in Employment Act of 1967, but the EEOC cites a recent ruling in the U.S. Court of Appeals for the Third Circuit in Philadelphia, which allows the commission to create reasonable exemptions in the public interest. The EEOC contends many employers stated they would eliminate all retiree benefits if they were forced to provide the same benefits to all classes of retirees.
Return to Headlines

"California, The Bellwether"
HR Magazine (12/07) Vol. 52, No. 12, P. 42; Cadrain, Diane

California's progressive employee rights laws carry implications for employers nationwide, with courts in other states closely following California court decisions that favor employee rights. For instance, rulings on wrongful termination and implied contracts were ruled in favor of employees in California, and those decisions were adopted nationwide. The court system in the state is not the only body with liberal leanings; the state legislature adopted a number of laws that are employee friendly, which migrated to other states. While the state was not the first to mandate sexual harassment training programs, its 2004 law was more specific and strict than those already in place. California also passed a family leave law that allows workers to take up to six weeks of family leave every year to care for a new child or ill family member. While leave is guaranteed under the federal Family and Medical Leave Act, California mandates that the employees on leave be paid up to 55 percent of their wages. California's disability discrimination statues also are more protective of employees than the national standard, considering employees as disabled even if the disability only affects one of a broad range of tasks. Employers operating in multiple states must decide whether or not they will apply California's standards to all of their operations; most firms are divided on the issue. One employer said that if a company values its employees as their most valuable asset, they should adopt the more protective standards; but others suggest that local jurisdiction should prevail with regard to workers' rights. HR professionals claim organizations need to assess the benefits and costs of applying a generous set of standards to the workforce and review legal liabilities associated with those standards before adhering to one set of standards for their entire workforce.
Return to Headlines

"Employers Tell Workers to Get Healthy or Pay Up"
Wall Street Journal (12/04/07) P. D4; Knight, Victoria E.

According to the Integrated Benefits Institute, employers are eager to see healthier workers. While some rely upon incentives, including higher employer contributions to health insurance plans, others are taking a more punitive approach, forcing workers to pay higher deductibles. Attorneys and consultants also are concerned employers penalizing workers for failing to improve their health are opening themselves up to litigation. The U.S. Equal Employment Opportunity Commission is examining whether wellness programs run afoul of the Americans With Disabilities Act. Unlike the individual insurance market, federal law dictates that employer-based plans must offer coverage to all workers under the same plan regardless of their health status. Meanwhile, smaller employers that struggle to cover the costs of employer-based plans are revamping those plans to force employees to take charge of their health and reduce or eliminate poor lifestyle habits. Employers engaged in these penalty and incentive programs for workers note healthier lifestyles among workers have resulted. Bank of Geneva in Indiana increased workers' deductibles for health coverage from $500 to $2,500, and those workers seeking a reduction in the deductible agreed to meet health benchmarks for cholesterol, body mass index, blood pressure, and tobacco use under a supplemental plan.
Return to Headlines


Workforce

"Norovirus Sweeps 2 Boston Hospitals"
Boston Globe (01/08/08) Smith, Stephen

A recent outbreak of norovirus at two Massachusetts hospitals and one daycare center highlights the dangers of breaking with hospital protocol. Norovirus is highly contagious and causes gastrointestinal disruptions that lead to vomiting and diarrhea, but the spread of the virus can be slowed through rigorous hand-washing. Massachusetts General, known for its efforts to promote hand-washing as a means of reducing infection rates, saw 31 staff members and 13 patients fall ill during the outbreak. As a result, the facility cleaned its serving tables, floors, and other environmental surfaces with bleach; patient charts and keyboards also were disinfected. The medical ward infected with norovirus ceased new patient admissions for four days until the danger abated, and those medical staff infected could not return to work until three infection-free days had passed. Visitors to the ward were asked to wear medical gowns and gloves. Brigham and Women's Hospital found 22 of its staff and eight patients infected on its cardiac unit. Epidemiologist Dr. Deborah Yokoe said, "We tried to make it really clear to them that anything less than perfect use of the hand-gel product was going to give the virus an opportunity to take advantage of the situation." Healthcare improvement specialists report without careful monitoring of hand-washing protocols, workers could adopt poor habits that leave them and patients vulnerable to infection. Hospital administrators are urged to ensure all hand-sanitizing gels are accessible and full in locations most accessible to healthcare professionals.
Return to Headlines

"Nurse Residency Program Implementation"
Journal of Healthcare Management (12/01/2007) Vol. 52, No. 6, P. 385; Poynton, Mollie R.; Madden, Connie; Bowers, Roxanne

Nursing staff shortages have many hospital executives, administrators, and managers scratching their heads, but one University of Utah nurse residency program could provide healthcare facilities with a viable option to fill in those workforce gaps. With graduate nurse turnover rates up to 60 percent in some cases, costing hospitals up to $67,000 in replacement and other costs, hospitals need solutions to recruit and retain talented workers and reduce these expenses. Nurse turnover not only costs hospitals and healthcare facilities money, but it also interferes with quality patient care, particularly when turnover leads to a breakdown in communication between medical staff. Under the Utah nurse residency program, cohort entry is aligned with nursing program graduation; and nurse residents are placed in individual hospital units as well as their cohort at the same time, rather than through a staggered entry process. Once in the program, residents are required to work 36 hours at the hospital and reserve 4 hours for their cohort seminar, which can either be taken on a day off or after a 12-hour shift so nurses are not obligated to return after long commutes home. The program--which once used a two-part curriculum based on the registered nurse (RN) degree at the university--now employs a blended curriculum of RN material and practical best practices; nurse resident feedback stipulated the old curriculum rehashed undergraduate education, and these nurses sought further instruction on stress management, shift rotations, sleep management for night shifts, work-life balancing, and additional issues. The ongoing feedback from residents helps shape the curriculum to meet each cohort's needs, and officials at the Utah center say the program helped residents garner leadership skills and develop professionally. A second key element of the program aimed to create autonomy, providing time for residents to share clinical experiences with their peers for recognition of good outcomes and cognitive development. Additionally, the nurse residents are given an opportunity to work outside their designated units to provide them with an enterprise-wide perspective and foster cooperation between them and other units' staff members as a way to provide better quality care. Other unique areas University of Utah officials believe must be addressed in nurse residency programs include mentoring, fostering mutual respect between residents and their supervisors, and meeting the particular needs of associate degree residents. As a result, the University Health Center says turnover of new graduate nurses and all other registered nurses fell from 24 percent in 2002 to just 1.56 percent in 2005.
Return to Headlines


Compensation

"Give It Back"
Human Resource Executive (12/07) Vol. 21, No. 17, P. 48; Silverman, Ed

Clawbacks are moving to the fore as a popular and necessary disciplinary action for errant executives, and both shareholders and board members benefit when organizations include clawback policies in chief executives' contracts. When an executive earns a bonus or reward from fraudulent or poor practices, a clawback policy gives the firm the right to retract those financial rewards. About 18 percent of Fortune 100 firms have these policies in place as a way to reassure shareholders. Boards have little authority to ask a CEO to return an incentive award without a clearly defined policy in place. Therefore, human resource (HR) managers and boards should decide what types of behaviors require clawbacks and how far down the corporate ladder these policies will extend. Boards need to determine how much flexibility they want with regard to these policies or whether they want clearly defined guidelines to help determine what actions warrant a clawback and what incentives should be included, notes Cindy Redding of the energy firm MDU Resources. HR managers play an integral role in the process of crafting these policies by outlining possible restrictions and penalties.
Return to Headlines


General HR

"Superior Scheduling"
Health Management Technology (01/08) Siek, Terry

Healthcare facilities around the country are trying to find a solution to a labor shortage and increased labor expenses. The Hays Medical Center, for example, decided to implement an automated staff scheduling solution to limit overtime costs, make sure each shift is fully staffed, and cut down on administrative tasks. The new system did not require the center to rebuild its interface from its old automated time and attendance system, and training managers how to use the scheduling and attendance software was a cumbersome process because 10 difference managers ran separate sessions that were not always applicable to each attendee. However, six months after implementing the system, managers easily created schedules, which helps the center save money. The system allows staff to be used in the best way possible while alerting managers when a member is approaching overtime or if a shift is not covered. The program also works with Hays' acuity system to provide managers with data on how much staff is needed based on patient conditions, allowing them to send a nurse home or call another one in. Staff morale and job satisfaction has improved because members can request more easily a specific shift or time off. However, the system hit a snag when nurses only filled in schedules based upon their own work schedule preferences and failed to volunteer to fill gaps in scheduling, but the center remedied the situation when it began requiring alternating weekend shifts for nurses.
Return to Headlines

"Do Your Employees Consider Your Corporate Policies Racist?"
Workforce Management (12/01/2007) Carlsen, Ann

Racism continues to color the perspectives of Americans, with 46 percent of African Americans believing race is a factor in the Michael Vick dog-fighting case; only 14 percent of white Americans responded similarly. As a result, employers must review their policies to ensure minority groups do not view them as discriminatory. In a racial discrimination case involving Microsoft policies, seven African American employees referred to the corporate culture as a "plantation mentality," with black people comprising only 1.6 percent of corporate management. To avoid a costly lawsuit and a divided workforce, employers must take steps to ensure they are seen as diverse from the top down. Human resource (HR) policies should be reviewed to make sure they address the entirety of the workforce in a fair manner. Employers should foster open communication with employees to encourage discussion and feedback on all HR policies. Additionally, employers should keep abreast of happenings within and outside their industry in terms of diversity and workplace trends and seek out best practices. Taking these steps can help a company show it is serious about diversity issues.
Return to Headlines

"Hospital Chemicals Threaten Nurses' Health, Report Says"
San Francisco Chronicle (12/12/07) P. A1; Allday, Erin

A new study conducted by the Environmental Working Group of Oakland, Calif., in conjunction with Health Care Without Harm--an international coalition dedicated to reducing the use of harmful materials in the healthcare industry--found that certain chemicals common in hospitals increase the risk of disease among those nurses exposed to them, as well as their children if exposure takes place during pregnancy. The study surveyed 1,500 nurses across the United States regarding their exposure to 11 common healthcare chemicals, including gases used for anesthesia, hand disinfectants, cleaning agents, latex, medications like chemotherapy and antiretroviral drugs, and many others. Those exposed regularly, defined as at least once per week, had higher rates of cancer, asthma, and miscarriage than their unexposed counterparts. Exposure during pregnancy increased the likelihood of birth defects, particularly musculoskeletal defects; nurses exposed frequently to sterilizing agents and anesthetic gases were seven to nine times as likely to have children with musculoskeletal defects compared to their counterparts. The study noted that few federal regulations exist governing the exposure to chemicals among healthcare workers, and nurses themselves seldom knew the risks of exposure. Though researchers admitted that the informal nature of the survey encouraged nurses with ailments and worries about workplace safety to participate, they hoped the results would prompt federal action. In California, meanwhile, hospitals made efforts to reduce the risk of exposure; many no longer use latex gloves due to potential allergic reactions, and others eliminated the use of vinyl-based materials because the chemicals used to make vinyl are linked to cancer and birth defects. At the Stanford University Medical Center and Lucile Packard Children's Hospital, new nurses undergo a physical exam that includes examination of chemical levels in their bodies, and they are offered annual monitoring of those levels. Nurses at both facilities also are trained regularly in how to handle potentially dangerous drugs, while the engineering staffs at the hospitals routinely check air quality and ventilation systems to minimize exposure.
Return to Headlines


Benefits

"Corporate Wellness: Implementing a Program With Strong ROI and Improved Health Outcomes"
Health Insurance Underwriter (12/07) Vol. 55, No. 12, P. 67; Fouts, Terry

Wellness programs have the potential to cut a company's healthcare costs by up to 25 percent, as such programs address "controllable behaviors" that account for nearly one-quarter of all healthcare spending in the United States. These controllable behaviors include tobacco use, physical inactivity, and overeating. Wellness programs can gauge the most prevalent health risks in a workforce and then customize interventions to tackle workers' needs. Employee enrollment and quantitative feedback data are used by employers to track the success of the program. Experts agree that for these programs to be successful, they must foster behavioral change, utilize personal health coaches, reward workers through incentives, employ 24-hour nurse lines, and provide employers with detailed reports on the program's operations. Low-risk people transform into high-risk people without the help of preventive programs, and higher risks mean higher annual costs for employers, reports Dee Edington of the University of Michigan Health Management Research Center. Edington also says wellness initiatives decrease health risks and healthcare costs together. Many studies have shown that wellness programs produce ROI averages of $3 for each $1 invested, and a review of 32 studies discovered reductions in claims costs, hospital admissions, and disability costs of 27.8 percent, 62.5 percent, and 34.4 percent, respectively. Experts also note that costs of implementing wellness programs can be offset by savings, productivity gains, and lower absenteeism.
Return to Headlines

"Retirement Debit Cards Sound Like a Nightmare, but Have Some Benefits"
Employee Benefit Adviser (12/07) Vol. 5, No. 12, P. 20; Robbins, McLean

Due to the feeble state of many employee savings accounts, the idea of allowing employees to borrow against their retirement savings has gained a number of critics. However, some argue there are a number of benefits associated with these accounts. According to the Employee Benefits Research Institute, 85 percent of 401(k) plan participants are part of a plan that allows loans. Currently, the U.S. Internal Revenue Service allows employees to take out a maximum amount of 50 percent of their savings or $10,000 in every 12 month period, and these loans are repaid through payroll deductions. However, if an employee leaves the company or is fired, they must pay back the full amount of the loan within 90 days, which can be painful for workers. To avoid these pitfalls, employers are turning to the ReservePlus debit card, which allows employers to outsource loan administration and eliminate payroll deduction, which eliminates the need of workers to immediately repay their loan if they leave the firm. The program--which does not have an annual fee--makes repayments faster, according to users. The program allows the loans to move into stable accounts where funds are doled out per purchase and allow remaining funds to gain interest, preventing immediate liquidation of the loan. According to ReservePlus, participants borrow 35 percent less from their 401(k) savings under its program.
Return to Headlines


Physicians

"Creating a Sustainable Physician Strategy"
Healthcare Financial Management (01/08) Warden, Jay; Woodward, Kevin

As physician shortages emerge and technology advancements improve care quality, hospitals and healthcare groups must cultivate solid relationships with physicians they interact with and others in the talent pipeline to ensure they will be readily available to perform necessary healthcare services. Changes to the regulatory landscape, increases in medical risks and liability, and other influences can impact hospital-physician relationships, such as declines in Medicare payments for physician-owned ambulatory and imaging facilities and declines in income for practices, which could force doctors to reduce on-call coverage, consolidate hospital privileges, and seek out pay-for-call deals. With the enactment of Stark III regulations in December 2007, some hospital-physician joint ventures, except the donation of electronic-records systems to physician practices, may now be in violation due to a lack of grandfather clauses in the regulations. As a result of these changes, hospitals must revamp their relations with doctors to ensure they are engaged in the strategic planning process and have input in how hospitals are run in the future through a physician advisory council or other means. However, hospitals must steer strategy sessions and engage physicians directly, rather than wait for doctors to come forward with input about market strategies for specific service lines, possible incentive programs, and other feedback. Another recommendation is to hire physicians in low-supply, high-demand specialties, which will help the facility provide necessary services to the community. Recruiting the best physicians requires robust compensation plans, and arrangements that are age-specific and specialty-specific should be considered. Relationships with PCPs also deserve attention, as the baby boomer demographic typically follows PCPs' referrals for outpatient care. PCP participation on hospital boards and regional referral network programs are some options for engaging PCPs. Drafting an official hospital-physician alignment plan, allocating capital to the plan, and proactively executing the plan will position hospitals for long-term success, say experts.
Return to Headlines


Management and Leadership

"Boards Increase Oversight of Human Capital Issues"
Human Resource Executive (12/07) Vol. 21, No. 17, P. 20; Behan, Beverly

A new study by the Hay Group reveals that more boards, especially those of the top companies, are paying attention to human capital issues. The Hay Group conducted a study of 150 top executives for Fortune magazine as part of their report on the World's Most Admired Companies. The survey found over 75 percent of boards added management of human capital to their to-do list in the past several years. Over 66 percent said CEOs and management often consult board members on human capital issues, like employee-turnover rates, job-acceptance rates, diversity statistics, and employee-satisfaction. Attention to these issues was even more prevalent in the most admired companies than average. For example, over 80 percent of the most admired companies developed human capital strategies as part of their overall corporate strategy, compared to 70 percent of most other boards. More than 80 percent of the most admired companies also included human capital measures as part of their CEO performance evaluation, and over 90 percent had emergency succession plans in place. This study demonstrates how attention to human resources is an important factor in helping a company get an edge on its competition.
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"What Every Leader Needs to Know About Followers"
Harvard Business Review (12/07) Vol. 85, No. 12, P. 84; Kellerman, Barbara

Though the contemporary leadership industry tends to ignore followers, differences among followers are as significant as differences among leaders, particularly in the business world where reporting relationships are changing and new talent-management strategies are emerging. Barbara Kellerman of Harvard University offers a new method for uncovering and valuing the various types of followers. Kellerman based her typology on one metric, level of engagement, as that element determines in large part the quality of the superior-subordinate relationship. After classifying followers according to where they fell along a scale ranging from "feeling and doing absolutely nothing" to "being passionately committed and deeply involved," Kellerman created five categories of followers. The first, "isolates," are totally detached, whereas "bystanders" watch but decline to participate. "Participants" are engaged enough to try to make an impact, "activists" are eager to act on their strong feelings, and "diehards" display an all-consuming devotion to their cause. As for what separates a good follower from a bad follower, Kellerman says good followers invest energy and time in the formation of judgments about their leaders and dynamically support ethical and effective leaders, but they actively contest unethical and ineffective leaders. In contrast, bad followers contribute nothing to an organization, oppose a good leader, or support a bad leader.
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"How to Lead Different Generations in the Workplace"
Beyond Numbers (12/07) No. 467, P. 8; Houlihan, Anne

With four generations of employees working side by side, it is important for managers to be able to motivate and control a diverse workforce. This can be challenging because each generation has different values that affect management style. The first step in effectively managing a diverse workforce is to identify the four generations: the Veterans (born pre-1946), the Baby Boomers (1946-1964), Generation X (1964-1980), and Millennial (1980-2000). Each generation has different strengths that can be harnessed for the good of the workplace. Veterans generally value quality; baby boomers are loyal and willing to make sacrifices; Gen X'ers care about their productivity; and Millennials can multi-task and are adept at using technology. Managers should encourage their employees to share their values in an open dialogue, which can foster a mutual learning environment among all workers. One obstacle facing managers is their own generational bias. For example, in a dispute involving an employee from a different generation, a manager must consider the employee's values as well as their own. Although a manager cannot change generational differences, there are some techniques that address the values and strengths of each set of workers. Veterans value authority and like knowing they are respected by their peers and supervisors. Boomers are motivated by personal gratification and monetary bonuses that show their sacrifices are appreciated. Gen X'ers prefer acknowledgement for their accomplishments, while Millennials like a structured workplace where they are both challenged and given feedback. By tailoring managerial responses to each generation, supervisors can encourage the best performances from their subordinates.
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