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ASHHRA Announces Inaugural Issue of Monthly News Brief

Dear Member:

I am excited to bring you the inaugural issue of ASHHRA News Brief: Hot Topics for Healthcare HR Leaders. As a member, you will receive this free monthly publication containing summaries of the latest news related to healthcare HR leaders.

For several years, ASHHRA members have been asking for a resource of current industry information and news. I’m thrilled to say we heard you and we are delivering! Feel free to share this information with your staff and colleagues. And be sure to let us know what you think about this new member service.

Regards,
Molly Seals
ASHHRA 2007 President


Headlines

ASHHRA News
AHA Launches "My Care Counts"
Get Involved in Advocacy!

Industry News
"Improper Notice Dooms Sexual Harassment Claim"
"Trying to Compensate"
"Taking the 'H' Out of HR"
"Nurse Wage Suit Expected to Last Into Mid-2008"
"Being Unhealthy Could Cost You"
"Clark County Struggles to Acclimatize Foreign Nurses"
"Taking the Pulse of 'Health Courts'"
"Industry Insiders Cite Reasons for Nursing Shortage"
"Competition Still Driving Compensation"
"Aligning Physician-Hospital Relations: an Integrated Approach"
"Nurse Training Bottlenecks and Job Burn-Out Rate Worsen Nurse Shortages"
"The Looming Crisis in Rural Healthcare"
"Nursing, Doctor Numbers Worsen"
"Hospital Workers Learn to Defuse Conflict"
"New Rules Could Make it Harder to Hire Foreign Workers"
"Report: More Doctors Signing Employment Contracts With Hospitals"
"Bill Would Extend Lawsuit Window"
"Survey: Cash Incentives Work Better Than High Deductibles"


ASHHRA News

AHA Launches "My Care Counts"

The AHA recently launched My Care Counts, a grassroots effort to let members of Congress know that Americans support their local hospitals and want to protect the care they receive in their communities.

The AHA is asking the men and women of our nation’s hospitals – hospital leaders, trustees and staff – as well as auxilians and volunteers to sign an online “Call to Action” expressing their support. It’s simple – visit www.MyCareCounts.org, fill in the information requested and click “Sign the Call to action” to add your name to the thousands that already have signed on. But don’t stop there! Share the Web site with your friends, family members and neighbors and ask them to join the effort by adding their names, and encouraging their family and friends to do likewise.

Today, hospitals must be able to respond to disasters both natural and manmade, update facilities and technologies to better care for an increasingly aging population, and upgrade information technology for patient safety. And they always need to be ready to provide the care you need at any time, under any circumstance. At a time when our nation's health care system faces these and other very serious challenges, cuts that threaten vital services are dangerous for all of us.

Please visit www.MyCareCounts.org to sign the Call to Action … and forward the address on to your friends and family and ask them to sign as well. Your hospital is depending on you!
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Get Involved in Advocacy!

That’s the message from the ASHHRA Advocacy Committee. As healthcare employers face the challenges of new legislation at the federal and state levels, the Advocacy Committee strives to provide you with the tools you need to "raise your voice" before the legislation takes effect. As an ASHHRA member, you have an opportunity to make an impact before a bill becomes law!

Here are some tips for getting involved:

Become knowledgeable about the proposed legislation by reading the ASHHRA position papers on www.ashhra.org. (in the Advocacy section). Read other professional journals, as well, such as the HR Pulse. Know what the issues are and how they will impact you as a healthcare employer. Stay current!

Identify who your elected representatives are. Go to www.thomas.gov, your state hospital association, your state ASHHRA chapter, shrm.org, or go through your public library.

Familiarize yourself with your representative's position on the bill, available on their Web site. You can also call their local office and speak with one of their aids.

Write (letter or e-mail) or call your legislator. Their Web sites list details about how they prefer to get information. Provide them with your perspective on the bill and let them know why you do or do not support it.


  • Speak to the specifics of the law and, if you think it is not in the best interest of healthcare employees, say specifically what the negative impact would be.

  • Always be polite and respectful, thanking them for hearing your perspective and considering it.

  • Make reference to your professional role in stating your position (“As a human resources professional with a healthcare organization of 1,500 employees . . . .”) .

  • Remind them that you are part of ASHHRA, an organization representing over 3,000 healthcare human resources professionals from across America.

Please remember, it’s important to not be vague (e.g.,”I oppose it because it’s wrong!”) or demeaning (e.g.,” you’re stupid if you support this!”).

Here's an example of a specific message that might have been sent about a piece of legislation - the Employee Freedom of Choice Act - that would have had a huge impact on healthcare employers: "This legislation would take away the right of employees to use a secret ballot vote in determining whether they want to be represented by a union. I oppose this legislation because it would cause employees to lose a basic right that is foundational in a democracy." In this particular situation, many of you - ASHHRA members - contacted your legislator detailing why you opposed the legislation.

The Advocacy Committee is currently planning a Webinar for the state chapter leaders to give them tools and ideas for involving members of state and municipal legislation. We can make a difference! Return to Headlines


Industry News

"Improper Notice Dooms Sexual Harassment Claim"
Business Insurance (07/23/07) P. 4; Greenwald, Judy

The July 6 Eleventh Circuit Court of Appeals decision in Nurse Bobbie Eicke O'Brien v. Columbia Palms West Hospital Ltd. Partnership overturned a $10,000 sexual harassment jury award in favor of the nurse because she failed to properly notify her supervisor about the alleged harassment. According to the case, O'Brien alerted her supervisor to the late night cell phone calls and other activities of Dr. Michael Chaparro, a contract pediatric neurosurgeon on staff at the hospital, but told her supervisor not to report the alleged harassment. The nurse feared retaliation and simply asked her supervisor to remove her private numbers from the staff directory. The calls ceased, but later the doctor allegedly approached her in a sexual way, following her into a closet, which prompted a formal complaint. HR investigated the incident, which the doctor claimed was the first time he had been rebuffed by O'Brien, who later resigned and filed suit against the hospital for perpetuating a hostile work environment. However, because the phone call harassment notification did not meet the legal requirements, the hospital was not sufficiently alerted to the problem, but when alerted, the three-judge panel concluded the hospital reacted appropriately. Legal experts expressed concern that the decision opens the door for other claims to be thrown out.
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"Trying to Compensate"
Modern Healthcare (07/30/07) P. 6; Galloro, Vince; Vesely, Rebecca; Zigmond, Jessica

For the past several years, Modern Healthcare has been researching the trends in compensation of the CEOs of 30 major healthcare providers in the areas of acute-care hospitals, health insurance, and specialty care. Their analysis began after several CEOs were harshly criticized for cashing in stock options immediately before their companies tanked in the market. Obviously, this debate has had an effect. According to Standard and Poor's Composite 1500 index figures from 2005, stock options now account for a third less of executive compensation packages than they did in 2001. New corporate disclosure rules from the Securities and Exchange Commission (SEC) are also expected to effect the results of 2006 pay packages, especially pension, severance payments, and change in control payments. Even with these changes, the 2006 Modern Healthcare study found that 25 out of 30 companies grant CEO stock options, and 20 were given restricted stock. Out of all current healthcare providers CEO, Jack Bovender of HCA came out on top, earning a total of $35.9 million thanks to HCA's transition to a private company. Bovender was not technically the highest paid of all healthcare CEOs. That title goes to William McGuire and Jack Rowe who walked away from UnitedHealth Group and Aetna respectively. Although Rowe stands to earn upwards of $55.8 million from Aetna that figure pales in comparison to McGuire's $1.78 billion backdated payout. He may not get to keep that sum; however, thanks to investor lawsuits and an investigation by the Internal Revenue Service and the SEC. Despite horror stories like McGuire, healthcare providers argue that robust compensation packages are sometimes the only way to attract the best CEO talent to their organization.
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"Taking the 'H' Out of HR"
Health Data Management (07/07) Martin, Zack

Blue Shield of California, once mired in paper applications and forms, now handles human resource tasks in a fraction of the time it once took, according to Senior Manager Tom Yardly. The firm purchased human resources management and customer relationship management software from Oracle in 2005 to automate over 150 administrative tasks, which officials estimate will generate up to $10 million in savings. Employees can now use online forms to change their addresses, hire and terminate workers, and allow human resources staff to track and audit personnel records efficiently. The new system also enables easier payroll processing, and Blue Shield's HR staff teams are now assigned to oversee services aimed at particular employee groups, like IT staff. BearingPoint Inc. Managing Director in the Healthcare Practice Craig Gooch these systems are popular in the healthcare market because executives garner "better visibility into the labor component of the organization and helps them figure out headcounts, turnover rates, where the demand is for employees and what level of resources are needed to staff certain business lines." Blue Shield says its new system has freed up HR personnel for other tasks, improved internal communications, and sped up the promotion and raise approval processes.
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"Nurse Wage Suit Expected to Last Into Mid-2008"
Memphis Commercial Appeal (TN) (08/06/07) Connolly, Daniel

Suzanne C. Clarke and Conise P. Dillard, former nurses, and the Service Employees International Union filed suit against Memphis-based Baptist Memorial Health Care and Methodist Le Bonheur Healthcare for allegedly conspiring to depress nurse wages in the city. The hospitals continue to deny the allegations, but failed to achieve a dismissal of the charges. Through June 30, 2008, both sides in the matter are expected to hammer out which workers can be included in the class-action litigation and what the merits of the case are. The union filed similar conspiracy cases in several other cities, including Albany and San Antonio, but the Memphis hospitals claim the cases are a publicity stunt.
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"Being Unhealthy Could Cost You"
Business Week (08/03/07) McGregor, Jena

Clarian Health, a hospital system in Indianapolis, is unlike other employers battling rising healthcare costs because it is not offering workers incentives for meeting wellness targets or joining voluntary disease management programs. Instead, the hospital system plans to penalize workers who fail to meet body mass index standards, as well as targets for blood pressure, cholesterol, and glucose levels; penalties will range from as low as $5 per check to as much as $10 per pay period. Employment attorneys and wellness program experts indicate Clarian's strategy to curb healthcare costs may not be outside the norm as more and more firms get aggressive in changing worker behavior. Final Health Insurance Portability and Accountability Act (HIPAA) regulations governing wellness plans encouraged Clarian Health to institute its new plan, according to the system's vice president of administration and human resources, Steve Wantz. The firm conducted surveys of its peers' programs and benchmarked the programs available before developing its own, and when Indiana laws allowed employers to offer financial incentives and surcharges to smoking employees, Clarian was further encouraged that its strategy would promote wellness and greater healthcare transparency. Employees advised by their physicians that they cannot meet the benchmarks set by Clarian will have to submit quarterly notes from their doctors regarding diet, exercise, and treatment plans. However, benefits consultants are concerned employees react better to wellness programs offering incentives rather than penalties. National Business Group on Health President Helen Darling says, "We're in a war for talent, and there are more than enough work-related challenges to manage people and performance that [penalizing] for something that is so complicated, so personal, so hard to deal with, just isn't the right thing to do at this point." Experts caution that employers implementing Clarian-like plans will have to be wary of other regulatory violations, like breaches of the Americans With Disabilities Act.
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"Clark County Struggles to Acclimatize Foreign Nurses"
Mohave Daily News (08/03/07)

University of Nevada, Las Vegas (UNLV) Professor Yu Xu, who manages UNLV's PhD in nursing program, has announced that he will create a curriculum designed for training nurses. Foreign-born nurses must be properly trained or "the nurses lose, the hospital loses and, most importantly, the American public loses," he says. The training nurses receive, especially in the areas of communication and acclimating, can help save the lives of patients, says Xu, whose curriculum will be geared toward hospitals across the nation. Many American hospitals find it difficult to acclimate foreign-born nurses to American society, industry officials say. The American Nurses Association will hold a conference in Chicago this August that will shed light on the best practices some hospitals use for training and acclimating nurses. Statistics from the U.S. Department of Health and Human Services show that, as of 2004, nurses who received their education overseas accounted for 3.5 percent of the nursing workforce. Most of these are from the Philippines, where occupational training for nurses is conducted in English.
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"Taking the Pulse of 'Health Courts'"
Minnesota Lawyer (07/23/07) Dahl, Dick

Physicians and tort reformers are promoting the Fair and Reliable Medical Justice Bill to subsidize a pilot program in 10 states that would found administrative panels called “health courts.” The bill is modeled on current systems in Scandinavia and New Zealand and is aimed at fixing alleged flaws in the American medical malpractice system. Rulings in American health courts, as in the model programs, would be made by specialized judges after conferring with a panel of experts. When making claims against doctors, patients would have to satisfy the standard of “avoidability,” rather than negligence. In addition, specific types of injuries would correspond to specified value ranges. Supporters of the legislation say the novel approach would improve patient safety, as doctors could speak openly about what went wrong. Such transparency would allow the health courts to track errors and assess new preventative measures. The system also could cut down on “defensive medicine” practices, in which doctors order an abundance of tests to protect themselves from being accused of carelessness later. In addition to addressing the soaring medical malpractice insurance rates for physicians, advocates say health courts would accelerate patient compensation, though some argue that doing so would prioritize a swift payout over a just resolution. Critics contend the legislation establishes a substitute for the court system, which is a constitutional right for Americans. Some reply juries lack the expertise needed to fairly resolve claims of medical negligence; however, a study by Philip G. Peters of the University of Missouri reveals juries concurred with experts’ evaluations almost 90 percent of the time in difficult cases with flimsy evidence.
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"Industry Insiders Cite Reasons for Nursing Shortage"
North County Times (CA) (08/03/07) Moss, Andrea

California is facing a shortage of qualified nurses, and the shortage is especially pronounced in North County, according to members of the nursing industry. Several factors are responsible for the shortage, including the region's high cost of housing and living, an expanding population, an aging workforce of nurses, low pay for nursing instructors, and insufficient state funding of nursing school programs. Colleges and universities find it economically prohibitive to offer nursing programs due to state restrictions on teacher-student ratios in lecture and clinical settings. The Palomar Pomerado Health and Tri-City hospital districts are providing funding for nursing programs at Cal State and Palomar and MiraCosta colleges, and both districts have created internship partnerships with the colleges and local high schools. Nationwide, the ratio of nurses is 787 per 100,000 residents, compared with just 622 per 100,000 for California, and 356 per 100,000 in North County, according to a 2006 study from the California Hospitals Association, which gives California a national ranking of just 49 out of the 50 states. Lorie Shoemaker, chief nursing officer at Palomar Pomerado Health, explains that 90 percent of licensed nurses are female. The current shortage dates back to the early part of last decade, when nurses were being laid off and career opportunities for women were expanding, industry members say; they also indicate that shortages in the industry tend to come in cycles.
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"Competition Still Driving Compensation"
Modern Healthcare (07/30/07) Evans, Melanie

The Internal Revenue Service has proposed new regulations requiring greater disclosure of the compensation packages enjoyed by non-profit executives. If approved, the new rules would obligate all tax-exempt organizations worth over $3 trillion to detail their annual revenue and spending, particularly executive pay. Experts warn; however, that new regulations will probably not do much to deflate executive compensation because the competition for good executives is just too high. This assertion is backed by the 2007 figures from Modern Health's annual survey of hospitals and health systems. Modern Health found that health system CEOs saw a total cash compensation increase of around 4.9 percent compared to 2006. CEOs at free-standing hospitals also saw a 3.4 percent total pay raise, while system-owned hospital CEO were given an average of 2.3 percent more. Other executives that faired well included chief medical officers who received an average 4.7 percent increase in total cash compensation and chief information officers who saw a 4.6 percent hike. Experts predict these numbers will continue to rise as boards struggle to find a balance between satisfying regulators and the public and attracting the best executives to their organization.
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"Aligning Physician-Hospital Relations: an Integrated Approach"
Healthcare Executive (08/07) Vol. 22, No. 4, P. 8; Byrne, Frank D.

Hospital CEOs are becoming increasingly concerned about physician-hospital relations. Indeed, physician-hospital relations ranked as hospital CEOs' second largest concern - after financial issues - in the American College of Healthcare Executives' survey, "Top Issues Confronting Hospitals: 2006." Specific worries included physician requests to the hospital for payment for service, constructing win-win collaborations, and rivalry with physician-owned facilities. Competition is growing between hospitals and physicians as more and more physicians establish their own practices to perform hospital outpatient procedures. Nonetheless, a stronger relationship between hospitals and physicians would produce myriad benefits, such as enhanced quality of care and lower costs. The interests of physicians and hospitals must therefore be in sync in terms of both clinical services and information technology; physicians and hospitals could unite to adopt electronic health records, for example. Communication between the two groups is another vital part of needs alignment. Situating physician lounges in a strategic way is one method for facilitating open, informal communication. Physicians should also be involved in the hospital's strategic planning, and included on governing boards. While change can be difficult to implement, healthcare leaders can help ease the transition period by recognizing any losses, acknowledging the impact of change on the staff, and continually endeavoring to improve.
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"Nurse Training Bottlenecks and Job Burn-Out Rate Worsen Nurse Shortages"
American Chronicle (07/19/07) Akinci, Ugur

There are multiple issues contributing to the nationwide shortage of nurses, and experts believe the situation will worsen before it improves. Local shortages occur when a group of retiring baby boomers enters a local population and drives up the demand for nursing services. A dearth of nurses results because it takes time to recruit outside nurses and time for more nurses to matriculate from local programs. While state laws require low student-teacher ratios in nursing programs to provide quality control, such regulations make it more difficult to swiftly replace retiring nurses. Some states try to circumvent such policies by introducing nurses from foreign countries. Locating a sufficient number of qualified instructors is also a challenge, thanks to retirement rates, maternity leave, and low pay. In the nursing profession, high burn-out rates and persistent frustration also take a toll. According to Yvonne VanDyke of Seton Family of Hospitals, “As many as 60 or 65 percent of nurses will leave the profession within two years of having entered it.” To protect future nurses from such occupational hazards, Texas hospital administrators are depending on strong on-the-job training programs.
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"The Looming Crisis in Rural Healthcare"
McCook Daily Gazette (NEB) (07/27/07) Roberts, John L.

Although healthcare is one of the largest industries in Nebraska, many rural communities in the state are experiencing a shortage of healthcare workers. The shortage of healthcare workers in Nebraska's rural counties can be attributed to several factors, including lower pay and poor benefits, a lack of training and career advancement opportunities, and recruiting difficulties within the industry. Experts indicate that in order to stave off further workforce shortages, local communities, states, and healthcare firms need to devise programs that offer tuition and loan repayment assistance. However, hospitals and others also should consider foreign workers in underserved regions under the Visa Waivers program, which recruits medical graduates to fill physician vacancies. Some healthcare facilities opt for Conrad 30, which provides each state with up to 30 waivers annually for physicians. Other recruitment programs showing some success include those offering flexible hours, time off for training, on-the-job training, and placement services for medical staffs' spouses who are seeking work.
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"Nursing, Doctor Numbers Worsen"
Washington Times (07/27/07) Lopes, Gregory

According to the U.S. Health Resources and Services Administration, there will be 1 million available nursing positions by 2020. PricewaterhouseCoopers' Health Research Institute has also released the "What Works: Healing the Healthcare Staffing Shortage" report that underscores the baby boomer generation's significance to the healthcare field, as an overwhelming number of doctors and nurses near retirement. Hospital executives in the PWC report said that their doctors would prefer working for hospitals over retail health clinics, while most nurses are shifting toward the latter. Nurse vacancy rates in hospitals are up to 10 percent in some cases, and the number of doctors available for patients varies by location and specialty. PWC's report concluded additional resources and support need to be given to nursing education programs, which continue to experience a dearth of educators. Without qualified nursing educators and available clinical training sites, the number of rejected nursing student applications will continue to rise, further exacerbating the worker shortage.
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"Hospital Workers Learn to Defuse Conflict"
Macon Telegraph (GA) (07/24/07) Rector, Gene

Overcrowding in the nation's hospitals often results in a growing threat of verbal and physical conflict between hospital workers and disgruntled or impaired patients and their family members. According to Houston Healthcare Education manager Sharon Gray, "If someone is afraid or anxious in a hospital--particularly if they believe we don't respond properly--it can escalate and people will start swinging, hitting people, throwing things." However, Gray indicates there have been very few serious incidents at Houston Healthcare because of a Wisconsin-based Crisis Prevention Institute program that teachers healthcare workers, emergency responders, and others how to nonviolently end a crisis. About 400 of the healthcare system's workers--many of them from the emergency and intensive care departments--have taken the two-day course and annual follow-up seminars in the last two years. Workers were trained on how to stand, hold facial expressions, and the proper voice level to use during conflicts to defuse the crisis. Instructors indicate if these tactics fail to calm the situation, hospital workers should just allow patients and families to vent their frustration, and if that fails, workers should contact security, who will restrain the individuals.
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"New Rules Could Make it Harder to Hire Foreign Workers"
Naples Daily News (FL) (07/15/07) Layden, Laura

New regulations from the U.S. Department of Labor will make it more arduous and costly for businesses to hire immigrants for permanent positions that cannot be filled by American workers. In Florida, the NCH Healthcare System imports foreign workers to provide the best possible healthcare in the area, according to Brian Settle of NCH, and will continue doing so despite the rising costs incurred by the new rules. Limits on employment-based immigrant visas are even more frustrating to NCH administrators, since the supply of these visas ran out in July 2007 and will not become available again until the next fiscal year. While the current nursing shortage has exempted nurses from having to request permanent status, at least one dozen foreign nurses recruited by NCH are ensnared in the certification process due to an absence of 2007 immigrant visas. In contrast, administrators at Lee Memorial Health System are unconcerned about the new regulations. The organization sponsors immigrants to fill critical vacancies and expects business to proceed as usual, as the transactions have already been completed in a straightforward manner.
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"Report: More Doctors Signing Employment Contracts With Hospitals"
Associated Content (07/20/07) McLaughlin, Brant

Increasingly, physicians are signing employment contracts with hospitals as private practice competition and medical malpractice insurance premiums heat up. Rather than work as independent contractors with hospitals, more doctors are becoming employees of those facilities. Merritt, Hawkins & Associates CEO Joseph Hawkins notes, "[T]oday they are more willing to exchange independence for the security and convenience of hospital employment."

Dr. Roger Hardl indicates the structure of the healthcare system requires doctors to operate more frequently to meet their financial obligations, but this places them at greater risk of litigation as independent contractors. While doctors employed by hospitals are still required to carry medical malpractice insurance, the premiums are offset by higher, guaranteed salaries and bonuses. Moreover, experts note "ambulance chasers" are less likely to sue hospitals than private physicians.
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"Bill Would Extend Lawsuit Window"
New York Times (08/01/07) Palank, Jacqueline

Despite a U.S. Supreme Court ruling in favor of employers and a veto threat from President Bush, the U.S. House passed legislation that would extend the period for wage discrimination lawsuit filings of workers. The U.S. Senate is working on a similar measure to extend the filing limit beyond the 180 days stipulated in the Civil Rights Act of 1964, which was confirmed by the U.S. Supreme Court decision in May.
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"Survey: Cash Incentives Work Better Than High Deductibles"
National Underwriter (Life and Health Financial Services Edition) (07/24/07) Bell, Allison

A survey of 115 businesses that each had at least 1,000 employees eligible for health coverage found that financial incentives and selective care management programs allowed companies to significantly decrease their healthcare costs. The poll concluded that offering cash, gift certificates, or continued reductions of insurance premiums to encourage staff members to assume certain behaviors cut premiums by 15 percent. Care management programs to aid employees with chronic or terminal health problems resulted in an 18-percent premium reduction. On the other hand, the survey found that certain tactics popular with companies looking to shrink their healthcare costs actually increased premiums. For example, allowing workers a number of different kinds of health plans upped premiums by 20 percent; while threatening employees with high deductibles and co-payments for choosing costly health options increased premiums by 29 percent.
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