Companies of all sizes are embracing technology and using Human Resource Management Software (HRMS) to administrate the “people” part of business. It can create a quantum leap in efficiency by deploying.

Once new HRMS software has been selected and purchased, the next logical step is to just simply implement the software. As with most things, HRMS implementation isn’t as simple as one might expect. It’s essential to keep several things in mind before you begin to change your HRMS system.implementation

First, you must define your objectives of implementing your new system. A deep dive into the current HRMS system should be in order to determine which areas need to be upgraded and which are just ‘nice to have.’ HRMS applications are flexible and can be adapted to businesses of all sizes, so it is important to consider what needs to be upgraded or changed altogether prior to implementation. Changes of this nature need to be endorsed by management and a project manager should be assigned to help ensure successful and positive implementation.

An HRMS comparison should be conducted in order to recognize how the new system can benefit the organization, as well as how effortlessly users will be able to master it. Regardless of what HRMS system you choose, employees should be offered training, and also be able to explore the HRMS demo product in order to understand how the implementation will be completed.

Whether it’s an HRMS payroll system or a simple HRMS management system, careful consideration needs to be made in order to best understand how to effectively implement the new HRMS. It’s important to be aware of the impact the new system will have on your business as well, and how to best put it into place.

With management onboard and a training program in place for employees, businesses can save time and money over the long term by offering better management services to their employees

By Melinda Beck WSJ 12/26/2014
Updated Dec. 25, 2014 2:59 p.m. ET

Internist Douglas Olson has seen firsthand the impact—and the side effects—of the Affordable Care Act’s first year of expanded health-care coverage.

One patient at his clinic had lost her previous insurance after being diagnosed with lung cancer. This year, she was able to find an affordable policy that covered her treatments and follow-up scans.

Another woman needed an MRI for her chronic shoulder pain, but had to pay the $1,000 tab out-of-pocket, because she hadn’t satisfied her new plan’s deductible. She decided her $50 monthly premiums weren’t getting her much value and is giving up her coverage until she qualifies for Medicare in two years.

“You and I know that’s how insurance works—you pay a little bit now and if you get really sick, it pays for itself,” said Dr. Olson, 39 years old, chief medical officer of the Norwalk Community Health Center in Connecticut. “But for someone who’s never had insurance before, it’s easy to think, ‘What am I paying these premiums for?’ ”

Dr. Olson’s patients illustrate the trade-offs and lessons in the sweeping federal health law.

Overall, 6.7 million Americans have obtained and paid for private coverage on the insurance marketplaces for this year, according to federal officials. Almost 10 million more qualified for Medicaid due to provisions in the law. And the percentage of uninsured dropped from 17.7% to an estimated 12.4%, according to the Urban Institute.

In the second yearly enrollment, almost 6.4 million people selected a health-care plan on the federal marketplace or were automatically re-enrolled between Nov. 15 and Dec. 19, Health and Human Services Secretary Sylvia Mathews Burwell said Tuesday. The figures include about 1.9 million new consumers but don’t include enrollees from state-run exchanges. Enrollment on the federal exchange runs through Feb. 15.

How the Affordable Care Act has helped—and what it has cost—consumers, employers and care providers varies enormously. Some people with life-threatening illnesses found coverage. Some hospitals and doctors are seeing more patients with the ability to pay. But many families and businesses are facing higher costs. There is still confusion over how the new plans work and a palpable disconnect between near-term expenses and long-term public-health goals.

The public remains deeply divided. As of last month, more Americans viewed the law unfavorably (46%) than favorably (37%)—a shift from four years earlier, when respondents favored it 42% to 40%, according to a Kaiser Family Foundation poll.

“The fundamental impetus for the law was to lower the number of uninsured, and it has clearly done that,” said Larry Levitt, a senior vice president at the Kaiser Family Foundation. “But simply getting people insured doesn’t mean health care is affordable.”

A Wall Street Journal project following 10 stories of people affected by the health law over the year shows the wide range of experiences.

The community health center where Dr. Olson works provides low-cost primary care. Many patients who signed up for coverage “have had tremendously positive experiences—they actually consider it a privilege to be insured, because they could never afford it before,” said Dr. Olson.

But others were frustrated that they had to pay premiums and pay for much of their care out-of-pocket because they chose cheaper plans with high deductibles.

Nationwide, the median deductible for individuals was $5,100 in bronze plans and $2,500 in silver plans, according to a McKinsey & Co. analysis.

To be sure, insured patients can get preventive care, including vaccinations and screenings for cancer, without any deductibles or copays under the law. But that has been a hard sell for some patients.

“Prevention, starting now, doesn’t pay off for a number of years,” said Dr. Olson.

All in all, Dr. Olson said he and his colleagues think even harder whether costly tests and procedures are necessary than they did before the ACA. “If you’d asked me a year ago, I wouldn’t have predicted that,” he said.

Some economists say the impact of high-deductible plans, prominent in employer-sponsored coverage as well, was a key driver in holding the growth of health-care costs to 3.6% in 2013—the lowest since the government started measuring it in 1960. At $2.9 trillion last year, the share of the nation’s gross domestic product devoted to health care remained 17.4%, unchanged since 2009.

Government actuaries expect to see a spurt in national health spending—rising by 5.6% in 2014, due to the ACA’s coverage expansion, and reaching 19.3% of GDP by 2023.

Some hospitals have already seen windfalls, with more paying patients boosting revenues. HCA Holdings Inc. —the largest hospital chain by revenue—reported a 41.9% increase in net income on revenue of $9.2 billion for the third quarter, compared with a year earlier.

But systems like Truman Medical Centers in Kansas City, Mo., one of the mostly Republican-leaning states that declined to participate in the law’s Medicaid expansion, face challenges. Truman cares for many uninsured patients and is desperate for Missouri to expand Medicaid. CEO Charlie Shields is also bracing for bigger financial problems in 2017, when federal payments that help provide that uncompensated care are set for cuts.

The impact on insurers has also been mixed. For actuary Mike Beuoy and his employer, Blue Shield of California, offering plans on the state’s marketplace turned out to be a good bet. The nonprofit made money because more people signed up than expected, and they were healthier than it projected when it set 2014 rates.

Several big companies warned they will post losses on their individual business. But for now, the industry seems willing to double down on the exchanges, with some companies, including giant UnitedHealth Group Inc., boosting their presence next year.

By CHAD TERHUNE
NOVEMBER 18, 2014, 7:48 PM
B olstering a chief complaint about Obamacare coverage, California regulators said
two major health insurers violated state law by overstating the number of doctors
available to patients.
More than 25% of physicians listed by Anthem Blue Cross and Blue Shield of California weren’t
taking Covered California patients or were no longer at the location listed by the companies,
according to state reports released Tuesday.
In some cases, these errors led to big unforeseen medical bills when patients unwittingly
ventured to out-of-network doctors for medical tests or a surgery.
Anthem, a unit of industry giant WellPoint Inc., said there’s no evidence that Californians are having widespread
difficulty finding a network doctor. (David McNew / Getty Images)
Top insurers overstated doctor networks, California regulators charge – The results of the five-month investigation come at a critical juncture as the second year of
health law enrollment gets underway and more than 1.2 million Californians are shopping in
the state’s insurance exchange.
“We found the provider directories made available to the public had significant errors,” said
Shelley Rouillard, director of the California Department of Managed Health Care. “When you
have a quarter or more of physicians that aren’t available, that is significant.”
Anthem and Blue Shield account for nearly 60% of enrollment in Covered California. The two
industry stalwarts have long catered to patients wanting the widest selection of physicians.
As a result, their narrower networks and more restrictive policies were a jolt to many people
and often came to light only when they were getting treated. The insurers compounded the
problem with inaccurate provider lists, mislabeled insurance cards and false assurances about
coverage, according to patients, doctors and regulators.
The latest findings could spark fresh criticism of Covered California, which has been faulted for
going easy on its biggest health plans. Exchange officials said they welcomed the audit and
insist they have pushed health plans hard to fix these persistent network problems.
The Department of Managed Health Care hasn’t determined what penalties, if any, will be
imposed on the insurance companies. The state plans a follow-up survey in six months to check
whether the insurers have fixed the problems.
Consumer advocates urged officials to impose fines or take other measures immediately so
patients will have reliable information for the current enrollment period through Feb. 15.
“These networks were narrower than advertised,” said Anthony Wright, executive director of
Health Access, a consumer advocacy group. “That’s a big violation of trust to patients and needs
to be corrected.”
The stakes are high for Anthem and Blue Shield as they compete for new members and try to
keep the ones they already have. The companies are also defending themselves against
consumer lawsuits related to these network inaccuracies.
Both health plans disputed the state’s findings and called the survey methods deeply flawed.
The insurers added that physicians and their office staff bear some blame for giving patients
the wrong information at times.
Top insurers overstated doctor networks, California regulators charge –
“The department’s report exaggerates the severity of the issues and understates the extent of
our corrections,” said Blue Shield spokesman Steve Shivinsky. “We have taken substantial steps
to address the confusion.”
Anthem, a unit of industry giant WellPoint Inc., said there’s no evidence that Californians are
having widespread difficulty finding a network doctor.
The insurer said it contracts with 36,000 doctors statewide in its individual plans for 2015;
Blue Shield lists more than 30,000 physicians.
Patient Darrell Done’s experience at the doctor’s office was typical for many under the
Affordable Care Act. The 57-year-old real estate agent from Pasadena said he confirmed on
Blue Shield’s website in December that his longtime family physician was part of his network.
Then he went for a check-up in May and handed his new insurance card to the receptionist.
“She said, ‘Oh. I’m sorry. This is an Obamacare policy, and Blue Shield changed all of their
plans,'” Done recalls.
Done said he was upset at being locked into his plan until the next open enrollment.
“I’m trapped in a policy that’s not what I thought it was,” he said.
Redondo Beach resident Doug Evans, 62, bought a Blue Shield policy through Covered
California a year ago only to find out later that his primary care doctor and orthopedic surgeon
were no longer covered.
“There was no explanation that Blue Shield in Covered California would be this limited
network,” Evans said. “That’s what ticked me off.”
In response to consumer complaints, regulators hired an outside firm to check the accuracy of
the two insurers’ online directories as of mid-June by calling a sample of physicians. The
PMPM Consulting Group placed thousands of calls in June and July.
For Anthem, the survey determined that 12.8% of doctors listed as in-network providers were
not accepting Covered California patients. Another 12.5% were no longer at the location listed
in Anthem’s directory.
In examining Blue Shield, the state found that 8.8% of doctors listed were not taking exchange
coverage and 18.2% were not at the location listed by the insurer.
Top insurers overstated doctor networks, California regulators charge – … Page 3 of 5
http://www.latimes.com/business/la-fi-obamacare-network-probe-201411… 11/19/2014
Copyright © 2014, Los Angeles Times
Both companies sought to discredit the state’s data. Anthem said 99% of its doctors described
as unavailable in the state survey were under contract.
Blue Shield said 67% of providers who reported they weren’t participating had submitted at
least one claim for Covered California members.
Rouillard, the state regulator, said those arguments miss the point of the survey, which sought
to replicate the consumer experience.
“If consumers are calling, they go on the information they’re told,” she said. “They don’t know
to dig into the contracts.”
Peter Lee, executive director of Covered California, took a softer line with his two biggest health
plans and agreed with some of their criticism about the survey questions being vague and
confusing.
“I’m quite optimistic the bumps we had the first year were part of the transition to new
networks,” he said, “and we will see a lot smoother road going into 2015.”
Last year, Lee promised Californians a comprehensive provider directory listing every health
plan so applicants could easily search for doctors before signing up. But the exchange quickly
scrapped its directory because of excessive errors.
Lee said the exchange will continue to refer applicants to health plan websites.
Physicians applauded the increased scrutiny, and they said health plans are responsible for
communicating more clearly with doctors’ offices.
Brett Johnson, associate director for policy at the California Medical Assn., said “we definitely
hope the audit will have a deterrent effect on the health plans.”

WSJ 10/31/2014
By Anna Wilde Mathews, Angus Loten and Christopher Weaver

Small companies are starting to turn away from offering health plans as they seek to reduce costs and increasingly view the health law’s marketplaces as an inviting and affordable option for workers.

In the latest sign of a possible shift, WellPoint Inc. said Wednesday its small-business-plan membership is shrinking faster than expected and it has lost about 300,000 people since the start of the year, leaving a total of 1.56 million in small-group coverage.

During a call with analysts to discuss third-quarter earnings, the No. 2 insurer said it had projected a five-year migration to “significantly reduce” small-employer membership, but it now thinks the dropoff will be compressed into two years.

Going forward, with the health law’s marketplaces running and functioning well, small employers will likely re-evaluate exchanges as an option for their employees, said Wayne DeVeydt, WellPoint’s chief financial officer. “We think [that] will become even probably a more prominent decision that they’ll make this quarter,” he said.

Some other insurers have flagged a similar trend. Aetna Inc. Chief Financial Officer Shawn M. Guertin said the company was seeing “some erosion at the bottom of the market” among employers with two to 10 workers. Kaiser Permanente is seeing “some contraction” in the small-group market, particularly in places where insurers are offering cheap individual plans, said Joe Smith, the nonprofit’s vice president for small business.

Laura Land, who co-owns cellphone-case-maker Empire Cell Phone Accessories in Riverside, Calif., which has 38 full-time employees, said the company plans to discontinue its health plan next year and instead direct workers to the state’s health-insurance exchange.

“It’s getting to be too much paperwork for us to administer the plan, especially if workers are going to decline anyway and go to the exchange,” said Ms. Land, adding that several new hires recently turned down the plan in favor of cheaper exchange options.

It’s not yet clear how widespread the shift will ultimately be. An April survey by the International Foundation of Employee Benefit Plans found that 22.5% of employers with 50 or fewer employees said they “definitely will” still be offering health benefits in five years, while an additional 42% said they “very likely” would. Among large employers with 500 or more employees, about three-quarters fell into those two categories.
The health law doesn’t penalize companies with fewer than 50 workers that don’t offer coverage, and those with fewer than 100 employees won’t face fines until 2016.

Some employers are facing premium increases to keep offering coverage as they shift to plans that meet the law’s requirements—though this impact has been delayed for many because the Obama administration has allowed states and insurers to keep older plans in effect.

Blake Meaux, owner of Mo’ Muscle Cars in Conroe, Texas, said his 13-employee company ended its health plan in July after being told its premiums could double or rise even higher.

“The company could not afford it, and the employees couldn’t afford it,” Mr. Meaux said. He talked over the issue with workers and brought in an agent to connect them with individual coverage. He is offering to pay about half the cost of workers’ individual premiums, the same share paid under the group plan.

The law has also eliminated several reasons small employers offered group plans to ensure employees could get coverage. Workers with pre-existing health conditions can now buy coverage on their own, and insurers can’t charge them more based on their health history, as they could before the law took effect.

The law includes subsidies for lower-income workers that can sometimes be as generous as the amounts small employers were paying toward health benefits. Indeed, insurers and brokers say small employers in lower-income industries are far more likely to switch.

“That’s often the main determining factor,” said Michael Z. Stahl, a senior vice president at HealthMarkets Inc., an agency that focuses on individual coverage and works with a growing number of small businesses.

King Par LLC, a golf retailer in Flushing, Mich., decided to end its plan in February as it was facing an expected rate increase. Ryan Coffell, the company’s chief financial officer, said those with relatively low wages, such as warehouse workers, are paying about the same amount toward their coverage as they did before because of the federal support.

For employees who made too much to qualify for subsidies, King Par in some cases offered a salary bump to make up for the lost health benefits.

“The few people who were affected the most, we made sure to make them whole,” said Mr. Coffell.

Insurers, for their part, are moving to recapture the lost business by signing up employees to their individual plans—a possibility raised by WellPoint, which is a big player in the health-law consumer exchanges. Mr. DeVeydt, WellPoint’s finance chief, said the company aimed to “become indifferent on where that customer wanted to buy their product.”
Medical Mutual of Ohio, which said it is seeing the strongest shift away from offering health benefits among the smallest employers with just two to four workers, is working to ease the transition for companies that want to move from a group plan to individual coverage.

“That’s the best way to maintain the membership,” said Dan Polk, a vice president who oversees small-group business. He added that the insurer is retaining “a very high percentage” of those whose employers are dropping plans.

Source: New York Times

Health insurance companies are no longer allowed to turn away patients because of their pre-existing conditions or charge them more because of those conditions. But some health policy experts say insurers may be doing so in a more subtle way: by forcing people with a variety of illnesses — including Parkinson’s disease, diabetes and epilepsy — to pay more for their drugs.

Insurers have long tried to steer their members away from more expensive brand name drugs, labeling them as”non-preferred” and charging higher co-payments. But according to an editorial published Wednesday in the American Journal of Managed Care, several prominent health plans have taken it a step further, applying that same concept even to generic drugs.

The Affordable Care Act bans insurance companies from discriminating against patients with health problems, but that hasn’t stopped them from seeking new and creative ways to shift costs to consumers. In the process, the plans effectively may be rendering a variety of ailments “non-preferred,” according to the editorial.

“It is sometimes argued that patients should have ‘skin in the game’ to motivate them to become more prudent consumers,” the editorial said. “One must ask, however, what sort of consumer behavior is encouraged when all generic medicines for particular diseases are ‘non-preferred’ and subject to higher co-pays.”

I recently wrote about the confusion I faced with my infant son’s generic asthma and allergy medication, which switched tiers from one month to the next. Until then, I hadn’t known that my plan charged two different prices for generic drugs. If your health insurer does not use such a structure, odds are that it will before long.

The editorial comes several months after two advocacy groups filed a complaint with the Office of Civil Rights of the United States Department of Health and Human Services claiming that several Florida health plans sold in the Affordable Care Act marketplace discriminated against H.I.V. patients by charging them more for drugs.

Specifically, the complaint contended that the plans placed all of their H.I.V. medications, including generics, in their highest of five cost tiers, meaning that patients had to pay 40 percent of the cost after paying a deductible. The complaint is pending.

“It seems that the plans are trying to find this wiggle room to design their benefits to prevent people who have high health needs from enrolling,” said Wayne Turner, a staff lawyer at the National Health Law Program, which filed the complaint alongside the AIDS Institute of Tampa, Fla.

Mr. Turner said he feared a “race to the bottom,” in which plans don’t want to be seen as the most attractive for sick patients. “Plans do not want that reputation.”

In July, more than 300 patient groups, covering a range of diseases, wrote to Sylvia Mathews Burwell, the secretary of health and human services, saying they were worried that health plans were trying to skirt the spirit of the law, including how they handled co-pays for drugs.

Generics, which come to the market after a name-brand drug loses its patent protection, used to have one low price in many insurance plans, typically $5 or $10. But as their prices have increased, sometimes sharply, many insurers have split the drugs into two cost groupings as they have long done with name-brand drugs. “Non-preferred” generic drugs have higher co-pays, though they are still cheaper than brand-name drugs.

With brand names, there’s usually at least one preferred option in each disease category. Not so for generics, the authors of the editorial found.

One of the authors, Gerry Oster, a vice president at the consulting firm Policy Analysis, said he stumbled upon the issue much as I did. He went to his pharmacy to pick up a medication he had been taking for a couple of years. The prior month it cost him $5, but this time it was $20.

As he looked into it, he came to the conclusion that this phenomenon was unknown even to health policy experts. “It’s completely stealth,” he said.

In some cases, the difference in price between a preferred and non-preferred generic drug is a few dollars per prescription. In others, the difference in co-pay is $10, $15 or more.