Hospital pricing transparency: More information, more confusion?

A new ruling on hospital pricing transparency now requires that hospitals provide a list of their prices for all of the services and medications they provide. Continue reading this blog post to learn more about this ruling.


As of the first of this year, a new rule is in effect that requires hospitals to list the price for all the services they provide and medications they prescribe for patients while they’re in the hospital. In theory, this should give patients more information that can help them decide where it makes the most economic sense to receive hospital care. In actuality, while there’s a wealth of new data available, it can be difficult to find — and nearly impossible for people outside the healthcare industry to understand.

The document that aggregates the price information is called a chargemaster, and it can contain tens of thousands of entries. The new rule doesn’t require that the information be written in plain language, only that it be machine readable, so much of the data reads like it’s in a yet-to-be-discovered language. For example, if you download Memorial Sloan Kettering’s chargemaster, you’ll find an Excel spreadsheet that contains 13,088 entries such as “CAP MALE/FEMALE RAIL, $765” and “BX SUBCUT SKIN/INC, $1,771.” Even if a patient puzzles out the meaning of these abbreviations, the prices listed are different from the lower fees that insurers negotiate, so estimating how much you would pay for care is complicated at best and impossible at worst.

The goal of the hospital pricing transparency rule is to help patients understand the cost of their care and choose more wisely when deciding where to receive that care. Unfortunately, the information that is now available adds to the confusion and doesn’t help patients make one-to-one price comparisons when choosing where to receive care. In addition, the rule only covers care delivered by a hospital, so patients don’t have the information they need to make price comparisons for services performed in doctor’s offices, urgent care facilities, diagnostic test sites and outpatient surgical centers.

Though the new rule generally doesn’t help employees, employers can.

Even if price transparency doesn’t help workers better understand the cost of care and choose where to receive that care, there are strategies and resources that employers can provide to help their employees make more informed decisions about healthcare. Here are some of them.

Second opinions. Wrong diagnoses, inappropriate treatments (treatments that don’t meet the evidenced-based standard of care) and medical errors all drive up healthcare costs for both employers and employees and can lead to poorer health outcomes. One strategy to lower the risk of these types of problems is providing employees with streamlined access to second opinions from experienced physicians.

A second opinion can confirm or change an employee’s diagnosis, suggest other treatment options and pinpoint misdiagnoses, especially in the case of serious and complex conditions like cancer, autoimmune disease and back and joint problems. In fact, a Mayo Clinic study found that 88% of people who sought a second opinion from the hospital’s physicians for a complex medical condition received a new or refined diagnosis. Employers can make second opinions available to employees through several channels, including a health insurance plan or as a standalone benefit.

Care coordination. Duplicate testing and medical care is another source of wasted healthcare dollars. When communication between healthcare providers is inconsistent or medical records aren’t updated and shared among all treating physicians, employees may undergo repeat testing — for example, when a primary care physician and a cardiologist both order a cardiac stress test for a patient with shortness of breath. Employers can offer care coordination through a case manager for employees who are living with multiple health conditions.

This support can lower the risk of duplicative testing as well as duplicate prescriptions or medications that can result in interactions, which can put an employee’s health needlessly at risk. Another piece of this equation is the review and coordination of medical records, which is especially important when employees see multiple physicians. A medical records management service should include a review of the employee’s records by an RN or physician, consolidation of a comprehensive medical record, and the creation of a secure electronic medical record that can be shared with the employee’s permission with all treating physicians.

Guidance on where to receive care. While you can undergo a colonoscopy, medication infusion or a range of common surgical procedures at a hospital, that may not always be the most appropriate or cost-effective place to receive care. By offering employees the ability to talk with a care manager or adviser about the procedure they need and the options for where they can receive that care (a hospital, outpatient surgery center or doctor’s office), employers can help them receive the care they need and lower both claims costs and employee out-of-pocket costs.

Medical bill review. Another resource employers can offer to make sure healthcare costs are carefully managed is a medical bill review. Experts estimate that between 30% and 80% of medical bills contain errors that increase costs. There are many different causes of these errors, including the use of the incorrect billing codes and use of out-of-network healthcare providers. In addition to offering employees the services of a medical billing review and negotiation firm, they can provide education that lets employees know what types of errors are commonly made and how to spot them on their own bills.

SOURCE: Varn, M. (13 February 2019) "Hospital pricing transparency: More information, more confusion?" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/hospital-pricing-transparency-more-information-more-confusion?brief=00000152-14a5-d1cc-a5fa-7cff48fe0001


No primary care doc, no problem: How millennials are changing healthcare

More and more Millennials and Generation Z are opting out of having a primary care physician and instead, opting for on-demand healthcare. Continue reading this blog post from Employee Benefit News to learn more.


Millennials, and Generation Z behind them, are changing the way they access healthcare. In fact, 45% of 18- to 29-year-olds say they don’t have a primary care physician. Instead, they’re opting for on-demand healthcare.

Traditionally, individuals and families see primary care physicians several times a year and build relationships with their doctors over time. Visiting the same primary care physician when an illness strikes, or for an annual wellness checkup, can help the doctor notice changes in a patient’s health and catch issues before they become more serious (and costly).

But for millennials, having a primary care physician isn’t necessarily a priority.

That’s in part because they seem to prefer on-demand healthcare options, such as urgent care, drug store clinics and telemedicine services, which are easily accessible and typically include shorter wait times. The number of urgent care centers reflects the trend — they’re projected to grow by 5.8% in 2018, according to the Urgent Care Association.

Then there is employers’ shift away from health maintenance organizations, which often required that each employee choose a primary care doctor at the start of the plan. HMOs also require a referral from the primary care physician to see specialists. Recent research shows that most often, employers offer preferred provider organizations (84%), while 40% offer consumer-directed health plans and 35% offer HMOs.

Finally, physician shortages are leading to longer wait times for appointments. The U.S. population continues to grow and age, which may lead to a shortage of 120,000 primary and specialty doctors by 2030, according to the Association of American Medical Colleges.

For employers, it’s important to understand the reasons behind the shift to on-demand healthcare and educate employees to ensure they can get appropriate medical attention when they need it.

One crucial part of this education is helping employees understand when they should visit urgent care versus the emergency room, and reminding them that telemedicine is available. More than 95% of large employers and just over one-third of small- and mid-size employers offer telemedicine benefits. But adoption rates among employees remain low — only 20% of large employers report utilization rates above 8%, according to the National Business Group on Health.

Ensure your employees know that the service is available throughout the year and help them understand the cost if any is associated with the service. You may consider offering $0 copays for telemedicine visits to encourage employee use.

Encourage employees to get a wellness visit each year to help uncover health issues and take steps to prevent others. One way to do this without forcing employees to wait for an appointment or commit to a doctor is to bring the service in-house. Increasingly, large employers are adding this service to help employees stay healthy. In fact, one-third of employers with more than 5,000 employees and 16% of employers with 500-4,999 employees now have onsite clinics. Another 8% of midsize employers plan to add clinics in 2019.

Providing health assessments as part of a health and wellness program is another way to get employees, especially money conscious millennials, in front of a doctor. Younger workers are likely to embrace incentives or premium discounts that are tied to a physician visit.

Direct primary care is yet another employer option to provide easy-to-access primary care. With direct primary care, employers partner with primary care physicians to offer a designated doctor for their employees. The benefit for employees is more face time with a doctor and the opportunity to get personalized care.

Importantly, employees who have known chronic issues should see a primary care doctor regularly to help monitor and manage their condition.

The trend toward seeking on-demand healthcare at alternative sites isn’t likely to reverse direction any time soon. Instead, it’s up to employers to understand why it’s happening and educate employees of all ages on their options for care.

SOURCE: Milne, J. (7 January 2019) "No primary care doc, no problem: How millennials are changing healthcare" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/no-primary-care-doc-no-problem-how-millennials-are-changing-healthcare?brief=00000152-14a5-d1cc-a5fa-7cff48fe0001


E-Verify Is Down. What Do Employers Do Now?

What do employers do now that  E-Verify, the federal government's electronic employment verification system, is down? The system compares employee information with the DHS and Social Security Administration (SSA) records to confirm employment eligibility. Read on to learn more.


What are employers supposed to do now that E-Verify—the federal government's electronic employment verification system—has expired?

Funding and congressional authorization for the program ran out Dec. 22, 2018, as the government went into a partial shutdown after Congress and the White House could not agree on how to fund some agencies, including the U.S. Department of Homeland Security (DHS), which administers the system, for fiscal year 2019.

E-Verify compares information from an employee's Form I-9 to DHS and Social Security Administration (SSA) records to confirm employment eligibility. Employers enrolled in the program are required to use the system to run checks on new workers within three days of hiring them.

During the government shutdown, employers will not be able to enroll in E-Verify, initiate queries, access cases or resolve tentative non-confirmations (TNCs) with affected workers.

All employers remain subject to Form I-9 obligations, however. "Remember that the government shutdown has nothing to do with an employer's responsibilities to complete the Form I-9 [in a timely manner]," said Dawn Lurie, senior counsel in the Washington, D.C., office of Seyfarth Shaw. "Specifically, employees are required to complete Section 1 of the I-9 on or before the first day of employment, and employers must complete Section 2 of the I-9 no later than the third business day after an employee begins work for pay."

No Cause for Alarm

Lurie advised employers not to panic while E-Verify is down. "Employers will not be penalized as a result of the E-Verify operations shutdown," she said. "Employers will not be penalized for any delays in creating E-Verify cases. However, employers are reminded that they must continue to complete I-9s in compliance with the law, and when E-Verify becomes available, create cases in the system."

To minimize the burden on both employers and employees, DHS announced that:

  • The three-day rule for creating E-Verify cases is suspended for cases affected by the unavailability of the service. "Normally, the employer enters information from the I-9 into E-Verify within three days of hire, but that won't be possible while the system is unavailable," said Montserrat Miller, a partner in the Atlanta office of Arnall Golden Gregory. "DHS will provide a window of time to submit those held cases once service resumes."
  • The time period during which employees may resolve TNCs will be extended. The number of days E-Verify is unavailable will not count toward the days the employee has to begin the process of resolving a TNC. "Employers can't take any adverse action against a worker with a pending TNC regardless, shutdown or not," Miller said. Currently, an employee who chooses to contest a TNC must visit an SSA field office or call DHS within eight federal government working days to begin resolving it. This period will have to be extended because of the shutdown, she added.
  • Additional guidance regarding the three-day rule and time period to resolve TNC deadlines will be provided once operations resume.

Amy Peck, an immigration attorney with Jackson Lewis in Omaha, Neb., advised employers to keep track of all new hires with completed I-9s for whom there are no E-Verify queries due to the shutdown. She also recommended attaching a memo in a master E-Verify file tracking the days that the program was unavailable. "I've seen the discrepancy come up years later during an audit," she said.

"Once the system is back up, work with counsel on how much time employees have to resolve their TNCs," Peck said. "Someone receiving a TNC the day before the shutdown is a different case than somebody who had 10 days to resolve their TNC when the shutdown occurred. Those circumstances should be considered on a case-by-case basis."

Federal contractors with a federal acquisition regulation E-Verify clause should contact their government contracting officers to extend deadlines. "Federal contractors have a particular concern because nobody is supposed to be working who has not been verified through the system," Peck said. "People can be hired, but whether they are allowed to work on the contract before being run through E-Verify is a critical consideration that should be discussed with counsel."

Prepare for the Resumption of Service

Miller said employers should monitor the shutdown. "When it is over, log in to the system and see what instructions there are for creating and submitting queries," she advised. "There is an obligation to create those queries if you are enrolled in the program, even if enrolled voluntarily."

The backlog created as a result of the shutdown might have a significant impact on employers that process many E-Verify cases and specifically on the HR staff and other team members in charge of the process.

"Not all employers will be able to push all their cases through at once when the shutdown ends," Miller said. "If everyone did that, the system would crash. DHS will provide instructions on how to submit queries. Employers will be asked why the query is being submitted after the required three days. In the past, 'Government Shutdown' was one of the options in the drop-down menu."

Peck reminded employers that the loss of E-Verify does not mean there is a prohibition against hiring. "Companies should continue to hire as they need," she said.

SOURCE: Maurer, R. (3 January 2019) "E-Verify Is Down. What Do Employers Do Now?" (Web Blog Post). Retrieved from https://www.shrm.org/ResourcesAndTools/hr-topics/talent-acquisition/Pages/EVerify-Outage-What-Do-Employers-HR-Do.aspx


Why it might be time to say goodbye to exit interviews

Have you ever taken part in an exit interview? While the concept seems sound, many companies, large and small, are ending the practice of exit interviews. Read this blog post to learn more.


The exit interview is a long-time staple of HR departments. But an increasing number of companies large and small are ending the practice of asking departing workers to sit down for a final interview.

The concept seems sound. You can take the opportunity to hear unvarnished opinions about what your company or team does well and what it needs to improve on, and then take that back to management and implement changes that’ll help attract and retain great talent.

In practice, however, the process is often uncomfortable and many HR pros report that the folks who are interested in talking are often the ones who complained the most while on the payroll. The litany of gripes and rehashed personality clashes rarely adds much to the organization’s insight into building a better workplace.

If you can’t say anything nice…

Most of the rest, if they even will agree to an exit interview – and you can’t make them do that, of course – are going to be very careful to say only positive or neutral things about their experience at your organization. That helps to prevent bridge burning for them, in case they ever want to come back or they run into a colleague at a job interview later in their career. But for your team, the result is likely the same as with the complainer in the first example: A one-sided, probably inaccurate picture of what you are doing right and how you can improve in areas that need work.

Finally, much of the work your HR team does to schedule an interview as workers are packing up their personal stuff is likely to be wasted. Advice on employee-focused employment websites and other social media leans heavily towards “How to Avoid the Exit Interview.” Suggested tactics range from saying you can’t spare the time because you don’t want to leave your soon-to-be-ex colleagues hanging to asking to schedule after the leave date and then just ghosting the phone call altogether.

It’s still worthwhile to do a formal review to close out individual projects and to debrief contractors as they wrap up, but it’s probably time to say goodbye to the “tell us what you really think” sessions with employees who have decided to move on.

SOURCE: McElgunn, T. (27 December 2018) "Why it might be time to say goodbye to exit interviews" (Web Blog Post). Retrieved from http://www.hrmorning.com/why-it-might-be-time-to-say-goodbye-to-exit-interviews/


How AI can predict the employees who are about to quit

How can artificial intelligence (AI) predict which employees are going to quit? Employers are now utilizing AI to help predict how likely it is that an employee will stay with their company. Read on to learn more.


Tim Reilly had a problem: Employees at Benchmark's senior living facilities kept quitting.

Reilly, vice president of human resources at Benchmark, a Massachusetts-based assisted living facility provider with employees throughout the Northeast, was consistently frustrated with the number of employees that were leaving their jobs. Staff turnover was climbing toward 50%, and after many approaches to improve retention, Benchmark turned to Arena, a platform that uses artificial intelligence to predict how likely it is that an employee will stay in their job.

“Our new vision is about human connection,” he says. “With a turnover rate that’s double digits, how do you really transform lives or have that major impact and human connection with people who are changing rapidly?”

Since Benchmark started using Arena, staff turnover has fallen 10%, compared to the same time last year. During the hiring process, Arena looks at third-party data, like labor market statistics, combined with applicants' resume information and an employee assessment that will give them a better sense of how long a candidate is likely to stay in a role.

“The core problem we’re solving is that individuals aren’t always great at hiring,” says Michael Rosenbaum, chairman of Arena. “Job applicants don’t always know where they’re likely to be happiest. By using the predictive power of data, we’re essentially helping to answer that question.”

Arena isn’t interested in how an employee responds to assessment questions, he says. They’re much more interested in how employees approach the questions.

“What you’re really doing is your collecting some information about how people react to stress,” Rosenbaum adds.

For example, if an employee is applying for a housekeeping role, Arena may give them a timed advanced math question to complete — something they may never use in their actual job. Arena then studies how the candidate responds to the question — analyzing key strokes and tracking how the individual tackles the challenge. The software can then get a better sense of how an applicant responds under pressure.

Overtime, Arena’s algorithm learns from the data it collects. The system tracks how long a specific employee stays at the company and can then better predict, moving forward, whether other employees with similar characteristics will stay.

“Overtime they are able to sort of refine that prediction about those that are most likely to stay, or be retained with our organization,” Reilly says. “They may also make a prediction on someone who might not last very long.”

Reilly says he’s been encouraging hiring managers at the facilities to use the data given to them by Arena to take a closer look at the candidates the platform rates as highly likely to stay in their roles. Although it’s ultimately up to the hiring manager who they select.

“Focus your time on the [candidates] that are more likely to stay with us longer,” Reilly says.

For now, Arena exclusively works with healthcare companies. The platform is currently being used by companies like Sunrise Senior Living and the Mount Sinai Health System in New York. Moving forward, Rosenbaum says, they’re hoping to get into other industries, although he would not specify which.

Rosenbaum says Arena is not only focused on improving the quality of life for employees, but also for the patients and seniors that use the facilities. The happiness of patients, he says, is closely tied to those that are caring for them.

“Is someone who is in a senior living community happy? Do they have a positive experience? It is very closely related to who’s caring for them, who’s supporting them,” he says.

SOURCE: Hroncich, C. (15 November 2018) "How AI can predict the employees who are about to quit" (Web Blog Post). Retrieved from: https://www.employeebenefitadviser.com/news/how-ai-can-predict-the-employees-who-are-about-to-quit?brief=00000152-1443-d1cc-a5fa-7cfba3c60000


U.S. Unemployment Drops to Lowest Rate in 50 Years

The U.S. unemployment rate fell to 3.7 percent in September, the lowest it’s been in 50 years. Read this blog post to learn how this is affecting the U.S. labor market.


Unemployment in the U.S. fell to 3.7 percent in September—the lowest since 1969, according to the Bureau of Labor Statistics (BLS).

The low jobless rate, down from 3.9 percent in August, is further evidence of a strong economy—employers added 134,000 new jobs in September, extending the longest continuous jobs expansion on record at 96 months. The continued gains run counter to economists' expectations for a significant slowdown in hiring as the labor market tightens. Through the first nine months of the year, employers added an average of 211,000 workers to payrolls each month, well outpacing 2017's average monthly growth of 182,000.

"This morning's jobs report marked a new milestone for the U.S. economy," said Andrew Chamberlain, chief economist at Glassdoor. "With good news in most economic indicators today, it's likely the economy will continue its march forward through the remainder of 2018."

Cathy Barrera, chief economist at online employment marketplace ZipRecruiter, pointed out that the jobless rate ticked down for all education levels. "Anecdotal evidence has suggested that employers have experienced labor shortages for entry-level positions, and the decline in unemployment for these groups reflects that," she said. "More of those joining or rejoining the labor force are moving directly into jobs, reflecting the high demand for workers."

The sectors showing the strongest jobs gains in September include:

  • Professional and business services (54,000 new jobs).
  • Healthcare (26,000).
  • Transportation and warehousing (24,000).
  • Construction (23,000).
  • Manufacturing (18,000).

"Retail job losses—20,000 jobs—were widespread, and the leisure and hospitality sector lost 17,000 jobs, largely confined to restaurants," said Josh Wright, chief economist for recruitment software firm iCIMS, based in Holmdel, N.J.

"We can clearly point to a slowdown in retail trade for the dip in [overall] payroll numbers in September," said Martha Gimbel, research director for Indeed's Hiring Lab, the labor market research arm of the global job search engine. "Retail trade had a strong first half of the year but has slowed down in recent months. In addition, recent Hiring Lab research saw a slight dip in the number of holiday retail postings, suggesting that the sector may struggle in months to come."

Prior to September, employment in leisure and hospitality had been on a modest upward trend and the losses last month may reflect the impact of Hurricane Florence.

The Department of Labor said it's possible that employment in some industries was affected by Hurricane Florence which struck the Carolinas in September. Nearly 300,000 workers nationwide told the BLS that bad weather kept them away from their jobs last month.

"That's far below the level in September 2017 amid hurricanes Harvey and Irma, but significantly above the average of about 200,000 over the prior 13 years," Wright said. Upward revisions are likely, he added.

Wages Stubborn but Rising

In September, average hourly earnings for private-sector workers rose 8 cents to $27.24. Over the year, average hourly earnings have increased by 73 cents, or 2.8 percent.

"That's down slightly from the 2.9 percent pace last month, but consistent with a steady upward trend in wage growth we've seen as the job market tightens and more employers face labor shortages," Chamberlain said. "We expect to see that pace continue to rise throughout the holiday season, likely topping 3 percent within the next six months."

Glassdoor has recorded strong wage growth in tech-heavy metropolitan areas such as San Francisco, New York and Los Angeles.

"If the true wage growth rate is at or below 2.8 percent year-over-year, it is disappointing that it is not growing faster," Barrera said. "Given how tight the labor market has been not only with overall unemployment below 4 percent, but particularly so at the entry level, we would expect wage growth to be higher. The labor turnover numbers suggest that mobility is lower than it historically has been in periods where unemployment is very low. This is one reason wages may not be rising as quickly as we'd expect."

Labor Force Participation Stalled?

The nation's labor force participation rate held at 62.7 percent.

"Looking at the labor flows data, the rate of movement of the civilian population into the labor force hasn't moved much in the last couple of years, however, more of those folks are moving directly into employment rather than into unemployment," Barrera said.

Wright noted that the number of new labor force entrants and reentrants going directly to unemployment was just 33,000. "This raises interesting questions—whenever we get a recession, how long will these reentrants and new entrants continue searching for jobs before leaving the labor force?" he asked.

The percentage of the population in their prime working years with a job also held around 79 percent, where it's been for about eight months, Gimbel said, adding that the measure suggests that the number of workers remaining to pull into the labor force may be exhausted.

"The share of the labor force working part-time but who wants a full-time job unfortunately ticked up," she said. "Any remaining slack in the economy may be concentrated in part-time workers who want more hours."

SOURCE: Maurer, R. (5 October 2018) "U.S. Unemployment Drops to Lowest Rate in 50 Years" (Web Blog Post). Retrieved from https://www.shrm.org/resourcesandtools/hr-topics/talent-acquisition/pages/us-unemployment-drops-lowest-50-years-bls-jobs.aspx/


OSHA Proposes Change to Electronic Record-Keeping Rule

On July 30, OSHA issued a change that would eliminate the need for employers with 250 or more employees to electronically submit certain data. Continue reading to learn more.


Worksites with 250 or more employees would not be required to electronically submit certain data to the Occupational Safety and Health Administration (OSHA) under a proposal to roll back an Obama-era rule.

The Improve Tracking of Workplace Injuries and Illnesses rule requires employers that are covered by OSHA's record-keeping regulations to electronically submit certain reports to the federal government. Certain establishments with 20-249 employees are required to submit only OSHA Form 300A each year—300A is a summary of workplace injuries and illnesses that many employers are required to post in the workplace from Feb. 1 until April 30 of each year.

In addition to Form 300A, larger establishments (those with 250 or more employees) were supposed to begin submitting data from Form 300 (the injury and illness log) and Form 301 (incident reports for each injury or illness) in July. However, in May, OSHA announced that it would not be accepting that information in light of anticipated changes to the rule.

As expected, on July 30, OSHA issued a Notice of Proposed Rulemaking (NPRM) to eliminate the requirement for large establishments to electronically submit information from Forms 300 and 301.

"OSHA has provisionally determined that electronic submission of Forms 300 and 301 adds uncertain enforcement benefits, while significantly increasing the risk to worker privacy, considering that those forms, if collected by OSHA, could be found disclosable" under the Freedom of Information Act, the agency said.

The electronic record-keeping rule has faced considerable opposition from the business community, in part because some of the data submitted will be made available to the public.

The proposed rule would also require employers to submit their employer identification numbers (EINs) when e-filing Form 300A. "Collecting EINs would increase the likelihood that the Bureau of Labor Statistics would be able to match data collected by OSHA under the electronic reporting requirements to data collected by BLS for the Survey of Occupational Injury and Illness," the agency said.

Anti-Retaliation Rules Remain

OSHA's electronic record-keeping rule also contains controversial anti-retaliation provisions. These provisions, which went into effect in December 2016, give OSHA broad discretion to cite employers for having policies or practices that could discourage employees from reporting workplace injuries and illnesses. For example, the provisions place limitations on safety incentive programs and drug-testing policies. OSHA has said that employers should limit post-accident drug tests to situations where drug use likely contributed to the incident and for which a drug test can accurately show impairment caused by drug use.

Prior to the new rules, many employers administered post-accident drug tests to all workers who were involved in an incident. The anti-retaliation provisions create another layer of ambiguity for employers, because they have to justify why they tested one person and not another, which may lead to race, gender and other discrimination claims, said Mark Kittaka, an attorney with Barnes & Thornburg in Fort Wayne, Ind., and Columbus, Ohio.

OSHA has not announced any plans to revise the electronic record-keeping rule any further. Many employer-side stakeholders were disappointed that OSHA made no effort to revise the anti-retaliation provisions, said John Martin, an attorney with Ogletree Deakins in Washington, D.C.

There are still undecided lawsuits in federal courts that challenged these provisions back when they were first issued but have been put on hold while revisions were pending, Martin noted. OSHA's proposed revision clearly did not resolve all of the challengers' concerns, so they are now deciding whether to ask the courts to resume litigation, he said.

What Now?

Employers should keep in mind that OSHA's electronic record-keeping rule refers to "establishment" size, not overall employer size, Kittaka said. An establishment is a single physical location where business is conducted or where services or industrial operations are performed, according to OSHA.

Large employers still need to electronically submit 300A summaries for each work establishment—office, plant, facility, yard, etc.—with 250 or more employees, Martin said. If they have work establishments with 20-249 employees and they are covered by OSHA's high-hazard establishment list, then they must also submit 300A summaries for those smaller establishments.

The proposed rule is open for public comment until Sept. 28. "OSHA made clear in the proposed rule that the agency was only seeking comments on the electronic submission and EIN" proposals, said Tressi Cordaro, an attorney with Jackson Lewis in Washington, D.C.

SOURCE: Nagele-Piazza, L (14 August 2018) "OSHA Proposes Change to Electronic Record-Keeping Rule" (Web Blog Post). Retrieved from https://www.shrm.org/resourcesandtools/legal-and-compliance/employment-law/pages/osha-proposes-change-to-electronic-record-keeping-rule.aspx/


Safety Focused Newsletter - April 2018

How Indoor Air Quality Affects Health

Indoor air quality (IAQ) has a direct impact on your health, comfort, well-being and productivity. Poor IAQ can cause chronic headaches, allergies, fatigue and irritation of the lungs, among other symptoms.

What’s more, when IAQ is poor, it can have a direct effect on your productivity. If you are worried about the IAQ at your workplace, watch out for these symptoms:

  • Dryness or irritation of the eyes, nose, throat and lungs
  • Shortness of breath and fatigue
  • Nausea, headaches and dizziness
  • Chronic coughing and sneezing

If you suspect you are suffering from the effects of poor IAQ at your workplace, keep track of your symptoms and speak with your manager. As with many occupational illnesses, individuals may be affected differently.

If you are experiencing symptoms that your co-workers aren’t, that doesn’t mean an IAQ problem doesn’t exist and it’s still important to notify your employer. If your symptoms persist, consider speaking to a qualified medical professional.

3 Defensive Driving Tips That Could Save Your Life

Many jobs require employees to drive a company vehicle. While most drivers are cautious and attentive, accidents can occur without warning—even if the operator has years of experience.

When accidents happen, it can be incredibly costly for employers. What’s more, just one accident can cost employees their job or lead to serious, debilitating injuries.

One way to stay safe while you’re on the road for a job is through defensive driving. Being a defensive driver means driving to prevent accidents in spite of the actions of others or the presence of adverse driving conditions.

To avoid accidents through the use of defensive driving, do the following:

  • Remain on the lookout for hazards. Think about what may happen as far ahead of you as possible, and never assume that road hazards will resolve themselves before you reach them.
  • Understand the defense. Review potentially hazardous situations in your mind after you see them. This will allow you to formulate a reaction that will prevent an accident.
  • Act quickly. Once you see a hazard and decide upon a defense, you must act immediately. The sooner you act, the more time you will have to avoid a potentially dangerous situation.

Defensive driving requires the knowledge and strict observance of all traffic rules and regulations applicable to the area you are driving in. It also means that you should be alert for illegal actions and driving errors made by others and be willing to make timely adjustments to your own driving to avoid an accident.

Keeping in mind the above tips will not only keep you safe on the job, but in your personal life as well.

4 Tips for Safe Driving:

Avoid Distractions.

Be Alert.

Keep a Safe Distance.

Don't Speed.

Poor indoor air quality can cause chronic headaches, allergies, fatigue and irritation of the lungs, among other symptoms.

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Trump urges legal action against opioid manufacturers

Where does Trump stand on the Opioid Crisis? Find out in this article from Benefits Pro.


President Trump says he wants his administration to take legal action against opioid manufacturers.

“Hopefully we can do some litigation against the opioid companies,” Trump said at an event organized at the White House on the opioid epidemic.

Earlier in the week, Attorney General Jeff Sessions announced that the Justice Department would be filing a statement of interest in support of a lawsuit launched by more than 400 local governments around the country against pharmaceutical manufacturers. The suit accuses drug-makers of using deceptive advertising to sell powerful, addictive pain medication and for covering up the dangers associated with their use.

It’s not clear whether Trump’s remarks were a reference to the action Sessions has already taken or whether the president is envisioning additional legal action, since he said during the event that he would ask the attorney general to sue.

 

Trump also promised during his presidential campaign to take on pharmaceutical companies over rising drug prices, accusing them of “getting away with murder.” Since his election, however, he has done very little to translate those tough words into policy. A meeting between Trump and pharmaceutical companies early in his administration was described in positive terms by both sides.

The president also has suggested stiffer sentences for drug dealers, even reflecting positively on countries that execute them.

“Some countries have a very, very tough penalty – the ultimate penalty,” he said. “And, by the way, they have much less of a drug problem than we do.”

In recent years, public opinion on criminal justice in general and the drug war specifically has shifted in favor of an approach that favors treatment over incarceration. Reducing the prison population has been a goal that has increasingly earned bipartisan support, both at the federal level and in state legislatures around the country. However, Trump and Sessions have both stuck to the “tough-on-crime” mantra that dominated in the 1990’s.

The administration has signaled that it will not support legislation to reduce mandatory minimum sentences for drug offenses. And although the Justice Department has not yet gone after marijuana distributors in states that have legalized the drug, such as Colorado and California, Sessions has rescinded an Obama-era policy that stated that the DOJ would take a hands off approach to pot in those states.

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Source:
Craver J. (2 March 2018). "Trump urges legal action against opioid manufacturers" [Web Blog Post]. Retrieved from address https://www.benefitspro.com/2018/03/02/trump-urges-legal-action-against-opioid-manufactur/


How Are Health Centers Responding to the Funding Delay?

Unfortunately, the funding delay is impacting healthcare centers everywhere - and not in a great way. Get the information you need to know in this article.


Health centers play an important role in our health care system, providing comprehensive primary care services as well as dental, mental health, and addiction treatment services to over 25 million patients in medically underserved rural and urban areas throughout the country. Health care anchors in their communities and on the front lines of health care crises, including the opioid epidemic and the current flu outbreak, health centers rely on federal grant funds to support the care they provide, particularly to patients who lack insurance coverage. However, the Community Health Center Fund (CHCF), a key source of funding for community health centers, expired on September 30, 2017, and has since been extended through only March 31, 2018. The CHCF provides 70% of grant funding to health centers. With these funds at risk, health centers have taken or are considering taking a number of actions that will affect their capacity to provide care to their patients. This fact sheet presents preliminary findings on how health centers are responding to the funding uncertainty.

WHAT FUNDING IS AT STAKE FOR HEALTH CENTERS

The Community Health Center Fund represents 70% of federal grant funding for health centers. Established by the Affordable Care Act, the CHCF increased federal grant fund support for health centers, growing from $1 billion in 2011 to $3.6 billion in 2017.1Authorized for five years beginning in 2010, and extended for two years through September 2017, the CHCF also provided a more stable source of grant funding for health centers that was separate from the annual appropriations process. Prior to the CHCF, federal 330 grant funds were appropriated annually. In fiscal year 2017, federal section 330 grant funding totaled $5.1 billion, $3.6 billion from the CHCF and $1.5 billion from the annual appropriation.

Federal health center grants represent nearly one-fifth of health center revenues. Federal Section 330 grant funds are the second largest source of revenues for health centers behind revenues from Medicaid. Overall, 19% of health center revenues (including US territories) come from federal grants; however, reliance on 330 grant funds varies across health centers. Federal grant funds are especially important for health centers in southern and rural non-expansion states where Medicaid accounts for a smaller share of revenue (Figure 1).2 These funds finance care for uninsured patients and support vital services, such as transportation and case management, that are not typically covered by insurance

Figure 1: Federal Section 330 Grants as a Share of Total Health Center Revenues, 2016

HOW ARE HEALTH CENTERS RESPONDING TO THE LOSS OF FEDERAL FUNDS?

Health centers have taken or are considering taking a number of actions that will affect their ability to serve their patients. Overall, seven in ten responding health centers indicated they had taken or planned to take action to put off large expenditures or curtail expenses in face of reduced revenue. Some of these actions involve delaying or canceling capital projects and other investments or tapping into reserve funds. Other actions, however, have or will reduce the number of staff or the hours they work, which may in turn, affect the availability of services. Already 20% of health centers reported instituting a hiring freeze and 4% have laid off staff. Another 45% are considering a hiring freeze and 53% said they might lay off staff. While health centers seemed to focus on shorter-term actions that could easily be reversed were funding to be restored, 3% of responding health centers had already taken steps to close one or more sites and an additional 36% indicated they are considering doing so (Figure 2).

Figure 2: Actions Taken or Considered by Health Centers in Response to Funding Uncertainty

Health centers are considering cuts to patient services. While most health centers have not yet taken steps to cut or reduce patient care services, many reported they are weighing such actions if funding is not restored (Figure 3). Over four in ten indicated they might eliminate or reduce some enabling services, such as case management, translation, or transportation services. Additionally, over a third of reporting health centers indicated they might have to reduce the dental, medical, and/or mental health services they provide while 29% said cuts to addiction treatment services are being contemplated. Fewer health centers reported that cuts to pharmacy services might be made.

Figure 3: Services Health Centers Are Considering Eliminating or Reducing in Response to Funding Uncertainty

WHAT ARE THE IMPLICATIONS OF THE FUNDING DELAY?

Continued delays in restoring funding will likely lead to cuts in health center services and staff. To date, health centers have tried to mitigate the effects of the funding delay by forgoing major investments or dipping into reserve funds. However, the longer the funding delay continues, the greater the likelihood health centers will be compelled to cut services and staff, actions they are currently considering but have not yet adopted in large numbers. These cuts could reverse gains health centers have made in recent years in increasing patient care capacity and expanding the range of services they provide, particularly in the areas of mental health and addiction treatment. Health centers play a particularly important role in rural and medically underserved areas. The failure to reauthorize the CHCF and restore health center funding could jeopardize access to care for millions of vulnerable patients.

Read the full report.

SOURCE:
Kaiser Family Foundation (1 February 2018). "How Are Health Centers Responding to the Funding Delay?" [Web Blog Post]. Retrieved from address https://www.kff.org/medicaid/fact-sheet/how-are-health-centers-responding-to-the-funding-delay/